Why Do Some Things Succeed and Other Don’t?

When last we spoke, Derek was extolling the virtues of independent bookstores and bragging about how he has an uncanny ability to “lift heavy things.” I encourage you to take him up on that boast the next time you have a move across town planned – please take a video of Derek huffing and puffing down the block with a sofa on his back.

While I did my fair share of furniture moving back in the day (way back in the day), I have retired from that arena. But where Derek and I do still have something in common is our love of bookstores – well, sort of. Being that I am not the independently wealthy sort like our good friend Mr. Warnick, I rely on libraries to feed my literary tastes. I honestly don’t get people who spend money on fiction – do you really go back and read the same book over and over? I can count on one hand the number of books I have read more than once in my adult life (The Count of Monte Cristo and, um, I think that is it). The library is free, people. You can read as much as you like. If you are lucky, your town/city has eliminated late fees, so you don’t even have that excuse anymore.


You don’t know how badly it pains me that, a good 18 months into COVID, Philadelphia still has not figured out how to safely reopen its libraries to the public. You still need to put books on reserve and then you have a very narrow window on weekdays to pick them up. It is super frustrating. The books are all there on the shelves, but whoa nelly! Don’t you dare try to actually browse and pick anything out you didn’t reserve days in advance that has been set aside in a special area! Masked, unmasked, vaccinated, nonvaccinated – it doesn’t matter. Stay back, hombre!


Anyway, here is how much of a book dork I am (and maybe how cheap, too.) Back in the late ’90s, the big chain bookstores like Borders and Barnes & Noble used to have very comfy chairs all over the store where you could sit and read. I basically treated the local B&N as my personal library. I would grab a book, sit in a comfy chair and read for an hour or two, put the book back on the shelf, and then pick up where I left off the next day. I’m sure others out there did the same thing, which is why there are no longer comfy chairs in bookstores. There were many times where I took dates to Barnes & Noble to sit and read (even women I liked!). Alas, I wasn’t exactly the leading Casanova of my day, though to my defense, this was in central Illinois where there wasn’t exactly a plethora of entertainment opportunities.

Which brings me to two weeks ago, when we took our annual family summer vacation to Chicago. The wife and I decided a few years ago that, on our summer trip, we would each get a day to do our own thing. Having been to Chicago’s main library before (called the Harold Washington Library Center), I knew exactly how I was going to be spending part of my day. I usually end up at the largest library branch in whatever city we are visiting, but Chicago’s is the best I have been to. It’s incredibly cool and worth a visit even for non-bibliophiles. I had been there before maybe 3-4 years ago and was totally wowed. It’s not how you think of a library, I promise.

Fortunately, unlike Philadelphia, Chicago’s libraries are still mostly open (some private rooms are closed) so I was free to spend hours wandering through the stacks and just grabbing random books to pick through. I ended up with a book by Kevin Maney called Trade-Off: Why Some Things Catch On and Other Don’t. It was written in 2009 (doubtful you’ll find it in any bookstore), and it had loads of interesting case studies. Amazon and Tesla were just beginning to break out, so it was an interesting look at how dicey their company prospects were once considered. Remember that Amazon was initially an online bookstore and not the behemoth seller-of-everything that we now know and love (like? tolerate?).

Anyway, the argument of the book is that, for a company/product to succeed, it has to offer one of two things: high convenience or high fidelity. Basically, it either has to be more convenient than anything currently on the market (McDonalds) or of better quality (Apple is the easiest example). If you fall in the middle and are sort of more convenient or sort of better quality (think Blu-Ray), it’s a tough slog. To excel, you need to focus on the tail end of either convenience or fidelity.

As I was reading the book, I started thinking about CMEpalooza and why it works. Are we of better quality than other meetings for CME professionals? Probably not. Of course, I am biased and would love to say yes, but I have been to some great sessions at other events. So let’s give this one a “No.”

What about more convenient? We are free, so no cost barriers. There is no registration, so no barrier in remembering to sign up. There is no travel, so that’s another winner. We have an easy-to-navigate website. So yes, I think I could argue that CMEpalooza is the most convenient educational event for our industry and is part of the reason why we continue to thrive.

Maybe when Mr. Maney writes his sequel, we’ll get a mention. But probably not.

5 thoughts on “Why Do Some Things Succeed and Other Don’t?

  1. CME Palooza is high everything, but mostly, highly humorous in a time where it is really needed. You’re creative and funny and the content is on the money. High fidelity for sure. I look forward to your e-mails and your sessions. Brilliant.

    1. Very kind of you Lauren. Alas, the book didn’t account for the value of humor in the success or failure of a specific enterprise. Maybe that’s a book Derek can work on in the future.

  2. Hi, Scott – I *love* my local library. I live in the sticks of so-called Pennsyltucky, but I can usually request and get the book(s) I want in a couple of days. And I’m happy to pay late fees because, although we borrow books for free, libraries are not free. Just like CME programs, there’s a lot of work being done we never see that requires funds from mainly local sources, but also state and federal funds with a fair amount of year-round fundraising. As you point out, library books are available for no cost and a lot of book lovers don’t use the service. This is a question we at NJAFP often ask about the many free CME offerings we have available. It’s free, and, like you, we know we provide high-quality education. I immediately thought about the physician resilience session on day 1 of the January Alliance conference. The presenters said CME providers are part of the burnout issue by “dumping literally millions of hours of CME on them every year.” To your point, I’d argue that programming needs to be both easy and high-value. Like libraries, we know from experience that easy and free isn’t enough. One of our members told us, “it’s got to be something I can’t get anywhere else.” So the sweet spot is free, easy, high-value, and unique? Challenge accepted! This is why CMEpalooza works, and why I spend a lot of time beating the bushes (virtually) for something that meets those very high standards. Funding said programs is the topic for another post, lol. Thanks for getting me thinking this morning (and helping me to remember that 2 books are due back today)!

    1. You make a good point about the “differentiation” of CME activities. It’s definitely not easy to separate yourself from the mass of options that are available to clinicians in essentially every specialty. I would argue that easy access is probably highest on the list – if you are making someone jump through multiple hurdles of registration, intro screens that are difficult to navigate, etc., they will get frustrated and never get to the education.

      And it’s good to know that I’m not the only one who loves my library. I have two books on reserve that I need to pick up today!

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