"Few doctors have heard of the world's leading medical public relations companies - Edelman, Ruder Finn, Noonan/Russo Presence, the Shire Health Group, and Medical Action Communications, among others," write Bob Burton and Andy Rowell in the British Medical Journal. "Yet barely a day passes without most doctors or their patients being exposed to messages that have been carefully crafted by these public relations companies, aimed at boosting sales of their clients' drugs." Several other articles in the same issue of the BMJ [3] examine the ethical conflicts of interest involved in drug company PR and the crisis of confidence they have helped create for the health care industry.