Belize, Whoppers, and the CME Community’s Response to the ACCME

During the summer between my freshman and sophomore years in college, I decided to spend a month doing a service project in central Belize. In theory, the team I was with would help with the construction of a new church/school. In reality, I spent five weeks in 100 degree mid-day heat pounding rocks with a sledgehammer. You see, the ground where the construction was to take place had not yet been cleared out and they could only afford a bulldozer for one day. The rest of the clearing and leveling of the rocky ground fell to me and my team. Thus: pounding rocks with sledgehammers. It was brutal. The bulk of my diet during that time was rice and beans, with the occasional meager chicken leg or thigh. I ate everything in sight. It wasn’t enough. In five weeks, I lost 25 pounds.

On our flight back to the States, we had a layover at the Orlando airport. Ravenous (as always) we spied a Burger King and wasted little time in ordering several rounds of Whoppers and fries. Those burgers will always stand out in my mind as the best freaking hamburgers I’ve ever had. We gorged and raved about how fantastic they were and then all sat around with big smiles on our faces. It was a great time.

A couple weeks ago, the ACCME held a webinar to announce their Proposal for Simplifying and Evolving the Accreditation Requirements and Process. The immediate response from those in the CME community listening to the webinar (at least those willing to be vocal about it) was fairly astounding: a massive outpouring of love for the ACCME. Even those participating in the impromptu simultaneous #ACCMEchat on Twitter – who tend to be a bit more of a cynical lot (guilty!) – were sending out tweets of approval and appreciation of the proposed changes. The CME community was hearing what the ACCME had to say and they were loving it!

I found this response to be…curious. Don’t get me wrong, I think the ACCME is on the right track with many of their proposed changes and I love how they’re really working to eliminate much of the redundancy that can be found in the current system and processes. But, I also didn’t think that anything in the proposal was earth-shatteringly awesome or something that will forever alter the course of CME. It was exactly as the title indicates: an attempt to evolve and simplify the accreditation process. So why the deafening roar of approval from the CME crowd? I was intrigued.

And then it hit me: this was the CME community’s  Whopper-in-Orlando moment and the past 5-10 years have been our summer-in-Belize. Whether accurate or not, it seems as though every major event in CME over the past few years has succeeded in making life harder and more difficult for CME professionals: the new ACCME criteria, investigations by the Senate Finance Committee, the IOM’s Redesigning Continuing Education in the Health Professions report, the AMA passing CEJA Report 1-A-11, the Macy Report on Reform of Continuing Medical Education, the Physicians Payment Sunshine Act, and so on. Add to this a negative image in the press, declining funds for education, and an increase in companies and departments shutting down – and working in CME these past few years has been, well…kind of brutal.

When suddenly, out-of-the-blue, someone comes along with a proposal that, at first blush, looks like it might actually make the lives of CME professionals a wee bit easier. We’ve been living on rice and beans and the ACCME just came along and gave us a Whopper. I think that’s a big reason why the response to the ACCME proposal was so laudatory and excited. After years of seeing every announcement about CME add more items to our to-do lists, we finally had an announcement that didn’t do that. Finally, we could listen to proposed accreditation and process changes and not have to worry about how drastically it would change our daily work lives. We could sit back with big smiles on our faces.

Quick epilogue to the Belize/Whopper story. That night, after pigging out at Burger King, every single person on my team ended up puking his or her guts out. Whether it was from food poisoning or our stomachs being unprepared to take in so much rich, fatty food, I don’t know. It does show that sometimes things in life that are great in the moment, can come with a price to be paid later. Let’s hope that’s not always the case…

A Howl for CME

I saw the best minds of my profession laid off. It’s madness, crazy hysterical sadness

Dragging themselves through unemployment at dawn, looking for another job

Levelheaded workers burning for a connection, an opportunity, another chance to be a cog in the wheel of the machinery of the system

Who wrote and edited and planned and brochured and powerpointed and webinared and essential’ed and element’ed and criteria’ed and Standard for Commercial Supported

Who bared their brains to CME under the sign of hope and saw days of work rejected, proposals staggering and falling and declining

Who got busted by muckraking newspapermen and caricature bloggers looking for stories that didn’t exist

Who saw the golden goose of commercial support blossom its gossamer wings and fall from the touch of those who would call it sin

Who cowered in drop ceilinged offices in khakis, fearing the closed-door meeting in the corner, listening to the Terror through the wall

I’m with you in this struggle, where you beat your head in wonder of the piece of your life now gone forever you gave to this beast company that drops you on the street when finished with you here’s a few bucks goodbye

I’m with you in this struggle, where you wish yourself back to the time of deep pockets, handshake agreements, winks and nods, and overflowing cubicle plains

I’m with you in this struggle, where you realize the massing crowds accept that the price of an industry to progress comes at the cost of you to regress

I’m with you in this struggle. It will get better.

