Tuesday, December 2, 2008

More Frederick Goodwin Developments

There have been a few developments regarding The Infinite Mind scandal since yesterday. Pharmalot posted a statement from Dr. Goodwin rebutting the New York Times piece. This statement had originally been published on an APA listserv, and was apparently leaked to Pharmalot--though not by me. I wrote directly to Dr. Goodwin to ask him if this statement was actually his, and whether I could post it, and he wrote back saying that he would send me a shorter version of the statement, which I'll post when I receive it.

Meanwhile, NPR's show On the Media aired this interesting 8 minute segment on the issue, which is worth a listen, because it brings these issues into perspective. Specifically, the host David Folkenflik points out that NPR is by definition a source of unbiased news, being the only major radio network which does not accept advertising. Thus, for it to air a show hosted by a psychiatrist who did not disclose $1.3 million in industry payments was a particularly outrageous betrayal of the listeners' trust.

Finally, you must check out this elegant essay by Jonathan Leo, which deconstructs, quote by quote, the notorious "Prozac Nation Revisited" show, during which Goodwin interviewed guests who shared his belief that the antidepressant-suicide connection is overblown. As it turns out, I mostly agree with Goodwin on this issue, but that's irrelevant. Whether antidepressants cause suicidality is a controversial point, with very complicated data on both sides of the argument. Goodwin brought together experts with clear financial interests in arguing for the drugs' safety (Nada Stotland is an exception, since she was there representing the APA and has no current pharma ties). Furthermore, the segment itself was partially funded by Pfizer, maker of Zoloft. The point is that the public was offered only one side of the debate, without having been informed of the fact. That's bad journalism.

Goodwin has been arguing that his pharma ties were available to anybody who chose to Google him, but this doesn't meet basic journalistic standards. Listeners should be able to trust NPR, and should not feel the need to rush to the internet to check up on every expert featured. That's why we suffer through those pledge drives!

5 comments:

James M. La Rossa Jr. said...

I respectfully submit that even the most robust debate on medical ethics distinguish between those "thoughtleaders" who influence drug research and marketing as a byproduct of their influence, and those physicians whose entire modus operandi is to attract income from industry.

I have known Dr. Fred Goodwin for 15-years. In the process of writing and conducting dozens of manuscripts and interviews, he has never once asked for compensation. He has organized numerous panels in Washington and elsewhere--often assembling eclectic participants such as William Safire--about ethics without any industry tie-ins. His NPR program has been integral to the public's increased awareness about the brain sciences.

Balance is not easy to strike in any debate. I do not think that Goodwin deserves to be painted with the same brush as others exposed on this blog and in the general media who have compromised their primary roles as healers. That is certainly not the case re. Fred Goodwin.

Frederick K. Goodwin MD said...

I was very saddened and disappointed to read Dr. Carlat’s post. While he and I may disagree on certain issues, I had always assumed that he adhered to minimum scholarly standards in his writings, standards that are expected of professionals with academic backgrounds.

While I was taken aback by the polemical over-the-top language from a colleague with whom I worked in a recent American Psychiatric Association symposium, e.g. “outrageous betrayal of the listeners trust,” I was most profoundly dismayed by statements that were simply not true. (And can easily be shown to be false.) For example, he said that “Goodwin brought together experts with clear financial interest in arguing for the drugs’ [SSRI’s] safety.” First, he ignored what I said in the statement that I had sent him before he posted this blog, namely, that the producer of the Infinite Mind, not the host, reserved for himself full responsibility for the selection of topics, selection of guests, preparation of the script, and even the questions to be asked.

If Dr. Carlat did not believe me, but still wanted to protect his own credibility, he easily could have checked this out with Mr. Lichtenstein, the show's producer, or I would have been happy to send him a copy of the contract which specifies the producer’s total control of content. The fact that he went ahead with his own version of reality, in the face of assertions to the contrary in his possession, (assertions which he apparently did not check out) is reminiscent of what the Times’ Gardiner Harris did in simply ignoring any reality that didn't fit his narrative.

