I believe it is important to give credit where credit is due. The current issue of the American Journal of Psychiatry features a commentary entitled "Conflict of Interest--An Issue for Every Psychiatrist." The article is authored by all 23 editors and editorial board members of the journal, with additional contributions from three others. This is a who's who of psychiatry, including Jerry Rosenbaum, the psychiatry chairman at Mass General, Robert Freedman, the Editor-in-Chief of the journal, Nancy Andreason, winner of the National Medal of Science, and many others.
Furious Seasons criticizes the piece for being too vague and offering no specific solutions, but I see it differently. The authors do a good job of laying out the major issues related to conflicts of interest in psychiatry, and in fact they do have some specific recommendations:
"More acceptable alternatives—-industry support of education through unrestricted gifts to APA, universities, or other public institutions and journal advertising that resembles sponsorships on public television rather than network prime time commercials—-will likely result in less financial support than we currently receive for our professional activities, because this financial support would no longer be assumed by the companies as part of their marketing strategy. The subsidy that each of us has been receiving is part of what has fueled the excesses that are currently under investigation. Accordingly, in the future it may cost more to attend meetings, to earn CME credits, and to receive journals."
It seems to me they are recommending that industry money be disconnected from specific educational programs, and instead should be donated to medical societies and universities into pools of money that can be used to fund any education, even programs that don't serve the specific promotional aims of the funders. If instituted, this would represent a huge change in business as usual.
Perhaps they are vague in not naming names--but when they reference "congressional hearings and articles in the New York Times or Boston Globe" it's pretty obvious who they are talking about. Look, this is a guild, folks, and you don't smear members of your own guild (unless you are as reckless as I am!). I think it is remarkable that these 26 authors were able to agree on a document that is pretty critical of industry's coziness with psychiatry--especially since many of them are direct beneficiaries of industry's largesse.
On another note, while the Furious Seasons post quoted me accurately in the opening paragraph, it was pulled from a different context--namely a December 1 posting in which I was responding to recent revelations on serious conflicts of interest regarding Dr. Biederman and Dr. Goodwin. The comment was meant to point out that if psychiatry were a patient, it would need ICU treatment to pull it out of its ethical crisis. The fact that the leaders in the field could have written this AJP commentary shows that the patient is looking much healthier.