 

Note: Yes, this is a complete rip-off of Allen Ginsberg’s Howl…

What If We Notified Oscar Losers The Same Way We Decline CME Grants?

Dear Mr. Pacino,

Thank you for the opportunity to review your movie, “The Godfather”. Every year, the Academy of Motion Picture Arts and Sciences receives numerous requests to review the movies of qualified nominees. As you can well imagine, we are often forced to make difficult decisions about the movies and actors we watch.

The Academy has concluded it’s review of your movie and, after careful consideration, has decided we are unable to grant you the Oscar for Best Actor. This decision was based on one or more of the following five reasons: 1) did not meet the Academy’s guidelines; 2) did not meet the Academy’s objectives; 3) you just weren’t that good; 4) you were good, but your movie was awful; 5) you were good, your movie was good, but we gave it to some other guy who should have won it last year, but we screwed up.

Due to …oh, let’s go with…”regulatory issues”…we are unable to tell you the exact reason you were rejected for the Best Actor Oscar.

This decision is not a reflection of the value of your movie or your work in it. The Academy appreciates your commitment to high quality movies and hopes that you will consider us again for any future award requests. Although we were unable to award you the Oscar for Best Actor, we wish you luck in securing awards from other organizations. Best of luck to you and your future acting career.

Best,

The Academy of Motion Picture Arts and Sciences Team

What Is Your “Better” CME?

I remember the moment it happened. I was sitting in the Dutch Wonderland movie theater in my home town of Lancaster, PA, watching Bruce Willis and Ben Affleck drill holes in an asteroid in “Armageddon” (“DON’T WANNA CLOSE MY EYES!!!!”) and thinking to myself,”This. Movie. Sucks.”  I was watching a so-called blockbuster, the hot movie of the summer, and I was bored. I clearly remember thinking, “There has to be something better than this.”

It was at that point that I decided to make a change. I was going to make a little more effort to be a little more discriminating in my movie watching habits and look for options beyond just the mass marketed films shoved down my throat at every possible advertising opportunity. I started to read movie reviews. I started to watch older movies. I started to challenge myself to watch movies that 18 year old me would have run screaming from. I started looking for specific directors and writers whose work I appreciated: Jim Jarmusch, David Mamet, Wes Anderon. I started to find my cinema experiences to be more meaningful, more fulfilling, and more enjoyable.

My search for “something better” started to filter into other areas of my life. No longer content with the next John Grisham novel about a southern lawyer facing tough odds, I progressed to authors who posed challenges to my worldview and made me work to read them: David Foster Wallace, John Updike, Neal Stephenson. In the world of music, the kid who once proudly owned a Milli Vanilli “Girl You Know It’s True” cassette tape (Oh, geez, this is embarrassing…), was now listening to Tom Waits, Leonard Cohen, and Nick Drake.

Eventually, the search for “something better” spread outside the world of pop culture and entertainment and into my standards of daily living – food in particular. From Maxwell House coffee to grinding fair trade beans at the local co-op. Organic fruits and veggies from a local CSA instead of waxed and colored produce from the Acme. Multigrain bread in place of Wonder bread.

I fear this makes me sound elitist, pretentious, snobby, whatever you want to call it, and that’s really not my intention. I still have an affinity for Will Ferrell movies, spy novels, 80′s Hair Metal, and McDonald’s Quarter Pounders. We all have our own definition of what “better” is. The great thing is that I went looking for something “better” and was able to find it. I’m sure many, if not all of you, have done the same in some avenue of your life.

The question I have for the CME community is this: when the doctor who has thus far been satisfied to sit and watch our talking head webinars and eat at our dinner meetings, suddenly decides he’s had it and he’s going to start looking for something “better” – what does the CME community have to offer him? What is our “better” CME? Is it PI-CME? Is it an iPad at every seat? Is it a gamified internet activity with a social community to crowdsource questions?

I encourage you to really think about this. If one of your CME participants came to you and said, “I want something more” – how would you respond? What activity would you point them to? This isn’t meant to disparage any of your other activities, but what is the program you have that is just simply better than the rest? It’s purely a rhetorical exercise, but if anyone is willing to share a description or link in the comments, I’d love to hear about it.

