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Our local Board of Registration in Medicine has a new requirement. To update a medical license, you have to take 3 hours of CME credit in opioid pain management, and another 2 hours in end-of-life issues. Fair enough. I prescribe OxyContin for my acne patients as often as the next dermatologist. As for end-of-life matters, a friend I told about the new regulation asked if I had many patients who wanted to end their lives. I said no, but I could think of a few patients who make me think about ending mine.

Anyhow, I took the courses as online webinars, featuring lecturers by academics from local medical institutions. Some of the information was likely to be helpful, at least for physicians in a position to use it often enough to remember it. Some was boilerplate, delivered in a monotone:

"As Sarkissian et al. found in a 2006 article published in the Journal of Annoying Interactions, 63% of patients seeking drugs may exhibit manipulative behavior." OK, thanks.

So you finish the webinar and take the post-module test. There are six questions, and you need to get four right. You pass. (Hooray!) Now you want to print out the CME certificate. But wait – first you have to take the Post Test Evaluation. So you click on the hyperlink, and there it is. The questions are in red, followed by open red circles. The first question is: How would you rate this presentation? 5 is Excellent, followed by Good, Fair, Poor, No Opinion, Not Applicable, and Nolo Contendere.

But here is the amazing part: 5 is already filled in! There’s a bright red circle staring you in the face. If you want to rate the presentation any way but Excellent, you have to change it by unclicking 5 and clicking a different circle.

In other words, they are not asking you to rate them Excellent. They are not telling you to rate them Excellent. They are doing it for you!

Surely, they must be kidding.

But they are not.

The other Evaluation questions range from irritating to inane:

• Did you find the presentation professional? (If you mark "No," you have to explain why. "I dunno, the shrink’s sport coat was kinda wrinkled.")

• Will it change your practice? (If you mark "Yes," you have to explain how. "I will not let patients manipulate me any more. Instead, I will hold my breath.")

• Did you find the presentation influenced by commercial considerations? ("Not really, except for the pop-up ads for methadone clinics.")

• Do you have any suggestions to improve future webinars? ("Maybe free opioid samples, so we can test out their half-lives for ourselves?")

So my by-default 5-ratings will be duly tabulated by little cyber-elves who live in statistical cyber-caverns, where they compile the data showing that the Massachusetts CME Consortium is indeed doing the Excellent Job that will entitle it to continue providing Continuing Education Courses of Excellence.

I don’t know how much any of this matters. Am I any smarter than I was before? Well, maybe in one way. Now I know what to do for myself:

Since you are reading this column, you have to rate it. The scale is from 1 to 5, with 5 being "Transcendent."

Please e-mail the editor of Skin & Allergy News. Tell her you want to give me a 6. Insist that she open a new category, so you can do it.

Never mind, I already told her, so we’re good.

You’re welcome, don’t mention it.

Dr. Rockoff practices dermatology in Brookline, Mass.

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