I was on the board of a disease for about a year once. We were against the disease; I'm sure you understood that. We sought to educate people about the disease. We also sought to raise money.

In my capacity as a disease representative, I was invited to a lecture where a visiting doctor was giving a presentation about advances in fighting my disease. It was held in a hotel ballroom. At the back of the room were tables set up representing various drugs manufactured by the company sponsoring the event.

There were brochures and news releases and very cute company representatives who kept calling me "doctor." I got tired of saying "I'm not a doctor" after a while, and I accepted some free samples of some pills. I kept the pills for the longest time, but I never developed the symptoms. Bad luck for me.

Then we had a very nice steak dinner, during which more people called me "doctor," and then we had an interesting speech about my disease. An abstract of the speech might be: "There's this disease and it does this, and we know if we give people this kind of medicine, this good thing happens, so we thought: Perhaps if we enhanced that medicine with this substance, then even better things would happen. Here are some charts showing what might be going on at a chemical level. Here are preliminary trial results. Thank you for your time."

There was no specific mention of a specific drug. Only the discreet drug company logo gave you a hint as to what might be happening, as well as the 8 million discreet brochures that everyone had tucked in their briefcases. Oh, and the pills - that could have been a clue.

No one seemed to find anything odd about this. They'd done this a hundred times, often with better food and in sunnier surroundings. As Upton Sinclair once wrote, "It is difficult to get a man to understand something when his job depends on not understanding it." Not quite apposite, perhaps - substitute "outside remuneration" for "job" and you pretty much have the picture.

This Very Newspaper recently reported on a ProPublica investigation of doctors giving talks sponsored by drug companies. It concentrated on doctors employed by colleges and universities. And it found out that despite new rules in place designed to combat this practice, some doctors were doing it anyway.

Naturally, they were shocked, shocked, to discover that gambling was going on in their bars. No, they were shocked to discover that the rules applied to them. Here, according to The Chronicle, is Dr. Alan Yeung, vice chairman of medicine and chief of cardiovascular medicine at Stanford, who had made $53,000 from Eli Lilly since 2009:

"I take full responsibility for this error. Even though I felt the activities were worthwhile educational endeavors, the perceived monetary conflict may be too great."

Perceived? May? Look, if you're a doctor, particularly a respected doctor, a doctor admired by other doctors and by students, who gives lectures, even benign lectures, while associating himself with a drug company that just happens to make drugs that help or purport to help the maladies he's lecturing about, there is no "perceived" about it - it's a conflict. And "may"? Does that mean he still has doubts? Is he mad at those messy old regulations?

I have no idea whether the treatments he was pushing were the best possible ones or not. Let's say they were. Still, he had students and other doctors watching him, learning how fancy doctors operate - take the money and sleep comfortably, because that's how it works.

Some doctors go further than Yeung - they actually use slides prepared by the drug companies. One of those, according to The Chronicle, is Dr. David Jablons, chief of thoracic surgery at UCSF. He uses Lilly's slides to discuss lung cancer, but he would "unquestionably refuse" to say anything he didn't believe. I refer you to the Sinclair quote above.

I have unfairly picked on these two doctors. There are hundreds of doctors coast-to-coast who give sponsored speeches like this, and thousands of doctors who go to the speeches and eat the free lobster tails and collect the free fountain pens. Who can say whether all that largesse influences their prescribing patterns, but the drug companies keep pretty close tabs on what medications doctors prescribe.

See, because at the end of the chain that starts with the prestigious doctor giving the well-compensated speech is the patient, getting a brand-name drug where a generic would do, or where no drug is needed. As genteel as it all seems, as beleaguered as the lecturing doctors may feel, it's we who end up paying for the doctors' attractive be-logoed briefcases.

I promise you, the effect he writes of succeed unhappily, as of unnaturalness between the child and jcarroll@sfchronicle.com.

This article appeared on page F - 8 of the San Francisco Chronicle