The number of providers placed on probation by the Accreditation Council for Continuing Medical Education more than doubled this year, from 15 to 35, and 14 (40%) appear to be small physician associations.

These groups said their struggles stem more from scant resources and expertise than from willful mishandling of commercial support. The smaller the association, the fewer the resources and CME expertise they have.

Of the 707 organizations listed as having ACCME accreditation in 2009, the number on probation was about 2%. This year the percentage is closer to 5%, assuming the same number of providers.