Conflict of interests--criticising the critics

Examining the relationship between the pharmaceutical industry and medical profession the BMJ raised concern including: describing doctors as 'lapdogs to drug firms'; unethical recruiting in third world countries; manipulating codes of conduct; and medicine corrupted by industry largess. This paper offers an alternative perspective, questioning if largess is automatically contrary to societal needs. Serving on advisory boards allows critical input. Critics who denigrate those who accept support often have undisclosed conflicts of interest. These critics usually do not come from private practice and hence responsible for their own expenses and do not acknowledge costs faced by private practitioners when attending meetings. Private practice does not provide salary when not consulting, has no trust fund support and cannot amortise sponsorship as is often done in the public sector. Failure to disclose this represents concealed conflict of interest, amplified by the 'publish or perish' philosophy, which may well underwrite some publications.