Monday, April 21, 2008

Pentagon Borrows Techniques of Commercial CME

While this blog generally focuses on how physicians sometimes manipulate information in response to financial incentives, last Sunday's New York Times covered another category of corrupted information brokers: military analysts hired to interpret the news. In a devastating expose, David Barsow details the ways in which the Pentagon has groomed former military men to deploy the official White House message to national TV audiences.

Any reader of this blog will immediately recognize the same techniques used by hired gun M.D.'s—the highlighting of the positive while downplaying the negative, the hidden conflicts of interests, the rationalizations, and, ultimately, the damage done to our nation’s sense of morality.

Television networks have long hired retired generals and colonels to serve as “independent” military analysts, brought on to help the public understand the meaning of the latest developments in war. Yes, they were once part of the military establishiment, but we assume that in their retirement they no longer have to answer to anyone, and they can provide a clear-eyed interpretation of confusing war-time events. At least, that’s the theory.

The truth is very different. “Hidden behind that appearance of objectivity,” says the Times, “is a Pentagon information apparatus that has used those analysts in a campaign to generate favorable news coverage of the administration's wartime performance….”

As a result of a lawsuit, the Times forced the Defense Department to release 8000 pages of e-mails and meeting transcripts detailing how these analysts are paid to say nice things about the army. According to newspaper, “internal Pentagon documents repeatedly refer to the military analysts as ‘message force multipiers” or ‘surrogates’ who could be counted on to deliver administration ‘themes and messages’ to millions of Americans ‘in the form of their own opinions.’”

The parallels to the industry-sponsored CME industry are eery. In both cases, “key opinion leaders” are paid to deliver the company message (the Pentagon uses the term “key influentials”); old boy networks ensure that friends reward friends; and e-mail trails of damning communications eventually expose the sham.

Unfortunately, military analysts and industry-sponsored CME are not the only examples of our country’s burgeoning culture of deceptive information-brokers. In the last couple of years, we’ve read about college loan officers referring students to banks in return for kickbacks (1) ;
financial analysts entrusting their customers’ money to certain stock brokers in return for golf and gambling vacations (2) ; and government officials accepting lavish gifts from lobbyists for decisions that enrich their clients (3).

The moral? As information becomes more complex and specialized, it becomes more valuable to stakeholders. And where there is value, there is the opportunity for corruption, whether in medicine, the military, or any other field.


Anonymous said...

A baffling posting, I must conclude. Politics and medicine, there are overlaps It is about evil in the end, whether or not that is an oversimplification. As has been said before, when good men lie silent, evil thrives. So skew the information that drives education, and the masses will be indoctrinated with falsehoods and empty promises.
Would the APA President give a quote for the record to you, Dr C?

No, the old guard has no investment in its apprentices or those it was to serve. "Old boy networks ensure that friends reward friends", per your posting. Cronyism and self interest are prevading principles these last 3 decades. Thank you Ronald Reagan and your ilk; "greed is good" per the movie Wall Street, THE defining movie at the end of that administration It is still reality at the end of the day. I hated it in med school, hated it in residency, hated it in jobs that had lots of politics.

I'm glad my father grew up in the times of the Depression and WWII. That was the last generation that truly understood the needs of the many outweigh the needs of the few. His philosophies resonate in me. What a selfish brew we have stirred these days. Well, you are trying, right Dr C?

Supremacy Claus said...

This article just proves the NYT is a hate sheet spreading left wing hate propaganda. It has nothing to do with psychiatry, except to show the pervasiveness of your left wing bias. It further detracts from your credibility.

Anonymous said...

What a crap comment I gave above. I guess I read today's posting and just lost it. It doesn't matter what venue you are in these days, there is just too much politics, special interests, and personal gain people are focused on.

the part about my father, that I would not retract or reframe. People of my generation or more recent periods don't know universal pain or struggle. Maybe the silver lining to a strong recession, or perhaps worse, will help this society gain some insight and judgment.

Perhaps the analogy to today's posting is this struggle to get control of physician education is a war. We just need some responsible generals to speak up for those in the trenches.

