Can you trust the medical advice you hear on the radio?

[Guest guest]

Doctors' Fees

Can you trust the medical advice you hear on the radio?

By Brownlee and Jeanne Lenzer

Posted Friday, Nov. 21, 2008, at 3:38 PM ET

The New York Times reported Thursday that over the past eight years,

Dr. Frederick K. Goodwin, who hosts the public-radio series The

Infinite Mind, received at least $1.3 million for giving marketing

lectures for drug companies that could have benefited from

preferential treatment on his show. In a " Medical Examiner " published

earlier this year, Brownlee and Jeanne Lenzer detailed the

profitable connections Goodwin and other doctors in the media have to

the pharmaceutical industry. The article is reprinted below.

A few weeks ago, devoted listeners of National Public Radio* were

treated to an episode of the award-winning radio series The Infinite

Mind called " Prozac Nation: Revisited. " The segment featured four

prestigious medical experts discussing the controversial link between

antidepressants and suicide. In their considered opinions, all four

said that worries about the drugs have been overblown.

The radio show, which was broadcast nationwide and paid for in part

by the D. and T. MacArthur Foundation, had the air of

quiet, authoritative credibility. Host Dr. Fred Goodwin, a former

director of the National Institute of Mental Health, interviewed

three prominent guests, and any radio producer would be hard-pressed

to find a more seemingly credible quartet. Credible, that is, except

for a crucial detail that was never revealed to listeners: All four

of the experts on the show, including Goodwin, have financial ties to

the makers of antidepressants. Also unmentioned were

the " unrestricted grants " that The Infinite Mind has received from

drug makers, including Eli Lilly, the manufacturer of the

antidepressant Prozac.

We don't know just how much funding or when the show last received

it, since neither Goodwin nor the show's producers responded to

repeated requests for interviews. But the larger point is that

undisclosed financial conflicts of interest among media sources seem

to be popping up all over the place these days. Some experts who

appear independent are, in fact, serving as stealth marketers for the

drug and biotech industries, and reporters either don't know about

their sources' conflicts of interests, or they fail to disclose them

to the public.

Take the November 2006 NBC Nightly News story that asked, " Can lung

scans really prevent cancer death? " Reporter Mike Taibbi, a former

smoker, underwent scanning by Dr. Henschke, a professor of

radiology at Weill Cornell Medical College in New York. Henschke

claimed on the show that early detection with lung scans could

prevent 80 percent of deaths from lung cancer. Although Taibbi

included another expert who said that Henschke's claim

was " outrageous, " viewers were left with little way to evaluate the

two conflicting viewpoints. And Taibbi himself concluded that early

detection was his " best chance. " At no point did viewers learn that

Henschke's research was funded by a tobacco company, which has an

investment in making the risks of smoking appear to be manageable—or

that many experts warn that more research is needed to determine

whether the potential benefits of scanning outweigh its harms.

How frequently are journalists glossing over such conflicts?

Schwitzer, a professor of journalism at the University of Minnesota,

is the publisher of HealthNewsReview.org, a Web site that reviews

health care news for balance, accuracy, and completeness. Schwitzer

and his team of reviewers have looked at 544 stories from top outlets

over the two-year period from April 2006 to April 2008. Journalists

had to meet several criteria in order to receive a satisfactory

score, among them: They had to quote an independent expert—someone

not involved in the relevant research—and they had to make some

attempt to report potential conflicts of interest. Half the stories

failed to meet these two requirements, Schwitzer says.

Conflicts of interest abound even in unexpected places. A recent

survey of academic medical centers published in the Journal of the

American Medical Association found that 60 percent of academic

department chairs have personal ties to industry—serving as

consultants, board members, or paid speakers, while two-thirds of the

academic departments had institutional ties to industry. Such ties

can be extremely lucrative. And according to these articles in the

medical literature, researchers who receive funding from drug and

medical-device manufacturers are up to 3.5 times as likely to

conclude their study drug or medical device works than are

researchers without such funding.

