shill (slang) n. One who poses as a satisfied customer or an enthusiastic gambler to dupe bystanders into participating in a swindle. v. tr. 1. To act as a shill for (a deceitful enterprise). 2. To lure (a person) into a swindle. 04/28/09 report  "It is time to end a number of long-accepted practices that create unacceptable conflicts of interest, threaten the integrity of the medical profession, and erode public trust while providing no meaningful benefits to patients or society." Bernard Lo, MD Chair of the IOM Committee on Conflicts of Interest in Medical Research, Education, and Practice Professor of Medicine and Director of Medical Ethics University of California, San Francisco Handsomely remunerated agents of non-stop "drugs 'til you die" status quo (Updated 1-May 2009) Left to right, from top left: Roy ("Trip") Gulick: former chair of FDA advisory committee for AIDS drug evaluations; lifetime member of NIH clinical practice guidelines panel; board member (and heir apparent to throne) of International AIDS Society, USA; executive committee member, NIAID AIDS clinical research network; Paul Volberding: former president and current board member of the International AIDS Society, USA; former chair and current (lifetime) member of the NIH clinical practice guidelines panel; former chair and current member of the executive committee of the NIAID AIDS clinical research network; editor-in-chief of major AIDS journal; Robert ("Chip") Schooley: former president and current board member of the International AIDS Society, USA; founding member of the NIH clinical practice guidelines panel; former chair of the executive committee of the NIAID AIDS clinical research network; HIV liaison to the Infectious Diseases Society of America; HIV editor of major infectious disease journal; Martin Hirsch: founding (lifetime) member of NIH clinical practice guidelines panel; board member of International AIDS Society, USA; executive committee member, NIAID AIDS clinical research network; David Ho (Aaron Diamon AIDS Research Center (ADARC), New York, NY; Michael Saag, University of Alabama/Birmingham; Doug Richman, UC-San Diego; Joel Gallant, Johns Hopkins University School of Medicine; Margaret Fischl, University of Miami School of Medicine; Dan Kuritzkes, Harvard University Medical School; Judith Currier, UCLA Care Center; Ian Frank, University of Pennsylvania; Diane Havlir, UC-San Francisco; Joe Eron, University of North Carolina/Chapel Hill; John Mellors, University of Pittsburgh; Constance Benson, University of Colorado Health Sciences Center "By the mid-1990s many American physicians had grown frustrated with the financial limitations imposed on them by the HMOs. Watching their salaries stall, [they] were easily seduced by the welcoming arms of the drug industry, where the money still flowed." - Melody Petersen, "Our Daily Meds," p 25 "I don't have a problem with doctors making $3,000 or $5,000 a year on the side, but it's a totally different thing when they're making $80,000, $100,000 and up." More distasteful still is that the slides used in many of these presentations are created by the drug makers--not the speakers. "That's like ghost-talking." - Dr. Robert J. Alpern Dean, Yale School of Medicine ### "Current self-regulation will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to ... continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts." Brennan TA, Rothman DJ, Blumenthal D et al. "Health industry practices that create conflicts of interest: A proposal for reform." JAMA 2006;295:429-433. (If you were bringing in an additional $50,000-$100,000 a year with very little effort, shuttling about rich countries extoling the merits of lifelong polypharmacy to clinicians less clever, less compeling than yourself -- loads of fancy dinners & hotels, business class travel, furtive financial exchanges, would you stray from the script?) (see also, 4/18 NPR feature: "Trained Monkey On the Take") "Private research efforts by pharmaceutical companies largely focus on treating chronic diseases--not curing them." - Rahm Emanuel Chief-of-Staff to the 44th President-Elect of the United States and US Congressman from Fifth District of Illinois  in "The Plan: Big Ideas for America"