Christiane Truelove of MedAdNews Says "Buy Our Space, Not Our Words"

Every Friday, I look forward to receiving my issue of Pharma Blogs: Week in Review written by Christiane Truelove, editor at MedAdNews (subscribe here). I like it because it often has excerpts from my favorite pharma bloggers, including myself!

This past Friday was no exception. Part of Truelove's newsletter that day was devoted to editorial vs. advertising practices of medical journals like JAMA -- an issue I first raised in my post "Pimp My Doc!" over at Pharma Marketing Blog.

Here's what Truelove had to say on the subject:

The Wall Street Journal Health Blog's Jacob Goldstein has posted an interview with Catherine DeAngelis, editor of the Journal of the American Medical Association: "'No doctor should be on a speakers bureau — none, zero,' DeAngelis said yesterday when she came by Health Blog HQ for a chat. Just in case we didn't get the message, she added that she once said to a doctor who dodged a tough question during an industry-funded speech, 'Do you understand what prostituting yourself is? That's what you just did.'"

Mr. Goldstein writes, "How does DeAngelis reconcile her tough stance on drug information with the pharmaceutical ads that fill JAMA? She notes that ads don't run in the section of the journal where research studies appear, and says she routinely bars ads that she deems misleading: 'A couple weeks ago, the ad people came down and said, 'You know, you've cost us $750,000 this year because you've turned down ads.' I said, 'Is that all?'"

The latter statement was highlighted by John Mack of the Pharma Marketing Blog, who took the opportunity to illustrate the story in his own unique way. "This leads me to ask, how much money does JAMA and other medical journals make from pharma advertising if Catherine can shrug off $750,000 per offhand remark?" Mr. Mack says. "At what point does it become Kettle, Pot, calling each other black?"

It's nice to be quoted by Truelove, but what I really want to focus on is Truelove's own opinion on the subject, which she thankfully includes in her article:

I do wonder the same thing myself, yet as a trade magazine editor, I empathize with Dr. DeAngelis. In the final analysis, however, when it comes to advertisers, we should all be guided by Betsy Throckmorton, the newspaper editor in the journalistic novel Fast Copy: "They buy our space. They do not buy our words."

This last statement of editorial principle is worth continued discussion and debate in the Pharma Blogopshere, which is confronted with the same "church vs. state" issues faced by publications like JAMA and MedAdNews; namely, the influence of advertisers over editorial content.

It's interesting that this subject has been linked to CME, which I was the first to do, because pharmaceutical companies and physicians use the same "space vs. words" argument in defense of pharma-sponsored CME. Just as in medical journal publishing, there are "no strings attached" to pharma support of CME (see my "No Strings Attached" post to Pharma Marketing Blog).

In other words, "They Buy Our Space, Not Our Words" is equivalent to "No Strings Attached."

This cannot be true. There are always strings attached no matter what trickery you use to prove that there aren't any.

Say what you want Dr. DeAngelis, but if you keep losing $750,000 in advertising every time you criticize the pharmaceutical industry, some day, some one is going to notice and you will no longer be heard criticising the industry (at least not within JAMA). As Don Corleone said in the Godfather movie: "Someday - and that day may never come - I'll call upon you to do a service for me."

Actually, what really happens is advertisers don't give the publisher any more chances to provide THEM a service -- ie, provide ad space. [Sometimes, advertisers have no choice -- the publication reaches so many of their audience that it would be foolish to pull their ads from publications like JAMA.]

"Trade publications," whose mission is to promote the drug industry anyway, may feel the pressure from advertisers the most. As long as they continue to publish "rah rah" stories about the industry, sponsor industry awards, etc., they will will continue to receive the ads.

I've personally seen how advertisers influence content at trade publications when I was commissioned to write a piece for an un-named biotech publication. In the middle of the project, the editor called and cancelled the project for no good reason. He was apologetic and it was obvious that someone got back to him -- in a true Don Corleone manner -- about a previous article I wrote that was somewhat critical of biotech DTC advertising practices. It was clear that I would never write for that publication again.

Welcome to the world of trade publication!

What about pharma bloggers? For my part, I do not accept any advertising -- except for job notices and other types of "classified ads" -- on my blog (Pharma Marketing Blog) from pharmaceutical companies or from their big ad agencies that I often write about.

