Corrupt New World

One decade ago when I began my career as a reporter, I was drawn to writing about science and medicine as much as I could. I had worked as a pharma rep and held docs in very high esteem. What's more, I had a decade under my belt as a psych patient and while I wasn't in awe of psych docs the same as I was cardiac surgeons, I nonetheless held them in high esteem as well and figured that patients and commentators who criticized them didn't know what they were talking about and were a danger to other patients. There was a time when I could've written some of the "we love SSRIs" articles that used to appear in the New York Times. Not that I felt SSRIs worked based upon my personal experience, but because I was part of the big old American groupthink on meds and couldn't bring myself to face the ugly reality that the system of care in the mental health world--and indeed my own personal mental health care--was deeply corrupt in many of its intellectual precepts and much of its evidence. Really.

I'm not sure when my thoughts on psych docs and patients and our screwed up mental health system and state medical boards turned more skeptical and critical. It was an evolution, hard won at that--both personally and professionally.

I mention this in connection with an article in yesterday's Times wherein the paper notes that psychiatrists who've been disciplined by Minnesota's state medical board have nonetheless been hired by pharma companies to recruit patients for studies, run clinical trials and give marketing talks about psych meds to other doctors. The reason the paper was able to uncover this situation in Minnesota is because of a unique public records law in that state which--if I recall--requires docs to report what companies give them money. All states should have this system. Patients, especially those with chronic conditions, have a right to know. That right is absolute especially if, like me, you believe in a free market of information in the medical world instead of the ginned-up world of denial and fudged research we now have.

I cannot even get into how massive I consider the ethical breaches on the parts of docs and pharma companies--Lilly, J&J and AstraZeneca are all at the party--uncovered by the Times. PhRMA, a trade group, declined to comment for the article. The FDA said it clearly needed to overhaul its system of monitoring who gets to do clinical research. No kidding.

Tellingly, one medical ethicist who commented for the article said:

"Dr. David Rothman, president of the Institute on Medicine as a Profession at Columbia University, said the Times analysis revealed a national problem. 'There’s no reason to think Minnesota is unique,' Dr. Rothman said.

“'Clinical trial investigators must be culled from only the finest physicians in the country,' he said, 'since they work on the frontiers of new knowledge. That drug makers are scraping the bottom of the medical barrel is an outrage.'"

Outrage is putting it mildly. And you almost don't know where to start with some of these docs who were getting over $300,000 in payoffs from pharma companies while being in a heap of legal trouble. Read the article for the details.

Of course, if pharma companies have been this successful in ginning-up the mental health world, it almost makes you wonder how clean their hands are with, say, cardiac care, diabetes care and so on. We already know how they've cobbled up the pain management world (i.e., Vioxx). But, then, maybe I am being a bit too skeptical.

On another front, let me once again congratulate the paper for continuing to investigate the psych med world. There's much more there and I look forward to seeing it. However, I am confused as to why much of the rest of the print world and all of the television news world has been silent on these matters. If this is going on in Minnesota, then it's going on...everywhere. It's the press' job to look into such things even if the Times got there first.