Is No Free Lunch paternalistic?

Pharm Aid and Dr. RW comment:

The web listing of No Free Lunch pledge adherents has yet to appear on line despite having been promised on the site for several years. One wonders if more than a small handful of doctors has taken the pledge. Indeed on close examination very few practicing physicians, at least in the United States, could honestly sign the pledge because of this requirement: “to avoid conflicts of interest in my practice”¦.” That pretty well disqualifies most doctors who practice medicine for a living. Depending on our compensation model most of us practice under either positive or negative financial incentives. These incentives influence the types and numbers of patients we see, the procedures we do, the tests we order and our referral patterns. Compared to the measly drug company pens, note pads and lunches these conflicts are much more powerful. They’re about real money and they impact each and every patient encounter.