Keep It Simple Stupid

Well, the blog’s been a little barren lately. I’ve been finding it harder and harder to convince myself to – after logging a full day face-to-face with my trusty MacBook Air – sit back down in front of the screen and write. Yes, I admit that the same person who once wrote this is now having some difficulty finding time for social media. And I’m OK with that. I love my gadgets, but I’m well aware that I spend too much time with them. I’ve been making a conscious effort to find hobbies that take me away from sitting on my butt in front of yet another screen.

I’ve written about my recent dedication to running, but lately, my evening hours have been taken up with a newfound interest in…baking. Yes, baking. It all started one night a few months ago, sitting at home, kids in bed, my wife at work, and I had the following conversation with myself:

Me: “I’m hungry.”
Myself: “Me, too. I could go for a scone.”
Me: “Someone should start a scone delivery service.”
Myself: “We could make scones.”
Me: “Pfft. We have no idea how to do that. We barely make toast.”
Myself: “Oh, c’mon, it can’t be that hard. I’ve seen some of the people who make scones…”
Me: “Hmmm…let me google ‘make scones’ and see if we have the ingredients…”

I did, made what you see on the left, and just kept going from there. Scones, biscotti, bagels – I tinkered around with all of these, but quickly found I got the most enjoyment out of making bread. And not just the occasional loaf of bread, either, but making it on a routine basis to the point where we haven’t bought a loaf of bread in almost a month (and my two kids have sandwiches for lunch on a daily basis). There’s something pleasantly satisfying about being able to produce something that the entire family enjoys and uses on a routine basis.

One aspect of bread-making that surprised me – but may be what I appreciate most  about the experience – is the physical nature of it. It takes effort and exertion to make a good loaf of bread. Kneading bread dough for 10 minutes is much more physically taxing than I ever realized. This was brought to my attention by my dear wife who, upon hearing me complaining about how flat my recently baked loaf of bread was, informed me that I wasn’t kneading my dough hard enough or long enough. After sputtering out a few exasperated excuses, I finally blurted, “I just don’t see the point of it!” To which she pointed to my too-flat bread. Point made. I’ve since upped the physical ante by refusing to use a mixer (wooden spoon only!) and getting a hand-crank grain mill to grind my whole wheat grain. Baking a loaf of whole wheat bread has now become a full-body workout for me.

Last week, I tried a recipe for a French bread called Pain Ordinaire Careme (pictured left), and it was amazing, easily the best thing I’ve baked. What I found so amazing wasn’t the taste (which was quite good, if I do say so myself…), but the process of making it. It only had four ingredients: flour, water, yeast, salt. It doesn’t get more basic than that. But, two additional elements were necessary in order to turn these four simple ingredients into a fantastic loaf of bread: time and care. It takes two days to make. The ingredients need to be combined in proper sequence, specifically the salt, which is added at a precise time during mixing. The dough must go through a triple-rising process which takes over six hours, yet is crucial for giving the bread its proper texture. Too little time, and the bread is dense and flat. Too much time, and it becomes too light and airy.

Simple ingredients, given adequate time and care, can produce a beautiful and complex product. This theme of simplicity is one I hope to carry over to other aspects of my life. I love trying out new learning tools and technologies and brainstorming ways to implement them into educational programs. The goal is to improve the learner experience, but I worry that sometimes in our quest to implement the latest “bright shiny object”, we end up only muddying the waters for those that matter most. By no means am I trying to imply that we should avoid using new technologies in our continuing education activities. Rather, I am suggesting that we give greater consideration to how crucial each element of our activities is to the learner experience and eliminate those pieces that are not essential. Let’s reconsider the “kitchen sink” approach to CME. Some of the best learning moments of my life have come from well-delivered lectures and carefully written articles, simply done, with proper time and care dedicated to their creation. Sometimes, those are the only ingredients you need…

My Email Manifesto

The other night while I was making biscotti and listening to Billy Joel’s “Greatest Hits” working on my Harley and listening to Motörhead, the constant DING! -ing of my cellphone to indicate a new email was driving me nuts – so nuts, in fact, that I finally  just turned it off completely (it has to be pretty bad for me to go to those lengths). It was yet another reminder of how much I have come to despise email. I don’t hate it – it’s my preferred means of interaction (introvert alert!) – but I do think the amount of email flying around has grown out of control. Far, FAR too much of my day is spent composing and reading email. The percentage of my day spent on email is ridiculous and something needs to change. So, I’m putting together an Email Manifesto to lay-out my expectations for email correspondence. Maybe, if we can all get on the same page with our email standards, we can cut down on the length and amount of email we read and send each day. This is, of course, a pipe dream, but hey, it’s worth a shot. This is what I have so far:

1. No more greetings, salutations, and/or closings. You don’t have to say “Hi”, wish me “kind regards”, or tell me you’re the best (the “Best, John” closing always cracks me up). We’re not writing formal letters here. Let’s all just right now acknowledge our warm regards and best wishes and use our email to get to the point and move on.

