It’s so simple, as Tom Lehrer said in another context; so very simple.

If you want to get paid for plugging the newest, most expensive, least tested drugs on the market, lose the white coat, put on a suit, and start gilding the Lilly.

If you want to be a university professor at a medical school, a person who pursues and represents legitimate research, you’re going to have to sacrifice the $30,000 you make each year by reading aloud from Eli Lilly powerpoints.

Eric Campbell, who researches the medical speaker’s bureau scam, and whose words provide this post with its headline, calls the lucrative practice of professors doing pharma’s bidding “a complete violation of the hallmark of academia: independence. … [Don’t be a drug salesman] under the shroud of academia.’’

The Carlat Psychiatry Blog alerted me to the article in the Boston Globe that quotes Campbell and others (including Daniel Carlat himself) on pill promo circuits and the doctors who love them. Carlat points out that although salesmen may claim their presentations are independent of the drug companies paying them, they’re clearly following orders. In response to one doctor who protests that he chooses the order of the slides he presents, Carlat writes:

The fact that [this drug company speaker may choose] the order of his Lilly-boosting slides hardly constitutes compliance with [his hospital’s] policy that the “lecture’s content, including slides and written materials, are determined by the clinician.’’ [The presenter] might argue that he follows the letter of the rules because he, in fact, determines which among a menu of Lilly slides he uses in his presentation. But this is a hollow argument, because he didn’t write the menu.

Here’s an analogy. If my son comes home and says that for lunch he ate a cheeseburger and french fries, I might express my dispeasure and ask him to make healthier choices in the future. “But there was nothing else on the menu,” he might respond. “Where did you go for lunch?” “McDonalds!” If you choose to go to McDonald’s for lunch, your “choice” of food is severely limited. Similarly, if [this doctor] chooses to go to Lilly for his medical information, every slide on the menu will be Lilly-friendly, meaning that his defense that he “chooses” what to teach is meaningless. His only choice was to become a promotional speaker, and he checked his academic independence at the door.