I hope to find the time to expand this post and write out in depth my 'speech' - as is, many of these slides may be open to interpretation and taken out of context.  But I am willing to take that chance just to get the broader story out to the community.

In brief this is a "Good is the Enemy of Great" story...given everything that is going on within the healthcare communities AND given the present and pending economic burden that our healthcare spend contributes to, we can no longer rest our hats on the one or two programs a year that have a real impact on healthcare quality...we must take a step back and accept the broader inefficiencies of the CME community and grant making systems AND we must move beyond this. 

I believe that we are a walking contradiction - advocating continuous improvement and performance improvement while operating as a Rube Goldberg machine...I agree with the IOM that in many ways the system is broken and fragmented...that the science of CME has been lost...and that the CME profession has been watered down to be inclusive of grant administration, coordination, and operations....we must move beyond this.

Anytime one rails against the status quo, emotions will flare - I just ask that you recognize that denial, anger, bargaining, and depression are stages of acceptance...and please take a breath a set a course to move beyond this.

You can download my slides by clicking on the following link: Re-envisioning Our Grant Making Models

If you have questions @ me or DM me on twitter and I look forward to continuing this debate.