Is the ACCME cracking down on quackery in continuing medical education (CME) offerings? Richard Jaffe thinks so.

If you’ve ever sat through a sleepy hotel-ballroom CME lecture while the speaker waxed poetic about detoxing mitochondria with magic water, you’ve probably wondered: “Wait… this gets the same credit as a solid update on sepsis guidelines?”

That tensionbetween serious, evidence-based continuing medical education and seminars that drift into pseudoscienceis exactly what sparked the debate over whether the Accreditation Council for Continuing Medical Education (ACCME) is finally cracking down on “quackery” in CME. Attorney Richard Jaffe, long-time defender of alternative and fringe practitioners, sounded the alarm years ago that ACCME was targeting complementary and alternative medicine courses. Science-Based Medicine (SBM) took a closer look and asked the obvious follow-up question: is this a genuine cleanup of CME, or just regulatory theater?

Fast-forward to today, with ACCME’s updated Standards for Integrity and Independence and a much sharper focus on content validity, conflicts of interest, and commercial influence. Has the landscape actually changed? Let’s unpack the players, the rules, and some real-world experience to see whether quack-friendly CME is really on the endangered listor just rebranding itself with fancier slides.

ACCME 101: Why CME accreditation matters so much

The ACCME is the main organization in the United States that sets and enforces standards for accredited CME for physicians. It doesn’t run courses itself; instead, it accredits hospitals, medical schools, specialty societies, and private providers so they can offer CME that counts toward licensure, board maintenance, and hospital credentialing.

In theory, this creates a trusted seal: if it’s ACCME-accredited, the course should be scientifically valid, free from commercial bias, and aligned with improving patient care instead of selling the latest miracle in a syringe or supplement bottle. ACCME’s Standards for Integrity and Independence in Accredited Continuing Education explicitly say that accredited CME must present “accurate, balanced, scientifically justified” recommendations and maintain a “clear, unbridgeable separation” between education and marketing.

That’s the ideal. In practice, the system has had plenty of weak spots, especially when “integrative,” “functional,” or “holistic” medicine enters the chat.

How quackery sneaked into CME credit

Historically, CME was sometimes treated as a mixed bag: you could learn about heart failure management in the morning, then sit through an afternoon session praising unproven chelation for autism or homeopathy for chronic illnessall under the same formal educational umbrella. Science-Based Medicine documented how certain CME providers offered credit for courses promoting outright pseudoscience, like implausible cancer regimens and “detox” protocols with no credible evidence base.

So how did that happen if ACCME is supposedly guarding the gate?

• Broad provider autonomy: Accredited providers are responsible for validating the clinical content of their activities. If a provider’s leadership is sympathetic to fringe ideas, “validation” can get… creative.
• Lagging enforcement: ACCME historically relied on periodic reviews, self-study reports, and complaints. If no one complained, a lot could slide under the radar.
• Confusing labels: Terms like “integrative” or “functional” medicine can blend conventional care with unsupported treatments, making it hard for busy reviewersand cliniciansto see where evidence ends and speculation begins.

Into this environment stepped Richard Jaffe, a lawyer who has represented figures like Stanislaw Burzynski and other practitioners criticized for promoting dubious cancer and alternative therapies. When Jaffe publicly worried that ACCME was finally going to stop granting CME credit for such content, skeptics took noticenot because they were sad, but because they were intrigued that the “foremost defender of quacks” smelled trouble.

What Richard Jaffe is worried about

Jaffe wrote that ACCME’s evolving standards and emphasis on “validated” clinical content threatened CME courses that promote complementary and alternative medicine. He argued that these changes could marginalize practices outside mainstream medicine by making it harder to get credit for courses about them.

From Jaffe’s perspective, the problem isn’t that these therapies lack evidence. It’s that organized medicine is allegedly biased against them and uses accreditation rules as a weapon. If ACCME requires that CME content be based on evidence “accepted within the profession of medicine,” then anything deemed “alternative” might be squeezed out, regardless of anecdotal enthusiasm.

From a science-based perspective, however, that’s sort of the point. The whole reason CME exists is to keep clinicians aligned with the best available evidencenot to legitimize every interesting hypothesis or long-running anecdotal tradition. When Jaffe says, in effect, “My clients can’t get CME credit for their favorite untested treatments anymore,” many skeptics respond, “Good. That’s how it should work.”

What ACCME’s rules actually say about quackery

ACCME has long had policies that, on paper, are pretty tough on unproven or dangerous treatments. Its content validation documents state that providers are not eligible for accreditation or reaccreditation if they promote recommendations or methods of practice that are outside the definition of CME, known to be ineffective, or carry risks that outweigh any benefits.

