My self-imposed goal is to get 200 hours of CME each year. My state only requires fifty credits every 2 years. I have my goal because I think it takes that much for me to keep up adequately and help me provide the best care for children. However the MOC (Maintenance of Certification) requirements provide a huge barrier. I have always participated in quality control programs. Part 4 of the MOC now requires hours of my time in order for me to document what I am already doing. Wasting time like that makes it harder than ever for me to continue to reach my personal goal of CME. Likewise the government-imposed EHR (Electronic Health Records) makes visits take almost twice as long as when I used a more efficient paper system. In this time of shrinking reimbursements, adding these extra time drains and expecting us to continue to provide quality care is unreasonable. I feel like the children of Israel when they were told to make more bricks with less straw.