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To the Editor: Dr Relman's commentary on professional independence and commercial support of CME¹ is timely but not encompassing enough. He is critical of the insidious influence of the pharmaceutical industry, as it becomes an all-encompassing "supporter" of physician education. Just as pervasive, though, is the role of the biotechnology and surgical implant industry. As a practicing orthopedic surgeon, I have observed the progressive influence of implant vendors within our professional organizations and independent journals. Manufacturers of implants and equipment have become the leading supporters of bioskills labs, continuing education courses, and technology-related research, with each company competing for a bigger plaque over the laboratory doorway. This seems analogous to the fox guarding the hen house. Although "unrestricted grants" might appear generous, we need to remember that there is no free lunch. It is difficult enough to sort through the numerous well-written, peer-reviewed articles, much less through the splashy vendor-sponsored . . . [Full Text of this Article]

Joel E. Cleary, MD
Helena, Mont

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