As I Read the op-ed piece “Does a Drug Firm's Free Lunch Influence Doctors?” (Boston Globe, May 18), I thought, how unusual — this writer actually seems to have a positive attitude about pharmaceutical industry/physician relationships. The piece was responding to the survey of those interactions published recently in The New England Journal of Medicine. Then I saw the byline — Scott Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America. Aha.

My next thought was: Why isn't there an organization out there advocating for the CME enterprise like PhRMA does for industry? I realize I've written here before about how the CME community needs to advocate for itself with the government, the public, and the media. But, after spending the past few weeks covering the Senate Finance Committee's report on CME and its subsequent letter to the Accreditation Council for CME, I believe the issue is more urgent than ever before. The SFC has concluded that drug industry influence compromises CME's independence and that some education programs are no more than veiled advertising vehicles. (See story, beginning on page 9.) Now, the SFC is waiting for the ACCME to respond before deciding its next move. CME is no longer marginalized, rendered invisible by bigger healthcare and drug industry issues. CME is now front and center of a Senate committee probe.

After I wrote my last editorial urging the CME community to respond to the government scrutiny, Harry Gallis, MD, then-president of the Alliance for CME, responded to me with a letter explaining that because the Alliance is a 501(c)3 not-for-profit association, it must define advocacy as a nonpolitical endeavor. I understand those limitations. But, if the Alliance is not able to assume a leadership role in response to the Senate Finance Committee report, CME professionals must take initiative.

When I spoke with Sondra Moylan, president, American Academy of CME, she proposed that a core group of providers sit down with the Senate committee to answer their questions face-to-face. A number of you have said that although the committee staffers did a good job researching CME, there are complexities and nuances they don't understand. You need to explain your views; for instance, that education about off-label uses is a critical component of improving patient care.

The CME community also must face head-on the issues raised by the committee. How can the ACCME improve its oversight process without overburdening providers? How can providers better protect activities from inappropriate drug company influence? I've talked with many of you who have come up with creative strategies for repairing the holes in the system. And, you are looking at the bigger picture — asking tough questions about financial relationships between CME offices' parent organizations and drug companies, examining issues of conflicts of interest at an institutional level.

To do our part to encourage debate, we will focus our July/August cover story on what the CME enterprise should do next in light of the SFC report. Contact me to share your thoughts and ideas — on or off the record.

The Senate Finance Committee began its inquiry into educational grants in June 2005. Back then, the CME enterprise should have formulated a plan to respond. Take action now. Nothing less than the CME profession's freedom from government intervention is at stake.