The propriety of giving paid speeches has been a subject of debate for many years. Readers may wonder whether appearing before a group biases a writer towards the group’s point of view--or whether writers are tilting their work in ways to generate more speaking income. It’s a particularly acute issue in health care, the issue I cover most frequently, given the ample evidence that drug and device makers have used free perks to influence the prescribing and treatment habits of physicians.

But speaking events can also provide opportunities to reach different audiences, which are a logical and, I believe, worthwhile extension of a journalist’s work. And, of course, the extra income is nice to have. Particularly at a time when the direct financial support for journalism seems to be dwindling, paid speaking can enable other activities, like giving free speeches to non-profit community groups or, say, working at political publications notorious for their low salary scales.

Approaches to paid speaking vary enormously: Beat reporters covering an industry for a newspaper tend to be subject to strict rules, under which paid outside speaking may be prohibited altogether. Opinion and magazine writers, as well as public intellectuals who communicate with the public primarily through books, tend to operate under much looser restrictions or no restrictions at all. Where does that leave me? I believe my work puts me somewhere between categories. I focus heavily on one issue, but I write about many other topics, too. I report, but I’m also free to express my opinions. I’m a journalist, but I’m also a purveyor of ideas and book author.

To date, the approach I’ve taken has been three-fold.

First, I avoid speaking primarily to one group or set of specific interests. Second, I am represented by a speakers bureau that handles all arrangements for my paid engagements. Groups deal with me through the bureau and sign a contract guaranteeing my editorial independence. They invite me based on my past work, which espouses a clear line of argument, and are told to expect a lecture consistent with that viewpoint. (For an example of my speech, which changes little from venue to venue, go here.)

Third, after obtaining my editors’ approval to do paid speeches, I asked that a short disclosure statement be appended to my online biography. It said that I do “public speaking about health care policy, sometimes for money and before groups with a direct financial stake in the issue (including unions, physicians, nurses, consulting firms, and drug companies).”

I believe that these steps have insulated, and will insulate me, from the potentially corrosive effects of paid speaking, at least sufficiently to make the speeches worthwhile. But ultimately readers must make this decision for themselves. That is why, as of November, 2008, I am have decided to expand my disclosure statement by providing readers with a list of every group that has sponsored one of my speeches, both paid and unpaid. By making available this information, I hope to equip readers with the information necessary to judge my reliability.

In addition, I have started giving the fees from health care industry groups to charity. 

Feedback is welcome, even encouraged. You can send it to me, and my editors, at letters@tnr.com.

Below is a list of sponsors for my speaking engagements, not including bookstores and book festivals. Asterisks (***) mark the events for which I was paid an honorarium or speaking fee. I will update this list regularly:

American Association for the History of Medicine

American Boilermakers Manufacturers Association***


American College of Chest Physicians***

American Medical Students Association

America’s Health Insurance Plans*** (Fees donated to charity)

American Society of Clinical Oncology*** (Fees donated to charity)

Association of American Physicians and Surgeons***

Brown University***

The California Endowment***

California Nurses Association

The City Club (Cleveland, OH)

City Commons (Portland, OR)

Community Unitarian Universalists of Brighton/Voter's Voice (Brighton, MI)

Drew University School of Humanities***

The Eastham Public Library (Eastham, MA)

Eli Lilly***

The Henry J. Kaiser Family Foundation

Human Arc***

International Union of Bricklayers and Allied Craftworkers***

Loyola School of Medicine***

MassINC (Boston, MA)

Michigan Universal Health Care Action Network

National Academy of Social Insurance

National Congress on the Un and Underinsured

Nichols College***

The Prevent Cancer Foundation***

Proctor & Gamble***

Siemens***

The Donald & Paula Smith Family Foundation***

Susquehanna University***

Society for Humanism in Medicine***


Town Hall (Seattle, WA)

University of Chicago School of Social Work***

University of Michigan Medical School

University of Michigan School of Public Health

University of Southern California/Annenberg School of Communication***

The Venice Free Clinic (Venice, CA)

The Victor Vaughn Society (University of Michigan)

Yale University Department of Political Science