NOTE: Like many other bloggers, I run Google Adwords on my blog and other Web sites and these may include product advertising form pharma companies. However, I do not choose what ads are included in Adwords. Sometimes, I can filter out the ones I do not want -- eg, Lunesta adwords that I believe violate FDA regulations. But it's really impractical to monitor all the ads served and filter out all the unwanted ones.

Truthfully, I never had to enforce or even publish this policy because no pharma company has ever approached me to place their product or service or self-promotional ads on my blog! I wonder why not!

It's a fact of life for me that I will never attract these kinds of advertisers, although I know that at least 40% of my readers work for the pharmaceutical industry. I will just have to survive without the ads.

And JAMA could live without pharma advertising as well, if the following comment to my "Pimp My Doc!" post has any merit:

The Senate Committee on Aging, which met yesterday, heard testimony from, among others, Jerome Kassirer, a Tufts University professor who was once editor in chief of the New England Journal of Medicine, pointed out that NEJM and JAMA could produce editorial publications WITHOUT the need for pharma advertising. The income derived from subscription and classified advertising was sufficient to publish these prestigious journals. Why then are they heavy on pharma-related content? Is this where the "pimping" starts?

Inquiring minds want to know.

'Round the Sphere: Wonky Kryptonite, Ethics, and Videotape

You know, of course, it is impossible to review al the important stuff going on in the expanding Pharma Blogosphere^TM. The best I can do is offer my own eclectic glimpse into trends, fun stuff, and major rants.

Thanks to Steve Woodruff of impactiviti, therefore, for putting together PharmaCentral (see "Flaky" PharmaCentral Launched!), a portal "designed to give you fingertip access to a number of targeted blogs, so that you can more easily and quickly find updated commentary on a variety of topics." Basically, Steve has organized public feeds from blogs into categories based on the focus of the blog. A number of "flakes" or windows into the feed content of blogs appear on a single page.

My suggestion: Use Pharma Blogosphere and PharmaCentral in concert -- the former gives you insight and commentary plus reviews of the blogs in the space (not to mention ratings by readers -- more on that later), the latter is an unedited glimpse into recent posts from blogs.

Steve's blog (impactiviti) is about pharma sales training, in case you are interested.

ASIDE TO STEVE: What ever happened to the discussion of sales training going too far (see Steve's post "How Far is Too Far?"). This question was prompted by the Zubillaga Affair (or Zube Affair, or ZubeGate; your choice) and sales training PPT, which seems to prompt sales reps to make off-label head to head comparisons of 2 drugs on sales calls. Steve asks: "The defense was made that this was a 'for information only' training piece, and the information was not to be used for detailing. Well, maybe. Here’s the question I’d like to have your comments on - where does a company draw the line between giving out information like this to sales reps, even if there is a “not for detailing” disclaimer? Where does this stand with the compliance/ethical practices of your company? How far is too far?"

Can we expect any answers to these questions any time soon? Inquiring minds want to know.

Drug Wonks Have Sense of Humor -- Who Knew?
Finally, Drug Wonks (aka "PR Wonks," Whoops! Did I just violate Rulemaker Giles' Rule #4?) post a light, humorous piece! Here it is in its entirety:

Real Kryptonite Found: FDA Puts Black Box Warning on Related Products

The FDA announced today that all supplements and products derived from kryptonite would have a black box warning. Dr. David Graham had pressured the agency after noting that the presence of kryptonite would pose a serious and life threatening danger to Superman, Supergirl and other survivors of the planet Krypton. Graham had been pushing Congress to expand it's drug safety program to move beyond "merely planetary surveillance activities" and into galactic exploration of pharmacovigilance matters. The FDA said in a press release " this pilot project is part of our effort to develop a global and indeed galactic risk management program." The agency had planned to establish this program in partnership with Luthor Industries and the Justice League of America but was attacked by members of Congress for being too "cozy" with special interests.

I guess everyone has heard of the discovery of Kryptonite on planet Earth reported recently in the press? If not, this tongue-in-cheek piece may cause you to scratch your head.

More Ethics Anyone?
There's a new kid on the block -- or, should I say, new orb in the Outer Sphere: Hooked blog, which was launched back in February "accompany the recent publication of [the author's, Harold Brody] book, Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry. Hat tip to Jack Friday at PharmaGossip, who continues to discover new planets!

