Doctors' Conflicting Interests Can Cost Money and Lives, and Hinder Medical Discoveries

[Guest guest]

http://abcnews.go.com/Health/medical-conflicts-interest-disaster-patients/story?id=13060973 & page=1

Doctors' Conflicting Interests Can Cost Money and Lives, and

Hinder Medical Discoveries

Are Doctors' Industry Ties Influencing Your Care?

OPINION

by STEFAN P. KRUSZEWSKI, M.D.

March 28, 2011

In recent months, the print media have once again outed

another group of physicians who benefit from undisclosed

financial renumeration from pharmaceutical companies,

accompanied by serious conflicts of interest. One headline

from The New York Times News Service read "California Docs

Paid to Promote Drugs," while other news outlets carried

similar stories.

More than a few of these doctors are psychiatrists who have

received tax-supported, public National Institutes of Health

and National Institute of Mental Health funding for clinical

research, have participated in U.S. Food and Drug

Administation advisory panels or have appeared on, or on

behalf of, various not-for-profit psychiatric advocacy boards

-- some of which are heavily supported by the manufacturers of

psychiatric medications.

In 2006, my colleagues and I wrote a brief letter to the

editor to the Journal of the American Medical Association, one

of America's premier peer-reviewed medical journals. Our

letter expressed concern about the lack of honest disclosure

of conflicts by certain psychiatric authors in a previously

published article.

Multiple authors had recommended specific antidepressant

therapy but failed to reveal that they were being paid by

multiple antidepressant manufacturers to speak, advocate and

do research for the companies that sold the drugs.

During the review process, an associate editor at the journal

asked the question (and inadvertently copied me on an email

that had been sent to another associate editor), "What's the

big deal? What's all this [expletive deleted] about conflicts

of interest?"

Academic journals, heavily supported by advertising money,

are biased and complicit in the conflict of interest fiasco.

Sometimes I wonder why I -- or anyone else for that matter --

should care about psychiatrists who pimp for drug companies.

After all, physician spokespeople and drug manufacturers are

capitalists, and capitalism is our economic cornerstone. Every

day, any financial news consumer hears the refrain invoking

the social advantages of free market capitalism. It is the

mantra of a major financial television network. And even

though I'm a psychiatrist, I'm also a capitalist, so why

should I worry?

But I do worry, because drug promotion and clinical

decision-making that are brokered on the backs of dollar bills

have a greater chance of causing serious adverse outcomes,

including illnesses and death. If a physician embellishes the

effectiveness of a drug or minimizes its risk, that directly

hurts you and me.

Physicians who are heavily supported by pharmaceutical

companies and medical device makers are not forming

independent, unbiased decisions. Instead, their brains have

been lined with gifts, perks and money, which influences their

rose-colored opinions.

My psychiatric colleagues are especially vulnerable here. The

result is that your mother, your husband or my child can't

make a reliable decision about the risks and benefits of

particular drugs. How could they? The prescribing doctors

often don't know the risks and benefits, so how could we be

expected to learn what they don't know?

Conflicts of interest promoted by pharmaceutical

manufacturers negatively affect decisions about current and

future medical care. That is tragic, because those half-baked

recommendations come with a price that no amount of capitalism

can justify. It's simple and ugly: If you or your mom suddenly

succumbs to an arrhythmia whose side effects were not

appreciated by your doctor because your doctor was misinformed

by another doctor serving as the manufacturer's spokesperson,

that is tragic.

I see it virtually every day in my clinical practice: in

young men who have breast lesions and abnormal breast

development from atypical antipsychotics; in sudden unexpected

deaths, or "suds," from psychiatric drugs in individuals who

had no risk factors for sudden death; in tic and dyskinetic

movement disorders in kids arbitrarily prescribed stimulants,

and the huge weight gain and symptoms of type 2 diabetes in

children and young adults who receive a sedative, such as

quetiapine, for sleep.

The bad news doesn't stop with current care. Conflicted

clinical research -- often done especially by and for a

particular psychiatric pharmaceutical manufacturer -- whose

design and analysis are biased and whose summary and

conclusions are misleadingly positive, fracture the backbone

of scientific research.

The legacy of fraudulent research lingers for years before it

is recognized and repudiated. That effort impedes real

progress, wastes time, money and human resources that could be

focused on finding real cures to help all of us. And that's

not good for anybody.

Dr. Stefan Kruszewski is an addiction psychiatrist and

CEO of Kruszewski & Associates, a burg, Pa.,

company that focuses on health care and financial fraud.