An equally clever way for companies to get out their marketing

messages is to go through a consumer group. Drug companies often

seed " pharm teams, " consumer groups that start out as legitimate

advocacy organizations and are subtly manipulated by funding from

pharmaceutical companies to convey the desired talking points. Unless

reporters ask where groups and individual researchers get their

money, they have no idea that their sources may be biased—and neither

do their readers, viewers, and listeners.

Which brings us back to The Infinite Mind and " Prozac Nation:

Revisited, " a show that may stand in a class by itself for concealing

bias. In addition to the show's unrestricted grants from Lilly, the

host, Goodwin, is on the board of directors of Center for Medicine in

the Public Interest, an industry-funded front, or " Astroturf " group,

which receives a majority of its funding from drug companies. CMPI

President Pitts was one of Goodwin's three guests for " Prozac

Nation. " We don't know which companies fund his group because when we

asked him, Pitts said, " I don't want to go into that. " But CMPI took

in more than $1.4 million in 2006 and, according to its tax forms,

spent $210,000 to influence the media through a large conference, a

blog the group maintains, op-eds published in major newspapers, and

multimedia programs and podcasts. Pitts has another title that might

have been relevant to The Infinite Mind; he is the senior vice

president for global health affairs at the PR firm Manning Selvage &

Lee, which represents Eli Lilly Inc., GlaxoKline, Pfizer, and

more than a dozen other pharmaceutical companies. Yet on the show,

Pitts was identified only by his title as " a former FDA official. "

The second guest on " Prozac Nation, " F. Leuchter, is a

professor of psychiatry at UCLA who has received research money from

drug companies including Eli Lilly Inc., Pfizer, and Novartis. The

third guest, Nada Stotland, president-elect of the American

Psychiatric Association, has served on the speakers' bureaus of

GlaxoKline and Pfizer. None of Leuchter and Stotland's ties to

industry was revealed to listeners—instead, each was introduced as a

prominent academic.

Share this article on DiggBuzz up!Share this article on BuzzThe

Infinite Mind's Web site states, " Our independence is perhaps our

greatest asset. " Perhaps, indeed. Neither Goodwin nor the show's

producers responded to our repeated requests for interviews and

queries about their funding. Pitts, who to his credit did give us an

interview, said he didn't know why his ties to industry weren't

revealed on the show. Curious, we tried to learn more about the

funding for The Infinite Mind—and could discover only that the show's

award-winning production company, Lichtenstein Creative Media, was

dissolved by the state of Massachusetts on March 28 for failing to

file a single annual report since its establishment in 2004.

Some reporters and producers argue that they can't be expected to ask

every source whether he or she gets money from the drug industry. But

there are obvious first steps to take. A list of academic researchers

who are known to have financial ties to the drug and medical-device

industries is available through the Center for Science in the Public

Interest. (Yes, the name is a lot like the Astroturf group we

mentioned earlier—coincidence?) To be fair, the list is inevitably

incomplete, and Astroturf groups and academics with undeclared

financial ties can make it difficult to ferret out their financial

conflicts.

In hopes of making reporters' jobs a little easier, we've created for

journalists an international list of prestigious and independent

medical experts who declare they have no financial ties to drug and

device manufacturers for at least the past five years. We have nearly

100 experts from a wide array of disciplines. E-mail us at

Brownlee.Lenzer@..., and we'll be happy to name names.

Correction, May 9, 2008: After this piece first appeared, Slate

posted a correction saying that the piece had incorrectly stated that

The Infinite Mind is carried on National Public Radio, rather than

public radio stations. We now understand from NPR's ombudsman,

Shepard, that it was the correction that was wrong. In fact, NPR has

a contractual relationship with The Infinite Mind to run the show on

two Sirius channels. The show also runs on NPR member stations.

Return to the corrected sentence.)