No more free lunches

Editor—The dispiriting BMJ of 31 May uses acres of newsprint to state the obvious that pharmaceutical companies manufacture drugs and promote them to prescribers, who sometimes succumb to the blandishments.¹

I have received 53 research grants from 20 sources: research councils, government departments, and medical charities, with one from a pharmaceutical company. I have dealt with industry at many levels, as well as with people from various institutions that support research. All institutions have agendas and special interests, and they are as aware as anyone else of their remit. Many of their agendas are as powerful as or more powerful than those of industry.

Have industry blandishments perverted my clinical practice? A meticulous search of my desk reveals nine pens, two of which have clear company logos on them. As an academic I attend academic meetings, usually overseas, at least once a month. I am certain that on at least four occasions I was sponsored by industry. I can remember the cities but not always the company. Has that made me a drug company lackey?

It is time we doctors grew up. Every doctor, like every person, has conflicts and agendas. There is little in our personal and working lives that does not affect how we manage patients. A few pens, a sandwich lunch, and even a trip to another forgettable conference are low in the list of things that affect our decision making.

An Orwellian world of prohibitions and restrictions is the proposed solution to this latest non-problem. My solitary industry grant means that I am to be banned from medical education. Neither can I devote more time to research. But nowhere does it say that I cannot see patients—yet isn't “protecting patients” the point of this ludicrous exercise?

Trust is gradually being eroded with a stream of articles such as this that states the obvious. Eventually we as a society will trust no one and nothing, seeing only conspiracy behind every action. Erosion of trust in our institutions, public and private, may ultimately be more corrosive to the public good than a few more company pens.