IT WAS WITH a growing sense of apprehension that I read the letter sent in June from the U.S. Senate finance committee to pharmaceutical companies asking them to explain their process for awarding educational grants. The senators want to make sure that grants to healthcare organizations are not a guise for promotion and influence-peddling. They said they were gathering information to see if further guidance or legislation (gulp) is needed. (See news story, page 15.)

In the list of questions the senators included in their letter, they differentiated between grants to Accreditation Council for CME — accredited organizations and other groups. Does this mean that certified activities will continue to enjoy something of a safe harbor from government regulation? There is no way to know the answer yet, though we will continue to bring you further developments. But, regardless of what happens, the Senate inquiry should set off alarms for the future of CME provider/industry collaboration.

Already, because of the current regulatory environment, pharmaceutical companies have restructured their systems for awarding CME grants, making the process much more difficult and frustrating for providers. According to CME experts, some companies are even considering eliminating support for CME because of the risks. There is an indication of things to come in the ACCME 2004 data report. Although commercial support — almost all of which is from drug/device companies — increased 10 percent in 2004 over 2003, that's the lowest rate of increase in recent years. And while commercial support accounted for almost 55 percent of CME providers' total income in 2003, that amount decreased to 52 percent in 2004. A small difference — but one which may augur more bad news for providers.

While I do believe industry/provider collaboration will weather the turbulence and survive, I also think it's time for the CME community to start thinking seriously about other funding models. In his column, Bob Orsetti suggests providers seek multicompany funding for activities. As we reported in “New Funding Formula,” (January/February 2004), CME veteran Lew Miller suggests creating an independent foundation that would funnel pharma grants to providers. Others have pointed out that doctors are the only professionals in the country who don't pay for their continuing education — and perhaps it is time they shoulder the responsibility. CME providers can also solicit government funding, as well as approach nonpharma companies, such as food and car manufacturers, for support. I'm sure there are lots of other creative ideas CME professionals could develop, if they made it a priority.

I realize the prospect of exploring a whole new system of funding sounds daunting, perhaps impossible — but if your program depends on industry for more than half its income, it is extremely vulnerable. Don't wait for the bottom to drop out before you find alternatives. It's time to choose change.

Tamar Hosansky

CONGRATS to the MM team for winning the following honors from the American Society of Business Press Editors:

Northeast Regional Bronze Award for original research, “Do Lectures Deliver?,” by Sue Pelletier, July/August 2004. This is the third year in a row Pelletier has been recognized by the ASBPE.

Northeast Regional Silver Award for signed editorial, “A Doctor's House Call,” by Tamar Hosansky, January/February 2004

National Bronze Award, front cover, buyer's guide, “2005 Guide to Medical Association Annual Meetings,” November 2004, Scott Raymond, art director