Many physicians will wonder if all of this is absolutely necessary since the physicians who pioneered the procedure didn’t rely on any sort of training. They simply “made it up” or “learned as they went.” As we move away from the innovators such as Pasricha and Inoue and the early adopters such as Stavropoulos and Swanström, a lot has been learned by these physicians. A structured training program allows the experiences and knowledge of many early adopters to be passed along for the betterment of patient experience. It’s ultimately about safety and achieving good outcomes from the very beginning. In addition, we have found that the time and effort invested in preparation for surgeons, team, and institution have yielded big dividends in performance satisfaction, decreased stress for the entire team, and enhanced credibility with colleagues and administrators, paving the way for a systematic approach to the introduction of new technology in the future.

Aside from the above, national organization and governing bodies are establishing best practice guidelines to guide technology adoption. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has already outlined key components required to introduce new technology into practice, and they specifically identified the POEM procedure as one where this type of structure program should be utilized [10]. These guidelines are listed in Table 14.2. Use of a structured training program allows the physician to meet each of these criteria.