Recent articles and editorials in major medical journals blast the industry while accusing drugmakers of deceiving the public, manipulating doctors, and putting profits before patients. Medical schools, teaching hospitals, and physician groups are also changing rules to limit the influence of pharmaceutical sales reps. As more voices have called for change, new guidelines for how drugmakers and doctors should interact are coming from both industries. But the industries' dealings remain fraught with potential conflict because the sectors depend on each other so much.