I wonder what Paul Marinelli, the author of the blog Pharma Ethics, My Foot! thinks of this new blog? Sounds like they should duke it out. BTW, where are you Paul? We haven't seen a new post to your blog since...February! Hmmmm...coincidence! Could Harold Brody and Paul Marinelli be alter egos of the same person! C'mon Paul! Write something scathing please (Rule #4 be damned!).

I'm a little conflicted about adding Hooked to the list of Pharma Blogosphere members. After all, Hooked is obviously geared to promote a single product: the author's book, which BTW I will definitely BUY and READ!

Brody, however, is engaged in an interesting project whereby a blog is designed to update the contents of a book and the author offers interaction with his readers:

"My major goal with this blog is to allow updates on the book's contents. The topic--the relationship between medicine and the pharmaceutical industry--is hot right now, and practically every day, new developments occur and new information is published. I wanted to have a platform to inform interested readers of those developments that seem to me especially pertinent or important, and that might modify some statement or fact given in the book."

But why the book? Why not just the blog? Will the blog out live the book, which may never make it it to a second printing? Too many questions for me to answer this early in the AM.

The AZ Videotape
Peter Rost is at AZ again! The latest brouhaha is the "Secret AstraZeneca Audio Tapes" (see here and here and practically everywhere in the Pharma Blogosphere; hope I implemented Rule #1 adequately).

So far, we've seen the lies and the videotape. Where's the sex Peter?

OK, so it's an AUDIOTAPE, not a Videotape! Sue me! The real question is where's the sex?

Frankly, I haven't been keeping up with all these revelations and have not listened to any of the tracks that Peter has uploaded. I notice, however, that he uses a third-pary storage site called Box where he deposits all his media file (see, for example, Track 7). You get 1 GB of storage free! If Peter keeps up this pace of revelations, he will soon have to upgrade!

Hey, Judge Mack has just had a tattoo done and wants to show you! Click here to see it.

Rules vs. Guidelines: You be the Judge!

What started out as a lone post on On Pharma, destined to be assigned to the outer dust clouds of the Pharma Blogosphere^TM, is now reverberating within the Inner Planets. I'm talking of course, about a Bloggers "Code of Conduct."

You'll recall that I was critical of the notion of civility on Cafe Pharma, because it is an oxymoron (see "Civility on CafePharma: Oxymoronic Wishhful Thinking"). Of course, I caught a boatload of criticism for that tongue-in-cheek satiric post, including scolding by Peter Rost, the Godfather of the Pharma Blogosphere!

Speaking of characterizing and otherwise dissing bloggers, let me point the finger at Pharma Giles who likens me to Drudge Dredd (see "The Judge Gets Bitch-Slapped..."), which was funny the first time, but a little old now.

According to Wikipedia: the term "bitch slap" is derived from American slang. In the original sense, a "bitch slap" is a powerful, full-swing slap in the face with the front of the hand, evoking the way an angry pimp might slap a defiant prostitute (not to be confused with a "pimp slap" which uses the back of the hand).

In the Pharma Giles post, if you bother to scroll on down, you will find Pharma Giles' "Rules" for bloggers. Some of these "Rules" make sense, some do not.

Before I get to the "Rules," let me say that we need GUIDELINES, not rules. And there's never going to be any enforcement. The best we can hope for is voluntary compliance with guidelines, just like the PhRMA DTC advertising guidelines.

Here's Pharma Giles' Rules and my take on them:

Rule 1: Always acknowledge or link to your sources. We Pharma Bloggers are always nicking stuff off of each other and that’s all part of the fun. But we should leave plagiarism to Pharma middle-management. It has no place here.

Good idea! I remember getting "bitch slapped" by Rost for asking Pfizer Rep Bill of Rights Blog not to use my copyright logos and images to illustrate posts (see "John Mack attacks, new blog apologizes."). Pfizer Rep Bill of Rights had no problem with my request, which was designed to protect my business's reputation. Misuse of logos and registered trademarks is even a stronger no no than using an image I may have created to illustrate a post.

Rule 2: If you get stuff wrong, correct it ASAP (I see Dr. Rost. did just that last night on his post about the Pfizer rep allegedly getting slapped.) If the error is pointed out by a fellow blogger, acknowledge that (like I did when I misquoted Fard Johnmar).

OK. Good idea, but what are we aspiring to? I don't know about you, but I don't want to be the Wall Street Journal. If I make errors, the offended party can always submit a comment. I think that's good enough for most purposes.