2. Eliminate the “Thank you” email. You ask me a question. I respond. That’s enough. You don’t need to let me know you’re thankful that I responded to you. We can all just assume (By the way: You’re welcome). I won’t think you’re rude. I promise.

3. Are you absolutely certain you need to CC me? This is a big one. I think at one time or another, we’ve all died the death of a thousand CC’ed emails. It’s not the first one that gets you; it’s all the responses from all the others CC’ed on the same email. Please, in the name of Don Draper, let’s only CC people who have a vested interest in the content of the message. I’m begging you.

4. Less is more. If you can respond to an email in three words…fine. Two words? Great. One word? Outstanding. Again, this isn’t a letter home to Mom from Camp Tittikakka. It’s an electronic message. Keep it brief and to the point. Can we all agree that we won’t be offended by emails that may seem abrupt and impersonal, but really are just short? Yes? Fantastic – let’s move on.

5. Stop the “!” emails. You know what I’m talking about, right? The little exclamation mark icon you can click to indicate you’re email is “high priority”? Here’s the problem…everyone thinks their email is high priority. Here’s how I read my email: someone sends me an email, I read it, I respond when I can. Here’s the amount of times I have thought “Well, I declare. I am enraptured by the “!“ this fine gentleman or gentlewoman hath added to their electronical parchment. I shall respond posthaste.”: zero. This is my expectation for responding to email: if you can respond promptly  then respond promptly. If you need a little time, then take a little time. If you need, say, 24 hours or more, then a quick email saying, hey, I got your email, I’ll get back to you in a day or two. This is reasonable, no?

Is that too much to ask?

The Origin of an Open-Mind

My dad drives me nuts.

True story: My Grandpa Warnick died 2 years ago at the age of 102, living at home the entire time. I jokingly asked my dad one time, “You’re not going to stick around that long, are you?” “You better believe it!” he retorted, “Just to make you suffer!” That’s my dad.

But, that’s not why he drives me nuts.

He drives me nuts because he forces me to think. He drives me nuts because he’s never allowed me to blindly take sides on an issue, any issue. He drives me nuts because he makes me work at understanding what I believe.

And I am thankful that he does.

My dad likes to argue. He might protest (argue?) a bit if you said that in his presence – but he does. Not arguments where tempers flare and voices are raised; maybe debates is a better word for it. Even if you are in agreement with him on a particular issue, he will gladly and quickly take up the opposite side, just to ensure that all angles are being covered. As an annoying know-it-all teenager, I had a hard time understanding why he did this, but I now see what a wonderful, life-changing skill he was teaching me: The value of an open-mind.

I learned at a young age that if I was going to take a strong stance on an issue – be it political, racial, religious, or anything else – I better be prepared to explain why and have a clear understanding of the other side. Because, if I didn’t…Dad would eat me alive. He could find holes in my arguments quicker than I could get the words out of my mouth (I don’t know why I’m using past tense here; it still happens today…). My sister and I were never allowed to answer the question “Why?” with the words “I don’t know.” We better know. If we didn’t know, well, Dad was a patient man, perfectly willing to sit and wait until we did know. It used to frustrate and infuriate me no end, but it has shaped the person I am today.

And who is that person? Self-assessment has never been a strength of mine (touche), but I hope I am the type of person who is slow to take sides without first considering a 360 degree view of the issue at hand. The type of person who keeps an open-mind no matter what the odds and is always willing to consider opposing viewpoints. The type of person who knows what he believes and why he believes it or what he doesn’t believe and why he doesn’t believe it. The type of person unwilling to accept the status quo simply because he’s supposed to.

I sometimes use this blog to push the boundaries of what the CME community is used to. I like to ask “Why?” and get annoyed with “I don’t knows.” I try to approach common topics from uncommon angles. I try. Some efforts are more successful than others. But now you know where it all stems from: My dad.

And I love him for it.