With the updated Standards for Integrity and Independence, the language got clearer and more structured. Among the key elements:

• Content must be valid and evidence-based. Clinical recommendations must be grounded in accepted scientific evidence, with appropriate discussion of risks and benefits.
• Ineligible companies and commercial influence are fenced off. Companies that produce or market healthcare goods used on patients (pharma, device manufacturers, etc.) cannot control educational content, choose speakers, or dictate who gets invited.
• Financial relationships must be identified and mitigated. Anyone in control of content has to disclose relevant financial ties, and providers must take steps to mitigate potential bias.

ACCME has even published guidance on dealing with controversial topics, emphasizing that CME can absolutely discuss new, emerging, or disputed therapiesbut the activity must clearly distinguish evidence from speculation and avoid promoting unscientific care recommendations.

On paper, that is a strong framework. The million-dollar question is whether it’s being enforced vigorously enough to change behavior.

Is this a real crackdownor just better paperwork?

So, is ACCME actually “cracking down,” or did Jaffe simply notice that vague guidelines were becoming more explicit and slightly more enforceable?

There are some signs of tightening:

• Providers that lean heavily into pseudoscientific content can be ruled ineligible or have their accreditation status downgraded.
• ACCME’s examples of noncompliance include activities where commercial sponsors or fringe therapies are promoted without balanced evidence or proper disclosure.
• The new standards require more robust conflict-of-interest mitigation, which makes it harder for a supplement-funded “expert” to turn a CME talk into a sales pitch.

At the same time, there’s still a lot of wiggle room. Integrative or functional medicine courses that stick to relatively mainstream topics, sprinkle in enough references, and avoid overtly recommending egregious nonsense can still pass review. Some activities walk right up to the line, hinting strongly at unproven interventions without explicitly endorsing them.

In other words, the crackdown is real in intent, but its impact depends heavily on how aggressively accreditors interpret and enforce the rulesand how willing providers are to push boundaries.

The skeptics’ view: progress, but not perfection

Science-Based Medicine’s analysis of the so-called crackdown was cautious. The authors agreed that, if ACCME truly enforced its standards, many quack-friendly CME activities could be curtailed. They pointed to prior examples where the council’s rules should have prevented pseudoscientific content from being accredited in the first place.

The skepticism has two main components:

1. Enforcement has lagged behind policy. The rules have looked good on paper for years; the problem has been inconsistent application and a tendency to give providers the benefit of the doubt.
2. “Quackery” rebrands itself. When one style of alt-med CME becomes untenable, it can shed the more inflammatory marketing, adopt gentler language (“supportive,” “adjunctive,” “personalized”), and slip back under the radar.

From this viewpoint, Jaffe’s alarm is less about a sudden, draconian crackdown and more about the gradual tightening of a system that used to be remarkably tolerant of nonsense.

Why this matters for physicians, patients, and the public

Treating CME quality like inside baseball is a mistake. What physicians learn in CME courses influences real-world decisions about diagnosis, prescribing, referrals, and how they talk to patients about alternative therapies.

If a doctor hears in an accredited course that high-dose vitamin regimens can “reverse” advanced cancer or that homeopathy is a valid option for serious chronic disease, that endorsement comes with the halo of legitimacy. Patients rarely see the accreditation details, but they feel the effects when clinicians recommendor fail to push back againstunproven treatments.

On the other side, if ACCME and other accreditors insist on strong evidence and honest communication about uncertainties, CME can help clinicians navigate patient questions about supplements, detox programs, or “natural” cures without either sneering at patients or endorsing false hope.

What a truly science-based CME ecosystem would look like

If ACCME is serious about reducing quackery in CME, several principles need to move from policy documents into everyday practice:

1. Evidence first, anecdotes second

CME activities should highlight systematic reviews, randomized trials, and high-quality observational data. Case reports and clinician testimonials are fine as illustrations, but they can’t be the backbone of an educational activity on treatment effectiveness.

2. Radical transparency about uncertainty

If a topic is genuinely unsettledsay, the best strategy for tapering certain medications or the evolving role of new immunotherapiesCME should say so clearly. Ambiguity is not a license to fill the gap with whatever sounds appealing.

3. Honest handling of “controversial” therapies

CME can and should discuss complementary approaches, but only in proportion to the evidence. That might mean describing some popular alt-med practices primarily in terms of what we don’t know, the risks of delaying proven treatment, and how to counsel patients who are interested in these options.

4. Active monitoring and real consequences

When providers repeatedly push pseudoscientific content, there should be meaningful consequences: probation, loss of accreditation, and clear communication about why. Quiet chats and gentle suggestions aren’t enough when patient safety is on the line.