Supremacy Claus said...

"... the same techniques used by hired gun M.D.'s—the highlighting of the positive while downplaying the negative, the hidden conflicts of interests, the rationalizations, and, ultimately, the damage done to our nation’s sense of morality."

That has never happened. Dan may have felt a need to do that. No one else has ever done that.

soulful sepulcher said...

TF: you need a therapist.for as many times as you say you refuse to be ignited by SC comments, you are, and for as many times you have stated on this blog (and mine!)you will refrain from commenting; well: Dr.C owes you no explanation for your insecure demeanor, and I suggest you take a very long vacation. this will hurt: i've been there and done that and though you want to help others, you are in dire need of some "off time".

Supremacy Claus said...

Steph: I hope that you and TF understand. I am arguing only in favor of your freedom to choose and for the freedom of speech and the freedom association for clinicians. The left has a lust for domination. I see Dan and TF as victims of wrongful lawyer propaganda. Their unwittingly act as Trojan Horses for the land pirates.

Anonymous said...

my mistake, being involved with blogs. Dialogue gets old when you are looking for change. Too many opinions, not enough results.

goodbye to all, and good luck.

Supremacy Claus said...

TF: It is a good idea to get involved with blogs. This is the place to test ideas, get rebutted by people who mean you well. It is a safe place to thrash ideas before facing the vipers in court or in policy debate.

How would Dan like to hear my questions from an industry influenced adjudicator of some sort, and for the first time? He has yet to cite a concrete harm from drug promotion to a real world patient. This is all left wing pretext, and bogus scapegoating, so far. I await the first fact that contradicts that conclusion.

soulful sepulcher said...

TF how the heck does one get results if one gives up and stops persuing change? If as you have stated before this blog might help further change [in your industry] then stop throwing unprofessional sounding fits and don't blame lack of change on blogs. Too many opinions? How can there ever be too many? OK so let's shut all of the blogs down and go back to our corners. Honestly, for a therapist/doc you whine a lot.
Sorry but true.

Anonymous said...

Interesting comments here. I had seen this article and emailed the link to Dan since it had the same theme he addresses about drug companies and medication.

TherapyFirst: I'm sorry you have been taking such a beating. Having a bit of knowledge of history I don't find these times much different from other times in history. Perversion of truth and manipulation of data has been the rule. Even the WWII generation, or at least our leaders, did that as the internment of the Japanese Americans should show. I hope you can find support so that you can continue to stand up for your values. ("If we do not hang together, then assuredly we will all hang separately" attributed to Ben Franklin prior to the signing of the Declaration of Independence.)

PS. In an earlier post you asked for some disclosure. I am a psychiatrist in private practice where I integrate meditation, CBT, and medications. I teach meditation and have written some material about it, including an article in the Psychiatric Times a few years ago.
Joseph Arpaia, MD

soulful sepulcher said...

Hey TF has not taken a "beating", TF has commented to me that I shouldn't blog about my life, and has told me he wouldn't comment on this blog a very long time ago. What I see, as a human being is that TF needs a break. Professionals need them. I teach disabled children for a living and am in this realm, and actually as off topic as this is here, wish TF well and hope he takes his own advice. Take a break. Because? it is OK to do so. [and one cannot be there for others when one is not whole themselves].

TF knows who I am, and I think knows what I am saying.

I am not 'just a patient'.

Be well.


James M. La Rossa Jr. said...

Here's the publishing point of view -- which may or may not make the cut...

This is an ingenuous premise: The money, influence and effect that the right expert with the appropriate-sounding credentials in the right place (the Pentagon in this case) at the right time is very parallel with how medicine pumps up the volume.

So Joe, if this was your idea, way to go. And DC really hit it -- a very hard thing to do -- and a really fine bit of writing. WOW!

I am surprised, though, that SC hit the LEFT WING BUTTON before acknowledging how smart and different a direction this transports us. You need some transmission work, SC. Your obviously a 5-speed, but I fear you're stuck in a low gear. Admit it -- this was a top-ten blog. (It was very hard for me to admit that disco was back. You can do it!)

