Shannon Brownlee on the Physician Payment Sunshine Act: "Other critics of the law worry that disclosure won’t do any good, that many doctors will continue taking the money even if their names are put up in lights on the web. They’re right: disclosure alone doesn’t discourage behavior, it’s the shame that goes along with it, and there are hints that even the prospect of being exposed for having a conflict of interest is starting to discourage doctors from taking the money. Between 2004 and 2009, the number of doctors with a financial relationship with industry declined from 94 to 84%."
"To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems, the very things we would most want to improve." Here is Alan Sroufe of the University of Minnesota, explaining why, in the long run, Ritalin and other stimulants do not work.
"In 1987, a Canadian man named Kenneth Parks drove 14 miles to the home of his in-laws. Upon reaching their home, Parks brutally attacked them both, killing his mother-in-law. When the case went to trial, he was acquitted on unprecedented grounds: The attacker was asleep. Carlos Schenck, a sleep clinician and author, describes the case and Parks’ history of parasomnias—severe sleep behaviors. He explains that a “witch’s brew” of sleepwalking risk factors could have precipitated the tragic episode."
Child labor, toxic chemicals, dubious safety inspections, crowded dormitories, a suicide epidemic. The New York Times is running a first-rate series of investigative reports on Chinese electronic suppliers, but for riveting, first-person storytelling on the same topic, you can't do much better than this episode of This American Life.
Johnson and Johnson has agreed to pay $158 million to settle a Texas lawsuit over its controversial Texas Medication Algorithm Project (TMAP), which was allegedly designed to increase sales of the antipsychotic Risperdal. The whistleblower in the case was Allen Jones, a Pennsylvania state investigator who uncovered the program. For years he has been unable to speak publicly about TMAP. Yesterday, he was interviewed by Ed Silverman at Pharmalot.
Janssen is helping the British government re-design its healthcare system. "Taking conflict of interest to a whole new level, a company that profits from selling drugs for mental illness is now officially working to help doctors commission mental health services." Ray Moynihan explains in the BMJ.
"The problem with you," she explained, "is that you have a chemical imbalance. It's biological, just like diabetes, but it's in your brain. This chemical in your brain called serotonin is too, too low. There's not enough of it, and that's what's causing the chemical imbalance. We need to give you medication to correct that."
Alix Spiegel of NPR, on the misleading "chemical imbalance" story of depression.
“By placing an order via this Web site on the first day of the fourth month of the year 2010 anno Domini, you agree to grant us a non-transferable option to claim, for now and forever more, your immortal soul.”
Elizabeth Rosenthal explains the problem with disclosure as a means of protecting consumers and patients.
Alison Bass, author of Side Effects, reflects on why it is so hard to blow the whistle on wrongdoing. (Hint: it is because whistleblowers are usually punished and vilified.)
"Texas and a subsidiary of health care giant Johnson & Johnson reached a $158 million settlement in a Medicaid fraud lawsuit Thursday, allowing the drugmaker to pay a fraction of the potential $1 billion in penalties and fines that state officials had initially sought." Read it in the Washington Post.
Pennhurst was a school in Spring City, Pennsylvania, for people with developmental and physical disabilities. Established in 1908, it eventually became notorious for its neglectful and abusive practices. Residents were raped, beaten and cruelly punished, often caged or left naked in their beds. Pennhurst was finally shut down in 1987.
But in 2010, as Emily Smith Beitiks writes in the latest issue of The Hastings Center Report, Pennhurst was resurrected -- this time as a "haunted asylum" amusement park, complete with mad doctors and crazed, ax-wielding inmates. Read her remarkable article, "The Ghosts of Institutionalization at Pennhurst's Haunted Asylum."
Of all the corrupt methods of marketing the atypical antipsychotics, perhaps the most notorious was the Texas Medication Algorithm Project (TMAP), a set of treatment guidelines that favored Risperdal over other drugs. For the past week, TMAP and Risperdal have been on trial in Austin, Texas. In attendance is Kal Applbaum, an anthropologist at the University of Wisconsin-Milwaukee, who is blogging the trial for Somatosphere. You can see his posts here.
A Charleston, South Carolina hospital has put a newspaper reporter on its payroll and is now "sponsoring" his columns in the Charleston News and Courier. Gary Schwitzer tells the story.
Want a baby? You can improve your odds at Planet Hospital, a California medical tourism outfit that will implant your embryos in two Indian surrogates at the same time. Read Douglas Pet's excellent article in Slate.
