The Milwaukee Journal-Sentinel continues its excellent series on academic medical centers' conflicts of interest with Pharma:
Here we read about cardiologist James Stein of the University of Wisconsin. He describes for the newspaper's John Fauber how he became "hooked" as a young faculty member on the speakers' fees provided by the drug companies for talking about statins, starting at $500 a pop and going eventually to $2000-3000--and how long it took him to realize that he was being used by the industry and that the independence that he fondly imagined he had retained was in his own head only. He first started donating all his speakers' and consulting earnings to charity, and then curtailed all income from Pharma except for actual research grants.
Roy Poses in his Health Care Renewal blog (http://hcrenewal.blogspot.com/2009/04/another-key-opinion-leader-confesses.html#links) adds some shrewd comments about the extent to which the industry actually creates many of its so-called "key opinion leaders." Perhaps the KOLs are not people who become independently famous and then are picked up by the companies at a price. Maybe at least some of the KOLs are young, impressionable and malleable folks that the industry decides it can bend to its will. The industry can then make its stable of starlets into KOLs through arranging exposure at all the major national and international meetings, and generally by throwing around its weight and its money. I am reminded of a chilling statistic that David Healy came up with some years ago, that articles in psychiatry ghostwritten by industry hacks end up being cited in the literature three times more often than honestly authored papers. This speaks to the ability of the industry to get its message, and its messengers, out there in the public eye in most whatever way they desire.