Rule 3: Respect the anonymity of those who wish to remain anonymous. People blog for lots of different reasons. I don’t wish to question them or try and find out who they are. (Unlike the Judge, who tried to trawl for info on the ID of Insider for reasons of his own a while back.)

I think this violates Rule 4, below. Anyway, Pharma Giles carelessly leaves out the remark I made in the post cited: "As much as we would like to learn the true identity of Insider, we must respect his wishes to remain anonymous. For if he were "outed" we would surely lose one of the best blogs in the Pharma Blogosphere."

Frankly, I don't see anything wrong with gossiping about the identity of the Insider -- it was an exercise in profiling and I certainly have no real knowledge who the insider is. Pharma Giles says "I also think that soliciting the ID of someone who clearly values his anonymity, even if you have no intentions of doing anything with that info, is equally obnoxious.'

What the heck does "soliciting" mean? For God's sake, get real! I clearly did not reveal anybody's identity.

Let me tell you a story, which several bloggers should recall. Recently a PPT was uploaded to the Pharma Blogosphere and an attenpt was made to redact the name of the person who created the deck. Unfortunately, no one realized that the person's name was there for anyone to see if they opened up the "Properties" of the PPT. Since anyone could do this, I thought the secret was out and I made a post about it. However, I was asked to rescind the post, which I did within minutes. I also fixed the PPT file by removing the name and suggesting that my new version replace the old version online. Hopefully, this was done and an innocent person's identity was protected. I don't think many people would go through so much trouble to (1) correct an error within minutes of being asked, and (2) help protect the identity of someone who wished to remain anonymous!

So, I DEEPLY resent Pharma Giles' obnoxious accusation. Of course, I don't expect an apology any time soon.

Rule 4: Don’t (be)rate other bloggers, or “dis” them, unless they break the code of conduct. Differences of opinions are fine but should be openly debated without sneering. CP is the place for that.

Been there, done that. See above.

Rule 5: If you are writing anonymously, then don’t criticise individual non-blogging folk by name. If you’re anonymous, then the subject of your writings should be afforded the same courtesy. That’s why I satirise, albeit thinly sometimes.

Rule 6: Don’t attempt to impose your own rules upon anyone else.

Regarding Rule 6, I wonder what prompted Phama Giles to include this rule because I cannot possibly imagine how anybody can impose rules on anyone else in the Pharma Blogosphere and I challenge anyone to cite a case where this has happened.

Some Other Guidelines
As I said abovem if we really want to get serious about a code of conduct, we need "guidelines", not "rules."

One guideline I would suggest concerns moderation, editing, and/or deletion of comments. I have received e-mails from pharma blog readers -- who wish to remain anonymous --who complain that their comments are not being posted. In the absence of a policy, this is rude and anti-blog by any standard.

Another guideline I would like to suggest is transparency. I remember the furor I created when i suggested that pharma bloggers who accept dinner from pharma companies should be transparent about it.

Speaking of Renegade Blogger Ethics or Lack Thereof

Peter Rost over at Question Authority recently recommended "an interesting new blog, started by John, an anonymous Pfizer sales rep" (see "New Pfizer Blog . . .").

For some reason John uses graphics from my blog (Pharma Marketing Blog), but doesn't have the common courtesy to link back to the source or give me any credit.

He also uses a logo from my web site with a link to a youTube video that I had nothing to do with, which is misleading and unethical.

But WTF should I expect from a Pfizer sales rep?

How do drug companies heard these cats anyway?!

'Round the Sphere: J & J Dinner Brouhaha, von Eschenbashing

The BIG gossip item this week in The Pharma Blogosphere is the J&J blogfest at an upscale restaurant in NYC.

Since my post exploring the "ethics" of bloggers who write about the drug industry accepting a free dinner from a major pharmaceutical company (see "Should We Dine at Pharma's Table?"), there have been a few comments from the inner and outer orbs of our sphere.

Peter Rost over at Question Authority (Peter, you're back on the list!) considered it "a terrible snub by J&J and their blog consultant" that he wasn't invited (see "J&J hosts a wild blogger party in New York!" -- thank God for direct links, else you'd have a hard time finding this post among all the self-promotion of Peter's new book!).

Peter can't understand why bloggers he's never heard of and whose blogs are not as big as his (as measured by Alexa traffic ratings) were invited whereas he was not. Peter, don't you get it? Size doesn't matter!

