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We're lucky in medicine to have an unending supply of mysteries to ponder. Some of these-like why vitamin A supplementation benefits some children while harming others-are amenable to scientific research (doi: 10.1136/bmj.39575.486609.80 ;doi: 10.1136/bmj.39542.509444.AE ). But there are mysteries of a different sort, ones that are in our power as a profession to resolve. Why, for example, is it considered normal for medical leaders to accept personal payment for promoting a company's drug or device?
This week Ray Moynihan asks whether paid "key opinion leaders" can be independent or are just drug representatives in disguise (doi: 10.1136/bmj.39575.675787.651 ). His interview with former sales representative Kimberly Elliott suggests the latter. We know from independent studies that paid opinion leaders can increase use of a target drug or...