There are two things every person I spoke with for this issue's cover story on the Accreditation Council for CME's new accreditation criteria agreed on: that the direction they will move the CME enterprise is the right one, and that there are a lot of providers who will absolutely balk at complying with them. Why the disconnect?

Jack Kues, PhD, assistant dean for CME with the University of Cincinnati College of Medicine in Ohio, summed it up when he told me, “The irony of this whole thing is that we're saying physicians have to be lifelong learners and be able to adapt, while we ourselves are becoming more entrenched in the bureaucracy of CME. When we are asked to change and move forward with the physicians, we get very freaked out.”

The reasons why are easy to understand — in fact, they are the same reasons docs resist when they are asked to change their ways. There's the inertia reaction: “We've been doing it this way for years and getting good results, so why fix something that's not broken?” There's the exhaustion factor: “It's just too much work. I can't stand the idea of taking all this on when chances are as soon as I do, they'll just change the rules on me again.” There's also the “who do you think you are?” response: “Who is the ACCME to tell me how to do my business? They don't know what my environment is like. No one asked me what I thought would bring the best results.” Finally, there are the system issues: “We don't have the time, the staff, the resources, or the connections to make it happen.” Sound familiar?

My heart really goes out to those I spoke with who just can't see themselves being able to achieve accreditation — especially accreditation with commendation — under the new criteria. My guess is that, similar to what happened once the dust settled under the new Standards for Commercial Support, the changes required will end up being incremental and doable, and those to whom meeting the new criteria now sounds like the impossible dream will find that it's an achievable goal after all.

Do I think that these new criteria ultimately will result in a more powerful and effective CME enterprise? Absolutely. Do I think that they will cause some to drop out of CME rather than try to comply? Absolutely. Isn't it ironic?

Sue Pelletier, (978) 448-0377,