I am sorry that it has been so long since I put up a post.  Things have been slightly hectic. Unfortunately, instead of reporting on new infectious disease information, with this entry I find myself responding to a story about my receiving payments to lecture from the pharmaceutical industry.  The story ran today (3/13/13) in the Philadelphia Inquirer and online at

When the original print story was run I had not had a chance to respond to the author, reporter Sam Woods.  I give Mr. Woods credit for updating the online story in response to some of my comments, reproduced below, which I emailed to him this morning.

I feel that the Pharma Industry has done an excellent job in disseminating important information that may otherwise not be available to those of us interested in saving limbs of patients with diabetes.  This is done in an unbiased, government approved and monitored way, under strict federal guidance.  My lectures are randomly, and independently audited for compliance with these guidelines and I have never been found to be deficient.

Here is my response to Mr. Wood in its entirety:


I read your article from today in  Just to respond to a few items:

1.   I did not call you yesterday since my family was at my father’s deathbed.  We lost him last night at 7PM.  You will probably see the obit in the Inquirer in the next day or so.  I had every intention of contacting you this morning (as I am doing now)

2.  As to responding to ProPublica, they phoned me while I was out of the country lecturing at a continuing education (non Pharma sponsored) meeting.

3.  All of my lectures given for the Pharma industry follow strict FDA guidelines and are consistent with the corporate integrity agreements entered into between the companies and the government.  There is full disclosure of this fact at all lectures.

4.  I have not worked at the Coatesville VA in a number of years.  I strictly work out of Roxborough and am a private, self-employed citizen; not an employee of any company, government, hospital, or health care organization.

5.  Thank you for at least quoting the article from last year.  I stand by what I said there.  Some organizations have an agenda to make interactions between Pharma and doctors somehow seem nefarious.  Let me give you some statistics if you want the REAL story:  There are 28 million people in the US with diabetes.  About 350 million worldwide (and yes, I have lectured around the world on this topic).  It used to be said that someone in the world loses a limb to diabetes every 30 seconds.  That is now down to every 20 seconds.  Diabetes is the cause for about 70-80,000 amputations per year in the US alone.  The single greatest cause. The 5 year mortality of people who present to their doctors for the first time with a diabetic foot ulceration is HIGHER than the 5 year mortality for breast cancer, prostate cancer and Hodgkin’s lymphoma.  If you add peripheral arterial disease to that, the 5 year mortality is even higher than colorectal cancer.  Diabetic foot infection accounts for about 33% of the >$100 BILLION spent on patients with diabetes each year and accounts for the greatest number of hospital days YET the NIH only provides <0.2% of all of their diabetes funding to study foot complications (soon to be presented new data).  The vast majority of research in the treatment of diabetic foot infections has been done by the private sector including the Pharma industry.  Yes, I go out and spread this information to my colleagues and it is often paid for by industry. However, by doing so I know I have saved countless limbs and lives.  Frankly, I don’t see anything nefarious about that…only good.

Kind Regards,

Warren Joseph, DPM, FIDSA

Consultant, Lower Extremity Infectious Diseases