Experiences and lessons from the front lines of CME “crackdowns”

So what does all this look like in real life, beyond policy PDFs and blog debates? Here are some composite experiencesdrawn from how CME providers, physicians, and skeptically minded educators have navigated this shifting landscapeto illustrate how a “crackdown” can feel on the ground.

When the wellness weekend hits a wall

Picture a regional hospital that has long offered an annual “integrative wellness weekend” with CME credit. For years, it featured a mix of reasonable content (mindfulness for stress, exercise counseling) and eyebrow-raising material: detox foot baths, energy balancing, and intravenous vitamin cocktails for vague “immune support.” Attendance was strong; the marketing photos were full of yoga mats and green smoothies.

Then the education office updated its processes to align with ACCME’s newer standards. Speakers now had to submit references for clinical claims, disclose all financial ties, and undergo more rigorous peer review. When the committee examined the slides on detox protocols and IV vitamin drips, it realized there were no credible trials supporting the sweeping claims being made. The presenters were also financially tied to the clinics selling those services.

The result? The course didn’t vanishbut it changed. The detox and vitamin infusion sessions lost their CME designation and were either dropped or moved to a separate, clearly non-accredited “wellness discussion” with toned-down claims. What remained in the accredited portion focused on lifestyle interventions with a reasonable evidence base. Some regular attendees grumbled that the event had become “too mainstream,” but the hospital avoided giving formal educational blessing to practices it couldn’t defend scientifically.

The conference planner’s dilemma

On the provider side, many CME planners now describe their job as equal parts educator and referee. One planner for a large specialty society talks about reviewing lecture proposals on “cutting-edge metabolic therapy” that sound excitingbut, once you dig into the references, are built on tiny uncontrolled series, preprints, or speculative mechanistic papers.

Under older, looser expectations, those sessions might have slipped into the program with minimal pushback. Under newer standards, planners feel more pressure to ask tough questions: Can you show high-quality evidence that this improves outcomes? Are you over-claiming benefit? Do you have financial ties that might color your enthusiasm? More than once, a proposed talk has been accepted only after being reframed as “emerging hypotheses and early data,” with explicit disclaimers that the therapy should not replace standard care outside clinical trials.

It’s not as dramatic as banning entire schools of thought, but it is a subtle cultural shift toward intellectual honesty.

The skeptical clinician’s path through the CME jungle

From the clinician’s perspective, the landscape remains mixed. A primary care doctor looking for CME credits can still find courses that lean heavily into glossy branding and soft claims. But a growing number of physicians are learning to “read” CME the way they read scientific literature: Who’s sponsoring this? How strong is the evidence? Is the speaker clearly separating data from opinion?

Some clinicians describe a personal rule: if a course spends more time on branding, testimonials, and vague promises than on study design, effect sizes, and limitations, they skip iteven if it’s technically accredited. Others have started asking their institutions not to pay for certain conferences that seem more like product showcases than education. That kind of bottom-up pressure complements ACCME’s top-down standards.

Patients notice, even if they don’t know ACCME exists

Patients rarely ask, “Is this CME accredited?” But they do notice when their clinicians’ advice feels grounded and consistent versus wildly variable. A patient with cancer who is told by one doctor that IV vitamin C is a miracle and by another that it’s unproven and potentially risky is stuck in a confusing, stressful tug-of-war.

As CME moveshowever slowlytoward stricter evidence requirements, patients may indirectly benefit from more consistent messaging. Instead of hearing, “I saw a great talk at a conference; you should try this unregulated cocktail,” they’re more likely to hear, “Some people are experimenting with this, but right now, we don’t have strong evidence it helps, and it may carry risks.” That’s not as thrilling, but it’s a lot more honest.

So… is the ACCME really cracking down on quackery?

The fairest answer is: more than before, but not nearly as much as a hard-core skeptic might wish.

ACCME’s policies have clearly evolved toward stricter, more explicit standards for evidence, independence, and bias mitigation. Providers that blatantly promote pseudoscientific or dangerous care have less room to hide, and some of the most egregious CME offerings have been curtailed or stripped of accreditation. The fact that Richard Jaffe and similar defenders of alternative medicine have publicly worried about these changes suggests that they are not purely symbolic.

At the same time, “quackery” is a moving target. As long as there is financial and ideological incentive to promote unproven therapies, there will be efforts to wrap them in respectable language and shoehorn them into educational offerings. ACCME can raise the floor and push the culture in a more science-based direction, but it cannot police every conference room or every persuasive speaker.

For now, the best path forward is a combination of strong, enforced standards from ACCME and other accreditors; vigilant, evidence-literate CME planners; and clinicians who treat CME not as sacred truth, but as information to be weighed criticallyjust like any other medical claim.