tag:blogger.com,1999:blog-26990864.post-54460192532058532232007-11-29T09:07:00.001-08:002007-11-29T09:23:35.040-08:00<p>For a first-hand account of how physicians are working with pharmaceutical companies as speakers -- which I have done extensively in the last several years -- read a very frank one published last week in New York Times Magazine, by Dr. Daniel Carlat: <a href="http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html">Dr. Drug Rep</a>.</p><p>Having had the privilege of meeting Dr. Carlat, I know that he holds himself to a firm ethical standard. You can see that in his article. But I have continued to give talks for a few select pharmaceutical companies, whereas he found the process ethically unacceptable. Am I violating a standard? Am I only fooling myself, to think that I have not?</p><p>Linking his essay, I posted the following paragraphs on my website on the page in which I explain <a href="http://www.psycheducation.org/start/Funding.htm">how I use pharmaceutical company funding</a>. I'm trying to be quite public about taking money for giving talks about bipolar disorder, to force myself to be as honest as possible about this practice. (Or am I using these posts as another false shield? I don't think so, but I must admit there is no way for me to really know.)</p><p>From the website, revised today:<br /><span style="color:#6633ff;">You would have to ask someone who has attended one of my talks to confirm this, but I still think -- after going through the exact same thought process that Dr. Carlat describes -- that I am managing to stay neutral. Oh, I still show the company slides where required, and emphasize (for example) "this is what AstraZeneca wants you to know". But as quickly as possible we move to a discussion of bipolar diagnosis; and when we come around to treatment, I moderate an open-ended discussion in which I try to emphasize treatment approaches with solid, well accepted evidence for their efficacy. I only give talks for companies whose medications meet that criterion, so I am not -- I don't think -- in Dr. Carlat's position. <br /></span></p><p><span style="color:#6633ff;">Indeed, I once gave talks for Wyeth, the company he uses as an example. When they required that I use their slides, as he describes, I declined any further invitations to speak for them. But before that, I did give a talk once for Wyeth in which I found myself promoting Effexor, just as Dr. Carlat did (after the same training experience with Drs. Thase and Sussman, who had a similar influence on me). I had the same feeling he describes: "whoops, I just went over the line". I remember that particular talk vividly (Dr. Robert Burton, a local internist colleague, was there, for example). I still feel guilty about that one. I don't want to have that feeling again.</span> </p><p>Dr. Phelps</p>PsychEducationhttp://www.blogger.com/profile/06943655017555585565noreply@blogger.com