(Incidentally the particular show that Dr. Carlat was discussing was put together in a hurry by Mr. Lichtenstein working alone because he wanted to get something on the air to reassure stations that he could still produce a new show now and then. I didn't even know who the guests were until I arrived at the studio and got the script that had been faxed directly to the radio station. Mr. Lichtenstein later acknowledged that he had not determined in advance that one of the guests was affiliated with a center getting funds from a pharmaceutical company. While this was not disclosed, as it should have been, it was an oversight by a vastly overworked producer. But that's a minor point.)

More damaging to Dr. Carlat's credibility is his loose throwing around of reckless charges referring to “experts with clear financial interests in arguing for the drugs’ [SSRI’s] safety.” Incidentally by referring to Zoloft in this context he seemed not to be aware that this drug has been available in a generic form for some time now. One would like to assume that the author of a pharmacology newsletter would be aware that once drugs become generic there is no further “promotion” by pharmaceutical companies and therefore no “clear financial interests” of anyone. His sweeping statement is more than naïve - it's recklessly damaging the reputation of distinguished academic scholars such as a professor at UCLA. Many of the readers of his blog may not understand how naïve it is to talk about “promotion” of a drug that's been off patent. Dr. Carlat must assume responsibility not only for misleading his readers, but also for recklessly and falsely damaging reputations. To use his phrase, “that's bad journalism.”

But he gets even more reckless. He asserts as fact that “ the segment itself was partially funded by Pfizer, the maker of Zoloft.” Where did he get this information? From a Scientology website? Unless Dr. Carlat can document this, he owes me, the Infinite Mind producer, the guests, and, especially his readers, an apology.

Dr. Carlat’s blog is, to use his own words, a “particularly outrageous betrayal of the [readers] trust,” readers who have a right to assume that his statements reflect the standards associated with professionals in academia.

Frederick K. Goodwin M. D.

John McManamy said...

Hi, Dr Carlat.

The "bad journalism" lies in the NY Times, not "The Infinite Mind."

"The Infinite Mind" show in question, at best raises some minor quibbles. The content, itself, is sound.

The disclosure issues were the responsibility of the producer of the show, not Dr Goodwin.

The NY Times reporting about Dr Goodwin, on the other hand is reckless and unethical. The facts are wrong, and have been manipulated to raise the innuendo that he was suppressing information to increase drug sales. We should all be outraged at this form of character assassination.

You can read my two blog posts on the topic:

Frederick Goodwin - What the NY Times Left Out
http://www.healthcentral.com/bipolar/c/15/49780/frederick-goodwin-ny

Frederick Goodwin - Why the NY Times is Wrong.
http://www.healthcentral.com/bipolar/c/15/50902/frederick-goodwin-ny

Don't get me wrong: I share your concerns about the corrupting influence of the drug industry on psychiatry. But it's time to stop squabbling amongst ourselves. The NY Times has gone rogue. We need to stand as one against this kind of outrage.

John McManamy
McMan's Depression and Bipolar Report
Living Well with Depression and Bipolar Disorder
2007 Recipient, Mogens Schou Award for Public Service

John McManamy said...

Hi, Dr Carlat.

The "bad journalism" lies in the NY Times, not "The Infinite Mind."

"The Infinite Mind" show in question, at best raises some minor quibbles. The content, itself, is sound.

The disclosure issues were the responsibility of the producer of the show, not Dr Goodwin.

The NY Times reporting about Dr Goodwin, on the other hand is reckless and unethical. The facts are wrong, and have been manipulated to raise the innuendo that he was suppressing information to increase drug sales. We should all be outraged at this form of character assassination.

You can read my two blog posts on the topic:

Frederick Goodwin - What the NY Times Left Out
http://www.healthcentral.com/bipolar/c/15/49780/frederick-goodwin-ny

Frederick Goodwin - Why the NY Times is Wrong.
http://www.healthcentral.com/bipolar/c/15/50902/frederick-goodwin-ny

Don't get me wrong: I share your concerns about the corrupting influence of the drug industry on psychiatry. But it's time to stop squabbling amongst ourselves. The NY Times has gone rogue. We need to stand as one against this kind of outrage.

John McManamy
McMan's Depression and Bipolar Report
Living Well with Depression and Bipolar Disorder
2007 Recipient, Mogens Schou Award for Public Service

Gina Pera said...

Thank you, James, for a rational perspective on this ongoing witch-hunt.