At least not size as measured with a non-pharma stick like Alexa traffic ratings. What's important in The Pharma Blogosphere is how many pharma industry people read your blog. Not only that, but how often they read it and how useful they rate it.

And the First Ever Pharma Blogosphere Reader Survey tells it all: Among pharma respondents who regularly read blogs, Question Authority scored very low in terms of credibility (only 9% of pharma respondents rated your blog somewhat or very credible). Compared to that, here's how pharma respondents rated some other blogs in the Sphere (some of which you claim never to have heard of):

• Pharmalot: 43%
• Pharma Marketing Blog: 42%
• HealthcareVOX: 29%

Fard Johnmar of HealthcareVOX had "A Few Words About The Johnson & Johnson Blogger Dinner" and agrees that there is more to the reach story than numbers:

"Thanks for your post. I'm sorry you've never heard of me, as my blog is read by a number of folks throughout the healthcare industry. As I like to say to my clients, reach is about more than Alexa numbers. I haven't said much about my attendance at the dinner, mainly because I didn't feel like I had to. However, I will say that yes, J&J picked up the tab for my food. I considered it an even exchange, as I got an opportunity to meet some of the folks there and they got to pick my brain about a host of issues relating to social media and healthcare blogs. The fact that I'm not only a blogger, but a communications consultant who works with a number of health companies, including pharma had a little something to do with it as well. In certain cases, I have paid my own way -- primarily when I'm invited to dinner by folks I am covering on my blog. I also regularly disclose apparent or implied conflicts of interest when I'm writing about organizations."

I don't particularly like Fard's defense of silence before he was forced to speak up: "I haven't said much about my attendance at the dinner, mainly because I didn't feel like I had to."

Keeping quiet in the face of criticism can lead to no good as any good corporate communications person will tell you. You've got to be pro-active and that's why I decided to write my post to bring this all out into the open.

The bastion of silence, however, is Peter Pitts, the Drug/PR Wonk. Nary a word about even attending the meeting over at DrugWonks, which is surprising given his tendency to toot his own horn even more than Rost toots his!

So, Fard has accepted the free dinner and is proud of it. Another attendee who accepted is a medical doctor -- Steven F. Palter, MD of the blog DocInTheMachine -- who defended himself this way:

"As far as pay for dinner, nope I did not foot my own bill -- but then again I did not bill them my expenses for travel, my customary hourly consulting fee for industry to pick my brain, nor did I eat the desert- ka-ching. It takes a lot more than a steak and fries with strangers on a precious night off of work to corrupt me and buy my influence. ... Maybe if they flew me to Paris for the dinner..."

Isn't that just typical of a physician? Right out of the pharma industry playbook. BTW, we all know how much it takes to corrupt a physician: no less than $50,000 (see "FDA Advisor Rule Loophole?").

vonEschenbashing
Well, we don't have Les Crawford to kick around anymore, so let's go after his successor, Dr. Andrew von Eschenbach.

if you've been cruising around The Pharma Blogosphere as long as I have, you would have found a few warning signs that von Eschenbach isn't quite up to speed yet in his new job as Commish of the FDA. Mark Senak over at EyeOnFDA, for example, wrote a piece about his inept communications skills.

Here's a von Eschenbach quote cited by Mark: "There is reality and then there's perception. Sometimes in this town those two things get confused. The point is, it doesn't matter. For me, if it is a perception, it is important....I want an agency in which people bring different points of view, divergent perspectives...At the end of the day, you make a decision."

To which Mark asks "Reality and perception aren't the only things confused. What the heck does that mean? Does it mean anything?" (see "Perception - Reality: The FDA and the Art of Communications").

Well, Mark, it does mean something: Andy is equivocating and he's done it again this week as pointed out by Ed Silverman at Pharmalot("Despite Denial, FDA Chief Wasn't Misquoted"), Jack Friday at PharmaGossip ("Locker talk with FDA Commish Andy"), and myself at Pharma Marketing Blog ("von Eschenbach & Gonzales: Two Birds in the Same Bush").

This is a very good example how several blogs can tackle the same story from different angles and give you a 360-degree view you'd never get from a single news story. Power to The Blogosphere!

I will leave you with this image (read "von Eschenbach & Gonzales: Two Birds in the Same Bush" if you want to understand what it means):

Should We Dine at Pharma's Table?