[Guest guest]

http://abcnews.go.com/Health/medical-conflicts-interest-disaster-patients/story?id=13060973 & page=1

Doctors' Conflicting Interests Can Cost Money and Lives, and

Hinder Medical Discoveries

Are Doctors' Industry Ties Influencing Your Care?

OPINION

by STEFAN P. KRUSZEWSKI, M.D.

March 28, 2011

In recent months, the print media have once again outed

another group of physicians who benefit from undisclosed

financial renumeration from pharmaceutical companies,

accompanied by serious conflicts of interest. One headline

from The New York Times News Service read "California Docs

Paid to Promote Drugs," while other news outlets carried

similar stories.

More than a few of these doctors are psychiatrists who have

received tax-supported, public National Institutes of Health

and National Institute of Mental Health funding for clinical

research, have participated in U.S. Food and Drug

Administation advisory panels or have appeared on, or on

behalf of, various not-for-profit psychiatric advocacy boards

-- some of which are heavily supported by the manufacturers of

psychiatric medications.

In 2006, my colleagues and I wrote a brief letter to the

editor to the Journal of the American Medical Association, one

of America's premier peer-reviewed medical journals. Our

letter expressed concern about the lack of honest disclosure

of conflicts by certain psychiatric authors in a previously

published article.

Multiple authors had recommended specific antidepressant

therapy but failed to reveal that they were being paid by

multiple antidepressant manufacturers to speak, advocate and

do research for the companies that sold the drugs.

During the review process, an associate editor at the journal

asked the question (and inadvertently copied me on an email

that had been sent to another associate editor), "What's the

big deal? What's all this [expletive deleted] about conflicts

of interest?"

Academic journals, heavily supported by advertising money,

are biased and complicit in the conflict of interest fiasco.

Sometimes I wonder why I -- or anyone else for that matter --

should care about psychiatrists who pimp for drug companies.

After all, physician spokespeople and drug manufacturers are

capitalists, and capitalism is our economic cornerstone. Every

day, any financial news consumer hears the refrain invoking

the social advantages of free market capitalism. It is the

mantra of a major financial television network. And even

though I'm a psychiatrist, I'm also a capitalist, so why

should I worry?

But I do worry, because drug promotion and clinical

decision-making that are brokered on the backs of dollar bills

have a greater chance of causing serious adverse outcomes,

including illnesses and death. If a physician embellishes the

effectiveness of a drug or minimizes its risk, that directly

hurts you and me.

Physicians who are heavily supported by pharmaceutical

companies and medical device makers are not forming

independent, unbiased decisions. Instead, their brains have

been lined with gifts, perks and money, which influences their

rose-colored opinions.

My psychiatric colleagues are especially vulnerable here. The

result is that your mother, your husband or my child can't

make a reliable decision about the risks and benefits of

particular drugs. How could they? The prescribing doctors

often don't know the risks and benefits, so how could we be

expected to learn what they don't know?

Conflicts of interest promoted by pharmaceutical

manufacturers negatively affect decisions about current and

future medical care. That is tragic, because those half-baked

recommendations come with a price that no amount of capitalism

can justify. It's simple and ugly: If you or your mom suddenly

succumbs to an arrhythmia whose side effects were not

appreciated by your doctor because your doctor was misinformed

by another doctor serving as the manufacturer's spokesperson,

that is tragic.

I see it virtually every day in my clinical practice: in

young men who have breast lesions and abnormal breast

development from atypical antipsychotics; in sudden unexpected

deaths, or "suds," from psychiatric drugs in individuals who

had no risk factors for sudden death; in tic and dyskinetic

movement disorders in kids arbitrarily prescribed stimulants,

and the huge weight gain and symptoms of type 2 diabetes in

children and young adults who receive a sedative, such as

quetiapine, for sleep.

The bad news doesn't stop with current care. Conflicted

clinical research -- often done especially by and for a

particular psychiatric pharmaceutical manufacturer -- whose

design and analysis are biased and whose summary and

conclusions are misleadingly positive, fracture the backbone

of scientific research.

The legacy of fraudulent research lingers for years before it

is recognized and repudiated. That effort impedes real

progress, wastes time, money and human resources that could be

focused on finding real cures to help all of us. And that's

not good for anybody.

Dr. Stefan Kruszewski is an addiction psychiatrist and

CEO of Kruszewski & Associates, a burg, Pa.,

company that focuses on health care and financial fraud.

