Friday, June 15, 2007

Welcome to The Carlat Psychiatry Blog

I decided to start this blog in order to follow up on some buzz generated by a recent New York Times op-ed in which I recommend that industry-sponsored CME activities no longer receive accreditation from the ACCME.

I've received dozens of responses, mostly supportive. A recurring theme of these comments is: don't blame only the drug companies, blame the doctors too. The Times printed this
letter to the editor saying exactly that.

It's true, everybody who stands to gain is complicit in this enterprise. The companies get a uniquely effective marketing vehicle, the medical education communication companies (MECCs) get millions in educational grants, the ACCME gets funding to continue its mission, hired-gun physician speakers get cash, prestige, networking opportunities, impact, etc...., and the doctors who attend the programs get free education. Who in their right mind would want to spoil the party?

Our patients, for one. Industry-supported CME always downplays the dangers of any product being sponsored. Sometimes, these dangers are trivial, as in the case of SSRIs. Other times, these dangers include diabetes, obesity, and high cholesterol, as in the case of Zyprexa.

The point is that we can never trust commercial CME, because of its inherent conflict of interest: it is education designed to encourage the audience to use more of the sponsor's product.

Please join me in my crusade. If you have seen any examples of obvious commercial bias in educational activities, let me know. Together, we can sniff out the worst offenders, and report them to the ACCME, to the Senate Finance Committee, which released
this report , and to whoever else has an interest in improving the ethics of medicine in America.

Thanks very much for your interest.


Anonymous said...

Congratulations on your new blog! It’s a great addition to the newsletter and I’ll be checking back regularly.

Anonymous said...

Finally! What I feared would never M.D. with a conscience about what's best for his patients.
And a psychiatrist at that.

Keep up the good work, Dr. Carlat.
From your parallel colleague fighting for the same things from the NURSING PERSPECTIVE, THE PSYCHOTHERAPY PERSPECTIVE, THE Rx drug marketing/promo/advertising perspective/ and THE LEGAL PERSPECTIVE. The very Best with your blog.
Medical-Legal Consultancy
200 West 79th Street - Suite 9L
New York City 10024-6215
Office: (212) 874-3394
Ongoing cases: (212) 873-5640

Special expertise:(1)Psychiatry, Psychology, Psychotherapy, Psychopharmaceuticals
(2)Medical/Pharmaceutical Advertising Agencies' "creative
marketing" strategizing
(3)Pharmaceutical Manufacturers' Marketing Practices
(4)All things Nursing -- med/surg; pediatrics, neurology, everything
(5) Rx drugs of all kinds from Ampicillin to Zovirax, from Abilify to Zoloft, for disease entities from Acne to other words:ALLRx PHARMACEUTICALS, FROM A TO Z, I HAVE RESEARCHED AND WRITTEN ABOUT AS A SENIOR WRITER AND CREATIVE DIRECTOR IN THE MEDICAL ADVERTISING INDUSTRY.

Anonymous said...

This is off-topic, but I'd be very interested in your comments about the CATIE trial. I have read your newsletter and agree that there's an issue with dosing. But I think you fail to mention that side-effects may have driven the doses that we selected. Not trying to antagonize, just really curious about your thoughts on this.

Anonymous said...

Great work, Danny- Keep it up! I'll be checking in regularly, and have already turned on some other friends to your blog.

Eric said...

Wow what a find! I am a big fan of your newsletter and stumbled upon this after reading your recent piece in NYT.

The blog is now bookmarked and will be forwarded to colleagues. Keep up the good work.

Anonymous said...

How much is "a little bit of money" from your newsletter, Dr. Carlat? Even if all the 2300 subscribers (as reported by the Boston Globe) to your newsletter were individuals paying $89 (compared to $149 for institutions), that adds up to $204,700 a year. Where on this earth is $204,700 "a little bit of money"? With all the publicity (or advertising) that you've been getting, I can't imagine that the number of subscribers has gone down. I'm shocked, just shocked, to find out that that you're...a hypocrite with an enormous financial conflict of interest.

Anonymous said...

If you ever have time, I would love to see some reporting on the lack of reporting of the number of people with kidney failure from taking lithium as prescribed. I am one of them and I know several others, which to me means there are a lot of us, but one never hears about it in the blogosphere or the media.

Thank you.

Anonymous said...

As a high-level employee of a medical education and communication company I recognize that many unbiased programs are incorrectly promoted as such. Yet I do think many of the treatment messages that come through CME programs can be useful in educating large groups of healthcare practitioners, especially those who practice outside of large communities with multiple research hospitals. I would like to see CME symposia continue to exist but morph into science-driven, real-life medicine educational programs with fewer - or better yet - no marketing messages.

Anonymous said...

Dear Alison,

I'm sorry to hear that lithium has caused you so many problems. It is a known fact though, that lithium can cause kidney failure, as you can also see in the following article. That is why people on lithium should have regular blood tests to check their lithium level and kidney function.
Or if you want to see a site about an other medical problem, just have a look at:

Otherwise, please continue the search for honesty in medical education and keep up the good work.

Dr Speedy.