This past week at the APA Annual Meeting, they held a session proposing new ethical guidelines for their association and members. The timing and distribution of the full document is yet to be finalized but expected sometime this week
The proposed guidelines are comprehensive and address:
Gifts from the pharmaceutical industry;- Gifts from the pharmaceutical industry;
- Receipt of medical samples;
- Attendance at industry-sponsored events;
- Consulting for industry;
- Contact with pharmaceutical representatives; and
- Disclosure of relationships with pharmaceutical companies.
According to Paul Appelbaum, M.D., Chairman of the eleven-member working group on psychiatrists’ relationships with industry that developed the draft document, they were reacting to fear of the media.
“If we don’t respond to the concerns that we see in the paper everyday, it seems almost certain that we will face harsh, probably rigid, perhaps even punitive, external regulation, unless we can persuade the public-at-large that we can erect a framework they can trust and that the decisions made by physicians are made in our patients’ best interest and not because of ulterior considerations driven by the relationships with industry.” (What a brave statement – this statement sounds more like he is being sent to Guantanamo than practicing medicine, we may get water boarded
In addition, MedPage Today, which is generally a fair-balanced organization, ran a very one-sided interview at the APA Meeting this week featuring Drs. Appelbaum and Carlat (the small town psychiatrist and anti-industry blogger).
The questions were by and large important questions like:
Question: “Perhaps there is a potential for relationships to do some good.”
Answer: (all the medicines we have, blah, blah blah, not really.)
Question: “Some physicians get the bulk of their income from industry, do they assert undue influence?”
Answer: (Yes)
Question: What we have been doing for the last fifteen years is disclosure and the feeling is it is not good enough:
Answer: Disclosure is essential and inadequate, disclosure goes just so far. (Research shows (you know research) – well not exactly, what do you do with the information, where are the real conflicts? (I am not certain if these guys are capable of a definitive statement.)
I encourage you to watch the interview (only the first couple of minutes, after that it rattles on).
The video serves as a wake-up call that the blame for everything wrong in the world is now focused on industry (those who are doing the most to bring new products which cure diseases, of which the practice of psychiatry has changed from we can not help you to yes we can), and away from the sheer inefficiencies of the healthcare system, of which both speakers are firmly entrenched.
Both speakers did admit that perhaps experts with ties to industry can contribute but should be limited. (You poor doctors with ties to industry, we pity you.)
This is not surprising given that the APA’s Chief Executive Officer, Jay Scully, M.D. is an author of The Journal of the American Medical Association (JAMA) paper on industry relationships with associations blasting industry.
The APA membership has the opportunity to comment on this draconian proposal before the policy becomes official.
I am not certain why an association would propose limiting samples, consulting, attendance at industry-sponsored events and visits by representatives as a condition of membership.
We encourage you to make your voices heard; right now all they are hearing is from the other side.
The side that says, “hey we are afraid,” perhaps we will get noticed if we do something to punish our friends who we used to work with to develop therapies that changed lives.
These are the same guys who treat schizophrenia.
Medscape: APA 2009: Draft Guidelines to Address Psychiatrists’ Relationship with Industry
MedPage Today:APA: Psychiatrist-Pharma Relationships Need Clearer Boundaries