[Guest guest]

http://abcnews.go.com/Health/medical-conflicts-interest-disaster-patients/story?id=13060973 & page=1

Doctors' Conflicting Interests Can Cost Money and Lives, and

Hinder Medical Discoveries

Are Doctors' Industry Ties Influencing Your Care?

OPINION

by STEFAN P. KRUSZEWSKI, M.D.

March 28, 2011

In recent months, the print media have once again outed

another group of physicians who benefit from undisclosed

financial renumeration from pharmaceutical companies,

accompanied by serious conflicts of interest. One headline

from The New York Times News Service read "California Docs

Paid to Promote Drugs," while other news outlets carried

similar stories.

More than a few of these doctors are psychiatrists who have

received tax-supported, public National Institutes of Health

and National Institute of Mental Health funding for clinical

research, have participated in U.S. Food and Drug

Administation advisory panels or have appeared on, or on

behalf of, various not-for-profit psychiatric advocacy boards

-- some of which are heavily supported by the manufacturers of

psychiatric medications.

In 2006, my colleagues and I wrote a brief letter to the

editor to the Journal of the American Medical Association, one

of America's premier peer-reviewed medical journals. Our

letter expressed concern about the lack of honest disclosure

of conflicts by certain psychiatric authors in a previously

published article.

Multiple authors had recommended specific antidepressant

therapy but failed to reveal that they were being paid by

multiple antidepressant manufacturers to speak, advocate and

do research for the companies that sold the drugs.

During the review process, an associate editor at the journal

asked the question (and inadvertently copied me on an email

that had been sent to another associate editor), "What's the

big deal? What's all this [expletive deleted] about conflicts

of interest?"

Academic journals, heavily supported by advertising money,

are biased and complicit in the conflict of interest fiasco.

Sometimes I wonder why I -- or anyone else for that matter --

should care about psychiatrists who pimp for drug companies.

After all, physician spokespeople and drug manufacturers are

capitalists, and capitalism is our economic cornerstone. Every

day, any financial news consumer hears the refrain invoking

the social advantages of free market capitalism. It is the

mantra of a major financial television network. And even

though I'm a psychiatrist, I'm also a capitalist, so why

should I worry?

But I do worry, because drug promotion and clinical

decision-making that are brokered on the backs of dollar bills

have a greater chance of causing serious adverse outcomes,

including illnesses and death. If a physician embellishes the

effectiveness of a drug or minimizes its risk, that directly

hurts you and me.

Physicians who are heavily supported by pharmaceutical

companies and medical device makers are not forming

independent, unbiased decisions. Instead, their brains have

been lined with gifts, perks and money, which influences their

rose-colored opinions.

My psychiatric colleagues are especially vulnerable here. The

result is that your mother, your husband or my child can't

make a reliable decision about the risks and benefits of

particular drugs. How could they? The prescribing doctors

often don't know the risks and benefits, so how could we be

expected to learn what they don't know?

Conflicts of interest promoted by pharmaceutical

manufacturers negatively affect decisions about current and

future medical care. That is tragic, because those half-baked

recommendations come with a price that no amount of capitalism

can justify. It's simple and ugly: If you or your mom suddenly

succumbs to an arrhythmia whose side effects were not

appreciated by your doctor because your doctor was misinformed

by another doctor serving as the manufacturer's spokesperson,

that is tragic.

I see it virtually every day in my clinical practice: in

young men who have breast lesions and abnormal breast

development from atypical antipsychotics; in sudden unexpected

deaths, or "suds," from psychiatric drugs in individuals who

had no risk factors for sudden death; in tic and dyskinetic

movement disorders in kids arbitrarily prescribed stimulants,

and the huge weight gain and symptoms of type 2 diabetes in

children and young adults who receive a sedative, such as

quetiapine, for sleep.

The bad news doesn't stop with current care. Conflicted

clinical research -- often done especially by and for a

particular psychiatric pharmaceutical manufacturer -- whose

design and analysis are biased and whose summary and

conclusions are misleadingly positive, fracture the backbone

of scientific research.

The legacy of fraudulent research lingers for years before it

is recognized and repudiated. That effort impedes real

progress, wastes time, money and human resources that could be

focused on finding real cures to help all of us. And that's

not good for anybody.

Dr. Stefan Kruszewski is an addiction psychiatrist and

CEO of Kruszewski & Associates, a burg, Pa.,

company that focuses on health care and financial fraud.