Kent State was all set to take a million bucks from scam artist and alumnus Jason Cope until a student journalist started asking questions. Here is the story, with brilliant commentary by Margaret Soltan.
My favorite part, from Wired editor Adam Rogers: "On persistence, I’m reminded of something Atlantic editor James Gibney said at a panel I was moderating: 'There is a special place in hell for editors who don’t call people back, and I am going there.'" (My own addition: James Gibney is right, but I can say from experience that he's not going there. At least not for this particular sin.)
Here is the always entertaining Gary Greenberg -- psychotherapist, Mother Jones writer, pen pal to the Unabomber -- on the latest embarrassment to the American Psychiatric Association:
"The APA is trying to thread a camel through the eye of a needle. In their own view, they have to revise the DSM. To do this, they have to address the reification problem–i.e., that many of us, civilians and clinicians alike, have taken the DSM too seriously and treated the disorders it lists as actual diseases rather than fictive placeholders. To address it, they have to admit that it is a problem, and that they don’t have a solution. They have to fix the plane while it is airborne, but they don’t have the tools or the knowhow to do so, and the more it becomes clear that the plane is in trouble, and the more the mechanics are swearing and banging belowdecks, the more likely it is that the passengers will find out and start asking for a quick landing and a voucher on another airline."
A free medication monitoring service? Read the fine print. When you sign up, you become part of a pool for recruitment into a clinical trial. Have a look.
"There is a problem so grave that it threatens the very validity of what we learn from the medical literature. Bad data? Not exactly. Actually, it’s missing data — information, relevant to the risks and benefits of treatments, that is simply not published." Yale cardiologist Harlan Krumholz summarizes the latest issue of the BMJ, which documents in alarming detail how publication bias and selective publication have distorted the medical literature.
"Those who stay in rural Iowa are often the elderly waiting to die, those too timid (or lacking in educated) to peer around the bend for better opportunities, an assortment of waste-toids and meth addicts with pale skin and rotted teeth, or those who quixotically believe, like Little Orphan Annie, that 'The sun'll come out tomorrow.'"
Another one:
"They speak English in Iowa. You understand the words fine. (Broadcasters, in fact, covet the Iowa 'accent,' since it could come from anywhere, devoid of regional inflections.) But if you listen closely, though, it's a wholly different manner of speaking from what folks on either coast are accustomed to."
"Indoor parking lots are ramps, soda is pop, lollipops are suckers, grocery bags are sacks, weeds are volunteers, miniature golf is putt-putt, supper is never to be confused with dinner, cellars and basements are totally different places, and boys under the age of 16 are commonly referred to as 'Bud.' Almost every Iowa house has a mudroom, so you don't track mud or pig shit into the kitchen or living room, even though the aroma of pig shit is absolutely venerated in Iowa: It's known to one and all here as 'the smell of money.'"
Bloom doesn't regret the essay; he says it is "satire." But nobody is laughing, including Bloom. Maybe that's because the essay is not funny. (It's not satire, either.) Have a look at this interview on MSNBC.
"My name is Allen Jones. I am a “whistleblower” who has sought the protection of the federal courts to tell the following story. I am employed as an Investigator in the Commonwealth of Pennsylvania Office of Inspector General (OIG), Bureau of Special Investigations. In November of 2002, I entered a CivilRights lawsuit against OIG officials to preserve my right to speak out on issues of vital public interest involving pharmaceutical industry influence on the treatment of mental health patients in state institutions. As an OIG Investigator, I attempted to expose evidence of major pharmaceutical company wrongdoing. The industry was influencing state officials with trips, perks, lavish meals, transportation to and first-class accommodations in major cities. Some state employees were paid honorariums of up to $2,000 for speaking in their official capacities at drug-company sponsored events."
As the January 9 court date for the Texas case against Johnson and Johnson approaches , Mickey Nardo reviews the ugly history of the Texas Medication Algorithm Project (TMAP) on his Boring Old Man blog. Allen Jones, the fired whistleblower, described TMAP as a "Trojan horse embedded with the pharmaceutical industry’s newest and most expensive mental health drugs." Read about it here.
Shannon Brownlee on the Physician Payment Sunshine Act: "Other critics of the law worry that disclosure won’t do any good, that many doctors will continue taking the money even if their names are put up in lights on the web. They’re right: disclosure alone doesn’t discourage behavior, it’s the shame that goes along with it, and there are hints that even the prospect of being exposed for having a conflict of interest is starting to discourage doctors from taking the money. Between 2004 and 2009, the number of doctors with a financial relationship with industry declined from 94 to 84%."
