Despite the economic uncertainty, the news for CME providers appears consistently positive. The CME industry has hit the $1.2 billion mark in income, according to the Accreditation Council for CME's 2000 annual report. The total number of CME activities is up — and so is commercial support. The value of CME is also garnering more recognition. At the Global Alliance for Medical Education conference held in June, industry leaders from around the world reported that interest in CME is rising from Europe to Asia to Africa to South America.

On the other hand, controversies about the unethical relationships between pharma firms, doctors, and CME providers are gathering force. The negative press, and government and public pressure has the potential to severely damage CME's reputation and growth worldwide, as Martin Cearnal of Physicians World Communications Group so eloquently declared in his keynote at GAME. (See story on page 8.)

As we went to press, the Patients Bill of Rights was approved by the Senate, and HMO Blue in California announced it will reward physicians for patient satisfaction rates and quality of care, rather than cost-cutting. While the HMO move is being criticized by physicians' groups, it is indicative of the public pressure to improve patient care.

CME providers are in the perfect position to lead the way in bettering patient care. But patients will benefit from CME only if it is unquestionably independent; only if providers refuse to bend to the pressure from supporting companies to prove CME's ROI in terms of dollars. At the GAME conference, Cees Leibbrandt, MD, European Union of Medical Specialists, made an extraordinary statement. “When pharmaceutical companies spend money on CME, they're not spending their money. They are spending patients' money. Pharmaceutical companies' profit is made from patients.” Whoa. OK — so that sounds totally idealistic. But to run with it for a moment — if commercial supporters and the CME providers they fund are the guardians of patients' money, then all players should share a common definition of the value of CME: The only truly important ROI is the patients' ROI.