[Guest guest]

http://abcnews.go.com/Health/medical-conflicts-interest-disaster-patients/story?id=13060973 & page=1

Doctors' Conflicting Interests Can Cost Money and Lives, and

Hinder Medical Discoveries

Are Doctors' Industry Ties Influencing Your Care?

OPINION

by STEFAN P. KRUSZEWSKI, M.D.

March 28, 2011

In recent months, the print media have once again outed

another group of physicians who benefit from undisclosed

financial renumeration from pharmaceutical companies,

accompanied by serious conflicts of interest. One headline

from The New York Times News Service read "California Docs

Paid to Promote Drugs," while other news outlets carried

similar stories.

More than a few of these doctors are psychiatrists who have

received tax-supported, public National Institutes of Health

and National Institute of Mental Health funding for clinical

research, have participated in U.S. Food and Drug

Administation advisory panels or have appeared on, or on

behalf of, various not-for-profit psychiatric advocacy boards

-- some of which are heavily supported by the manufacturers of

psychiatric medications.

In 2006, my colleagues and I wrote a brief letter to the

editor to the Journal of the American Medical Association, one

of America's premier peer-reviewed medical journals. Our

letter expressed concern about the lack of honest disclosure

of conflicts by certain psychiatric authors in a previously

published article.

Multiple authors had recommended specific antidepressant

therapy but failed to reveal that they were being paid by

multiple antidepressant manufacturers to speak, advocate and

do research for the companies that sold the drugs.

During the review process, an associate editor at the journal

asked the question (and inadvertently copied me on an email

that had been sent to another associate editor), "What's the

big deal? What's all this [expletive deleted] about conflicts

of interest?"

Academic journals, heavily supported by advertising money,

are biased and complicit in the conflict of interest fiasco.

Sometimes I wonder why I -- or anyone else for that matter --

should care about psychiatrists who pimp for drug companies.

After all, physician spokespeople and drug manufacturers are

capitalists, and capitalism is our economic cornerstone. Every

day, any financial news consumer hears the refrain invoking

the social advantages of free market capitalism. It is the

mantra of a major financial television network. And even

though I'm a psychiatrist, I'm also a capitalist, so why

should I worry?

But I do worry, because drug promotion and clinical

decision-making that are brokered on the backs of dollar bills

have a greater chance of causing serious adverse outcomes,

including illnesses and death. If a physician embellishes the

effectiveness of a drug or minimizes its risk, that directly

hurts you and me.

Physicians who are heavily supported by pharmaceutical

companies and medical device makers are not forming

independent, unbiased decisions. Instead, their brains have

been lined with gifts, perks and money, which influences their

rose-colored opinions.

My psychiatric colleagues are especially vulnerable here. The

result is that your mother, your husband or my child can't

make a reliable decision about the risks and benefits of

particular drugs. How could they? The prescribing doctors

often don't know the risks and benefits, so how could we be

expected to learn what they don't know?

Conflicts of interest promoted by pharmaceutical

manufacturers negatively affect decisions about current and

future medical care. That is tragic, because those half-baked

recommendations come with a price that no amount of capitalism

can justify. It's simple and ugly: If you or your mom suddenly

succumbs to an arrhythmia whose side effects were not

appreciated by your doctor because your doctor was misinformed

by another doctor serving as the manufacturer's spokesperson,

that is tragic.

I see it virtually every day in my clinical practice: in

young men who have breast lesions and abnormal breast

development from atypical antipsychotics; in sudden unexpected

deaths, or "suds," from psychiatric drugs in individuals who

had no risk factors for sudden death; in tic and dyskinetic

movement disorders in kids arbitrarily prescribed stimulants,

and the huge weight gain and symptoms of type 2 diabetes in

children and young adults who receive a sedative, such as

quetiapine, for sleep.

The bad news doesn't stop with current care. Conflicted

clinical research -- often done especially by and for a

particular psychiatric pharmaceutical manufacturer -- whose

design and analysis are biased and whose summary and

conclusions are misleadingly positive, fracture the backbone

of scientific research.

The legacy of fraudulent research lingers for years before it

is recognized and repudiated. That effort impedes real

progress, wastes time, money and human resources that could be

focused on finding real cures to help all of us. And that's

not good for anybody.

Dr. Stefan Kruszewski is an addiction psychiatrist and

CEO of Kruszewski & Associates, a burg, Pa.,

company that focuses on health care and financial fraud.