Tuesday, December 11, 2007

From Embarrassment to Scandal: Lilly + APA + The Psychiatrist's Program + Lots and Lots of Money

What began as an embarrassment of Eli Lilly, PV Updates, and PRMS is gradually becoming a full-fledged scandal. The Indianapolis Star picked up the story last weekend (read it here), and psychiatrist David Port, M.D. wrote me a letter alerting me to an expanding crisis of trust in psychiatry. Here is an excerpt:

"Whatever Lilly's justification for sponsoring a course ostensibly to help the psychiatrist to better deal with professional liability risks, I am outraged that PRMS has accepted money from Lilly and has chosen to offer its authority and reputation toward this Lilly effort. PRMS is the American Psychiatric Association-endorsed entity which directs APA members to a selected malpractice insurance agency. PRMS is thus the agency many or most of us psychiatrists turn to for guidance and direction as to liability exposure and malpractice coverage. For PRMS to work for Eli Lilly is a glaring conflict of interest between their psychiatrist clients and a pharmaceutical corporation whose interests do not necessarily coincide with those of the psychiatrists with whom they have a professional relationship. This is analogous to the same law firm representing two individuals opposing one another in a law suit; in that situation we assume that there cannot be fair representation of either client, and we may imagine that the client with an attorney who has more clout in the law firm may well prevail in the action. How can we trust PRMS, or the APA for that matter, to provide us with the best liability support? David Port, M.D."

Yes, it's true. PRMS runs The Psychiatrist's Program, a malpractice carrier that is officially endorsed by the APA.

I know, it can get very confusing. Let's follow the money. Eli Lilly gives the APA at least $1.3 million in 2007 (so far) for industry-supported symposia and fellowships. Lilly then gives PRMS a bunch of money (Lilly refused to tell John Russell at the Indy Star how much) to produce a web-based slide show teaching psychiatrists how to prescribe potentially toxic medications like Zyprexa without being sued. The APA officially endorses PRMS' psychiatry malpractice insurance for its members. Does APA receive any type of kickback for this endorsement? I assume that would be illegal, but who knows?

Look, I get as annoyed by conspiracy theorists as the next guy. But the web of money and influence here is so murky and repugnant that it leaves me wondering what's going on. I officially invite both the APA and PRMS to respond. And I'd love another diplomatic letter from Eli Lilly!


Anonymous said...

I just read your article in Dr. Ben Kim's newsletter as well "One Psychiatrist's Experience Working With Big Pharma" Very eye-opening, but not shocking to truth seekers who follow the money trail in hopes of keeping themselves and their families healthy and protected from Big Pharma. Dr. Kim is fearless in his attempt to teach the truth, and you seem to be as well, but at what risk?

I know you wondered how your actions might have had a negative impact on some patients, but I wonder how the people pushing useless, dangerous, life-threatening vaccines on innocent children sleep at night. Talk about setting up a future customer base by injecting their poison into children and either killing them or causing life-long chronic debilitating illness, which by coincidence they have a drug to treat. Another fellow hero, Dr. Donald Miller, a Harvard trained physician, wrote an article on the subject that is quite eye opening and has probably saved the lives of countless children. “A user friendly vaccination schedule” and “An important update to this vaccination schedule”

Personally, I would be afraid to do anything publicly that might affect the profits of these drug companies, since the regard for human life is so low on their priority list. The old adage, never mess with another man’s livelihood comes to mind.

Ultimately, with the power of knowledge at our fingertips, people have some responsibility in their own health care. I feel that I have 100% responsibility for my family’s health care, but I seem to be in the minority. I try to bring to the attention of people I know, the fact that doctors see an enormous amount of patients on a daily basis; when do they think their doctors have time to do any kind of research on their own, not just the research information being fed to them through the drug reps? Their doctors may not have the time or incentive, even though their ignorance is hurting and killing their patients, but surely family members do. It is the sacred cow people do not question, and unfortunately they will have to live with the consequences of their ignorance.

I thank you Dr. Carlat for your honesty and commitment to the truth.

Anonymous said...

Dear Nick:

Do you have citations handy for Dr. Donald Miller's articles, “A user friendly vaccination schedule” and “An important update to this vaccination schedule?” If not, I'll do a search. No worries. Thank you. Regards, jim