This is how dumb America is getting: I just moved to Manhattan Beach -- perhaps the wealthiest, fittest, minicity of Los Angeles -- which is saying a lot. I wake early --try to get a little something done with Europe first thing, and then work on EST for most of the day and do sit-ups until dinner. Today I broke at 4 pm PCT -- just about when the Pennsylvania polls closed and started to watch the democratic returns closely; this is the last big-state primary and meant everything to Mrs. Clinton if she is to survive. I digress because between 4pm and 7pm, people of various ages stopped by to pick up kids, have a drink, deliver needless items, and everyone regarded me plastered to CNN repeating the salient points of the returns to any warm breathers in the vicinity with ... well, let's just say ... curiosity. I spend your important time to illustrate the lack of attention and caring to things like this ... so we are very much in the minority. (One would think that the kids, at the very least, would be tracking the election, no?! Meanwhile my Father's wife, a Parisian, is texting me every 10-minutes she is so enrolled in the primary ... go figure!)

For The NY Times to dedicate three columns (granted on a Sunday) to such a creative second-day lead was really different. And to recognize that the "expert talking heads" in the military are not very different than our own medical top guns is very ingenuous.

When there's a war on, I watch these Pentagon guys; hang on their every word, hope for geographical lessons and strategic underatnding. (I spent two years in the Merchant Marines and woke up in Libya one mornig being fired on when I thought I was about to go on leave in Genoa for a plate of pasta, so military strategy is not a fine point of mine.)

As far as the Pentagon experts go, I don't have any favorites (I can only reliably remember where CNN or MSNC is on my clicker), though I think that Hillary's VP will be Wes Clark, because he can truly speak to both the military and political world and has the right alter ego for the would-be-President.

These select few military talking heads depicted in the NYTs are perfectly equivalent to the medical symposia chairs we know and love. But here's the thing: I wouldn't know nearly as much about Vagus Nerve Stimulation or Gaza, respectively, without them.

So, I need them. Don't you? Come on, imagine Iraq w/out Seymour Hirsch's atom bombs in the New Yorker. Imagine psychopharmacology w/out Don Klein, epidemiology without Klerman/Weissman, ADHD w/out Biederman ... I could go on, but you know what I'm driving at.

Here's the rub: The Pentagon rummies might be more notorious, perhaps richer, but they have second-generation influence being smart enough to have "retired." Psychiatrists have a very real, tactile influence on day-to-day lives and the practice of medicine.

I have a much more technical response to the last article -- especially the published supplement, which I am still sleeping on. The "Pentagon Borrowing Techniques of Commercial CME" is not so far fetched, though. Bravo DC! A nice departure from the everyday. We certainly needed it. Thank you so much.

Anonymous said...

SC, where do you get lines like, "[They] unwittingly act as Trojan Horses for the land pirates?" You are a poet, not a lawyer/doctor/assassin/ thorn-in-the-side kinda guy! Why harp on the "left" and not go straight for the juggler -- the idea itself?!

Yours truly, anonymous. HA!

Supremacy Claus said...

Anon: I plead guilty to combining metaphoric Greek siege military deception with criminal enterprise hijacking on land.

However, I should be allowed some lapses in compositional rigor from emotion. I love the lawyer so much, and want to help correct it, I lose it sometimes.

Jim: Second gear is for court. Third gear is for the book.

Supremacy Claus said...

Is Trojan Horse metaphor or metonymy?

Anonymous said...

My rudimentary understanding is that metaphor is representative, symbolic, or even something (that has become especially) abstract. I think of metonymy as s substitution -- the most contemporary being "suit" for "business executive." While the Trojan Horse is a classic code for metaphor, the fact that you use it consistently in this context, makes me vote for metonymy. If anyone can transform a metaphor into something metonymic, it would be you.

As for being emotional, I guess that partly fuels your gymnastic linguistics. We are all prone to repetition when the blood is up, but since I come from a long line of maniacs, I am have a soft spot for people who express themselves emotionally. Yours, ANON