Wednesday, May 20, 2009

Med Page Today Interviews Dr. Paul Appelbaum and Me on Industry Relationships

Yesterday, John Gever of Med Page Today interviewed me and Dr. Paul Appelbaum on various topics about the relationship between the pharmaceutical industry and psychiatry, which I have posted above for your viewing pleasure. Dr. Appelbaum is a former president of the APA and is the chairman of the "Ad Hoc Work Group on Relationships Between Psychiatrists and Medical Industries." He and the members of this group have drafted a report with recommendations for how we can clean up our act. While the report has not yet been formally approved by the Board of Trustees and is therefore not public, I can tell you that it contains many of the same elements as the recent Institute of Medicine report, which I described here. Appelbaum's report was discussed in the APA Assembly on Sunday and the review was frankly somewhat mixed. What will happen next is that the Board of Trustees will continue to elicit feedback from the APA membership and will eventually vote on whether to adopt some version of the current report. My prediction is that the current version will be adopted with very few changes, but that's only a prediction (I'm not a member of the Board, just the Assembly).

There have been a number of excellent symposia over the last few days on how to set the right distance between doctors and commercial interests and I'm coming away from this meeting with high optimism that we are really turning a corner in our profession.


Gina Pera said...

The video kept stopping (maybe my computer's problem), so I didn't watch it all the way through. But I thought you articulated a well-balanced perspective, Dr. C.

therapyfirst said...

As a last comment to this blog site, I know you are trying to be the mensch and fight battles with respect and politeness, but, you are battling an enemy that is so rigid and inflexible due to the money, power, and prestige these good ol' guys and gals accumulated before you and I started practicing. They will not compromise or negotiate, just give little exercises in what is considered expendable, and people like you will be fooled and feel respected and appreciated. But, in the end, you aren't respected or appreciated, or this debate would be over. Physicians who know better would do what is right. But, the ones who make the difference haven't, eh?

The people who run the APA, lead at universities, and are the big wigs in private practice have no conscience or soul, or they would not have allowed managed care and big pharma to get away with what they have forced on us. I leave you and the readers with what I have said repeatedly, and still feel it applies now:

Deeds, not words, are what define us. You do what is right, not what is convenient or easy. I know in my heart a sizeable majority of our colleagues are lost. And DSM V will be the final nail in the coffin that buries psychiatry as it evolves now.

Good luck, good wishes, and more good times than not.



localdoc said...

APA was indeed awash with self-congratulation - which might be expected when only one side of the argument is represented. How many of these horribly conflicted academics, or even industry representatives, participated in the panels?

Like it or not, we work with these guys (yes, mostly guys) or we wait for another generation of me-too drugs and slow-to-emerge side effect data. Seems to me the relevant discussion is what the parameters of these relationships should be - rather than vilifying collaborative relationships in the first place. But having these parameters be defined by folks with little or no understanding of how drugs are developed, studied, and marketed seems misguided to me.

And therapyfirst, your gift for cutting through nuance to get to the underlying diatribe and paranoia is, as always, appreciated. It is, indeed, all part of the conspiracy - but don't tell.

James M. La Rossa Jr. said...

I echo Gina's sentiment as well, DC. You are the right person to bring this debate to the surface and for that we are all grateful.