Well, I'm back from Florida. Unfortunately, I wasn't able to escape the after effects of the freaky ice storm that hit the Northeast. I've been chopping 6-inch thick solid ice off my driveway since Sunday! It's no fun going to Florida unless you can laugh at your neighbors who had to shovel snow when you didn't!

Not only am I pissed at that, but I missed out on free drinks and dinner at an upscale New York restaurant hosted by J&J PR people. This was an informal get-together of several bloggers, including Ed Silverman of Pharmalot (see "Bloggers Do What?") and Jim Edwards of BrandweekNRX (see "J&J Hosts Blogger Summit. Much Wine Consumed."), among others yet to fess up.

According to Jim Edwards, blogosphere attendees included: "Fard Johnson of Healthcare Vox, Nicholas Genes from MedGadget, Peter Pitts from DrugWonks, Steven Palter from Doc in the Machine and Ed Silverman from Pharmalot. And me."

As pointed out by Jim, I was invited but cancelled at the last minute, thus insuring that everyone else gossiped about me behind my back. I will reveal here the mysterious reason why I cancelled at the last minute. But first, a little history.

Let me confess that I was responsible for the format of this meeting. Marc Monseau, the director of media relations at J&J who organized the meeting of minds, called me sometime in February and wondered if I'd be willing to come by the J&J offices in New Brunswick, NJ to discuss blogging with some people there.

This was a first for me. It sounded like an interesting opportunity, but for what I wasn't sure. Marc really had no agenda or questions he could share beforehand. So, it sounded like a fishing expedition to me.

As you know, I'm a busy guy and I hate day trips without a clear purpose or benefit to me. As I told Marc, I don't work for a large corporation with an expense account. My time is my money.

I asked if I would be compensated for my time, but Marc demurred. So, he suggested meeting for drinks and conversation. Unfortunately, I only drink during dinner. "Make it dinner with those drinks," I said, "and you got yourself a deal!"

An that's how this dinner thing got started. I feel responsible because I am sure that Marc had something much simpler in mind.

Then I cancel!

Anyone with a suspicious mind -- ie, most PR people -- might view my last minute cancellation as an insult or manipulation on my part. After all, now I am writing this piece on bloggers accepting free meals from pharma and I can take the high road because I did not partake.

BTW, I cancelled for personal reasons (think of Alli oops! side effects and you may guess what those reasons were; imagine me eating a huge steak along with Jeff Leebaw!). I also cancelled an appointment with my dentist, which I was looking forward to with as much gusto as the J&J meetup.

So, J&J, please don't hate me!

But the question remains: Should we bloggers dine at pharma's table?

It did cross my mind that this could be an issue when I first suggested dinner, but I thought harder about it after a conversation with Jim Edwards before I left for vacation. He was concerned about how to pay for the dinner because he could not accept such a freebie. I see that he has worked out a way to do it as has Ed Silverman over at Pharmalot.

The majority of attendees of the J&J soiree were PR wonks or journalists -- birds of a feather that the J&J corporate communications people could easily relate to. Only two of the four journalist bloggers that attended have indicated what their policy is regarding accepting free gifts -- including dinner. As yet, I haven't heard from Fard Johnmar or Peter Pitts. [I suspect Pitts often wines and dines at pharma's table and enjoys it very much, thank you!]

Journalists like Ed and Jim just cannot accept any gratuity from the people they may be investigating and writing stories about. That seems pretty clear.

[BTW, I just learned that Ed Silverman is no longer a journalist. But you still work for a newspaper, right? I don't get what it is you are now.]

But bloggers who are not also journalists are a special case. I'm an even more special case -- sort of in between a journalist blogger and an ordinary blogger. I'm a newsletter publisher/blogger. I also wear all the hats, including the business development hat, which requires that I schmooze with advertisers and help them promote their products and services. So, wining and dining with clients and potential clients is something I do all the time.

After my conversation with Jim, the issue of whether or not I should attend was working it's way through my system and probably lead to the Alli-like condition I developed while on vacation (or was it the Dungeness crab I ate? It could happen: see "F.D.A. Warns Against Eating Organs of Crab").

Subconsciously, I was battling whether or not I should attend. For me, as for most independent bloggers, paying for the drinks and dinner out of pocket wasn't an affordable option.

What would I get in return? I've already taken the pulse of pharma's attitude about blogging by meeting and talking with executives at conferences and through personal contacts -- eg, simple phone calls.

I weighed all these factors and decided I would not dine at J&J's table.

What would you have done?