Recognizing the negative public effects, actual and attitudinal,24–25 of industry largesse toward medical professionals and fearing increasing federal regulation, a variety of professional organizations and the pharmaceutical industry itself have promulgated guidelines attempting to limit and define acceptable practices for transactions between industry and clinicians.33 As rules and recommendations seek to limit the more egregious transactions between industry and clinicians, alternatives arise. For instance, generously reimbursed clinician participation in industry “focus groups” or “advisory panels,” where input and expertise is nominally but not actually sought, avoids prohibitions on gift giving. Many of the new guidelines provide for specific monetary limits on the value of gifts and vague restrictions on how often they can be received, with only the guidelines of the American Medical Student Association recommending the refusal of all gifts, no matter how small, provided by industry. Although compelling on its face, limiting the receipt of gifts based on monetary value assumes that “low-value” gifts are less ethically troublesome, presumably because they are less likely to influence behavior. (Every doctor may indeed have a price, but it is presumably over $100.) Unfortunately, no empiric evidence demonstrates a threshold effect of gift giving, a practice that most often induces change through the development of generally positive sympathies toward the giver rather than an explicit quid pro quo.,29 The receipt of gifts of any size, it appears, can effectively align a clinician’s interests with those of industry, creating a conflict of interest that may go unrecognized.