On September 9, 2011, I was asked to be a guest editorialist for the Tennessean’s article on the relationship of the pharmaceutical industry and physicians. I respectfully declined. My response, if published, would have been as follows:

Generally speaking, this issue is already settled for many; any financial relationship of the pharmaceutical industry to individual physicians is merely influence peddling to doctors bought by "drug companies".  Although probably not appreciated, these critics are basing their conclusions on simplistic beliefs and assumptions:  (1) the root of all evil is money, (2) all exchanges of money from one party to another have nefarious consequences, and (3) human nature in general is easily persuaded by money into unethical actions. Certainly, there are many examples in history to support these stereotypic beliefs. In a capitalistic society, money is the currency of exchange of services. Consequently, are all relationships tainted which involve the exchange of money? If true, the implications are extensive. For example, are all of our politicians merely puppets of those that finance their campaigns?

In my case, I am paid for legitimate services of educating my healthcare colleagues. My participation in lectureship programs is driven by a genuine interest in learning and teaching. The content of and discussions in these programs are scripted by the Federal Drug Administration (FDA). The information that I offer regarding disease state management and correct usage of medications is consistent with the science sanctioned by the FDA.  The effects of these educational programs in which I participate are much needed. Although the pharmaceutical industry is criticized for “pushing” drugs for profit, there is an increasing need for such drugs to help individuals prevent or control diseases. What harm is causing society for promoting FDA sanctioned medications for treating diseases? In this society when personal accountability for one’s health is not encouraged effectively, pharmaceutical agents are in many situations substitutes for healthy lifestyle. Currently, the proportion of individuals that meet national treatment standards for diabetes, hypertension, and hyperlipidemia is abjectly low The national record in controlling these main diseases of modern life is abysmal and can be directly tied to lack of education of the health care providers in implementing theses guidelines. Only one out of twenty individuals with type 2 diabetes has their sugar, lipid, and blood pressure under control; only one out of five individuals with coronary artery disease has their lipid goals met; and only two out five individuals with hypertension have their blood pressure controlled.

Even if my statements were viewed as earnest, critics would see my comments as simply rationalizations for my continued receipt of money. Even if they acknowledged my sincerity, they would conclude that my financial relationship with industry had poisoned my reasoning.  They would argue that I was just spinning the truth to justify my position with industry. Even given the current strict regulatory environment governing education promotional programs, they would argue that such programs which I am associated are carefully staged to appear educational but really are vehicles to deceive or present misinformation for the purposes of promoting the sell of medications. With such attitudes, any response by me could never be compelling. Since the exchange of money is viewed as influencing and altering my objectivity, the critics would conclude simply that being a financial recipient of an agency taints me. In other words, it is mere receipt of money that is assumed as compromising my ethical standards and objectivity.

What do such viewpoints tell us about the critic’s own belief systems? Arguably, people criticize those things in others for which they see potentially offensive issues in themselves; in this case, the recognition of their own susceptibility to influence is the driving force behind their arguments. They assume that under similar circumstances, the financial ties to an agency could potentially influence their own actions. Inherent in their thinking is that man’s nature is flawed. They dismiss the notion that most individuals could morally hold up to the influence of money.

So what determines the nature of these relations? Although a presumption of influence legitimately should be presumed in ever transaction, what determines in the end whether the nature of a relationship is ethical or not is the moral strength and character of the parties- not the exchange of money!  Consequently, how can any one judge such a relationship without knowing the heart of the persons involved? As Dan Millman stated, “Money is neither my god nor my devil. It is a form of energy that tends to make us more of who we are already, whether it’s greedy or loving.”