Update: Dr. Kopelow is going to talk with me this afternoon. I know he likely won’t be able to give me many details, but I look forward to hearing whatever he can say, and will share it with you as soon as I can.

OK, I admit I was a little miffed to learn we had been scooped on our own turf by The New York Times when that venerable paper reported that the Accreditation Council for CME was going to be publicly outing accredited providers who were found to be in violation of its accreditation criteria. But really, shame on me for not jumping on the story first, I thought.

But now I am doubly miffed. After waiting for weeks for an interview, then at least some e-mailed comments, yesterday ACCME Chief Executive Murray Kopelow, MD, declined to discuss with me at all what he had already told the Times, much less answer any follow-up questions I sent. They did issue a statement last week that, to me anyway, didn’t say a whole lot (here’s the best I could do to provide an update, based on the information in the statement).

I understand that his hands are tied due to the nature of the organization, which answers to many masters, but it makes me think that the ACCME’s new approach to transparency is going to be one of those one-step-forward, two-steps-back type of things.

On one hand, ACCME wants to open up its processes and let people comment, as it did last spring when it issued a request-for-comment on four proposals it was considering. On the other hand, in this case anyway, it sounds as if ACCME doesn’t want to publicly specify—except in very general terms—what the board is even deliberating until the deliberation is done. Except to The New York Times, of course. But now ACCME’s lack of willingness to talk about what it already said makes me think it is backing off from those statements as well.

Any time the ACCME sneezes, the entire CME community gets pneumonia, and questions were flying around the Alliance for CME listservs after the Times article came out. If an accredited provider is found to be noncompliant, would it be required to notify learners and provide corrective materials? Who would have to pay for it? How would it work? A lot of people seemed to jump the gun and, as this community is wont to do, start sweating the details before any decision is finalized. It would be nice to know if in fact this is something people need to start thinking about or not. It also could be a good argument against increased transparency, if all that transparency is going to do is cause unnecessary stress if the board decides not to go this route.

But it would be nice to at least be given the sense that the community’s input is important to the board’s decision-making process. While I’m still miffed, I’m putting my faith in the ACCME and hoping that one of the next steps it will make as soon as the board issues its decisions on whatever specific policies it is deliberating will be another call for comments—before it hands down any final decisions.

Today is Independence day here in the U.S., a day where we celebrate our establishment as a free nation. It is difficult, even for one day, for our country to set aside our differences to rejoice in what binds us together as a nation. Liberals and conservatives are at each other’s throats, and I expect the divisions to worsen in the coming days. We still haven’t figured out how to meld our increasingly multicultural country into a working whole. Racism, sexism, ageism, and all the other isms still roam our streets and tear up lives. We still allow those with money and power to wield their influence over those less fortunate.

Yet I’m proud to be an American. Proud to live in a country where we can bicker, snipe, and sneer loudly; where we can still criticize our government without fear of reprisal; where we can, if we stop bickering, sniping, and sneering for a few minutes, actually hear what the people think–all the people, not just those in power. Yes, our way of life is messy. It can be loud. It definitely can be frustrating. But at its heart, it also, I believe, stays true to the wise words of our founding fathers:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. –That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, –That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.

These guys knew of what they spoke. The real message America sends to the rest of the world is not about McDonalds, or TV and movies, or a culture of excess. It’s that governments are accountable to the people, not the other way around, and that when a government forgets that, the people have a right to bring it down and set up a new one that will be accountable to them. No one is so rich, so powerful, so omnipotent that a determined group of people can’t make change happen. Our forebears did it, with some help from our friends (even back in 1776, our nascent country understood that it was fighting to become one self-governing piece of an interdependent whole). But freedom is never free–you have to want it bad enough to bear the unspeakable costs.

The other day, an online discussion group was talking about what they think defines patriotism. For me, it’s loving your country so much that you’d be willing to die for it. It’s not forgetting that bad things can happen in your own backyard, and that you have to be willing to do whatever it takes to keep your land, your people, and your ideology safe. But it’s also respecting the many cultures, subcultures, species, environment, systems of thought, politics–all the physical, spiritual, and ideological things that make your country the unique place it is–the place that’s worth fighting for. Even the parts we don’t personally like or agree with, because without the warts, we’d be a different frog altogether.

Another important piece of being a patriot, to me, is ensuring that you keep working toward “liberty and justice for all.” For me, “all” doesn’t just mean “all Americans,” and independence doesn’t mean solitude–hand in hand with independence are responsibility and accountability as independent nations who inhabit the same planet, whose actions and inactions have a profound impact on the rest of our global network. Within our own country are worlds of differences, and within our world, universes of differences. But liberty and justice for all is something I think we can all agree with as a worthy pursuit of a true patriot, whatever country you reside in. When all people are free and treated justly, all our nations are freer and more just.

So wherever you live, please join me in a round of applause for all who cherish freedom, manifested in both small ways and large. Please join me in celebrating not only our independence as individuals and nations, but even more so our interconnectedness with and responsibility to each other. In the midst of all the flag-waving and fireworks, let’s remember just what it is all the bunting is about. And if you disagree with me, let’s talk about it. That’s the beauty of America, all these disparate voices coming together to make a song. That’s the beauty of humanity, all these disparate voices coming together

to make a symphony.

Happy Independence day.

Whether you’re a CME provider or with a pharmaceutical company, it’s hard to argue that the competition is getting tougher all the time. For providers, there are more meetings, more online activities, more enduring materials, than ever before–and physicians have less time to spend on CME than they used to. For pharma, well, mergers and acquisitions are almost as big a part of life as freaking out about the Office of the Inspector General and the FDA. But are they doing us any good?

Tom Asacker addresses all this in a must-read article on his Web site for anyone who is facing increased competition–and who isn’t? Maybe the nichiest of niche associations still has a fiercly loyal constituency, but most of us have more and more information sources that are in direct competition to our products, whether they be meetings or magazines. A snip:

Your new imperative is to assess and appeal to your customers feelings period. Feelings are the basis for all profit generating consumption in a market at the mercy of customer choice. Focus on feelings, especially the subtle ones that customers themselves cannot articulate.

Pay attention to what they do, not what they say, when assessing feelings, Tom says. If they say they love the organization, but  no longer come to your meetings, something’s out of whack, obviously.

I’m going to think long and hard about this, because our magazines also face huge (and, believe it or not, growing) competition. How do you feel about us? Just having come back from the Alliance for Continuing Medical Education conference last week, I got at least some indication of how people feel about Medical Meetings, the main magazine I work on.

One thing I noticed was that whether they like what we’re doing or not, the readers I spoke with do care about the magazine (and this blog, which is really exciting!). They care if we get it right–and they’re quick to let us know when they think that we don’t (though I’d love to get more constructive criticism). This is a good sign, at least anecdotally, from some of the people I spoke with.

But it’s nowhere near enough. What can we do to enhance our relationship with you? What would spur you to feel better about us than the other information sources out there?

And if you’re not asking these questions of your "customers," why not? I’m trying to think of brands that I feel passionate about, and what makes me feel that way about them–why I’ll spend twice as much on a turkey sandwich from Filo’s than I would on a turkey sub from the Groton House of Pizza. What makes us passionate about an organization, a meeting, a journal, or a listserv? How can we inspire that same passion in our constituents?

It’s not enough to have ACCME accreditation or exemplary FDA compliance, or an award-winning magazine. With the rapidly burgeoning sources of competition out there, if we don’t know the answers to these questions–and act accordingly–some of us may not be doing what we do in a few months or years. Of that, my friends, I feel sure.