Today there are over 10,000. It's physically impossible for any one individual to learn all of that and keep up to date with the barrage of knowledge. Fifty years ago, we had the first randomized clinical trial. Today we have 10,000 a year being recorded in the literature. Fifty years ago, there were probably no more than 100 medical journals in English.
Today there are thousands of peer reviewed journals.
There's no way the average clinician can hope to keep up with what's the absolute best way to treat a diabetic who happens to have peripheral vascular disease and is also experiencing hypertension, because the knowledge base continues to expand. CME can't possibly keep up with it. That's our problem. The good news is that it's not because that doctor isn't trying hard enough. He or she is.