1) Ghost-writing medical articles appears to be wide-spread, as JAMA exposed when examining the Vioxx studies.
My take: The blame goes far beyond Merck. Journal editors and the authors themselves bear responsibility.
These articles amount to nothing more than propaganda. Any study funded by a pharmaceutical company has to be viewed with a skeptical eye.
2) A Massachusetts physician group boasts that all their practices have patient openings.
My take: Want to know what the most powerful marketing tool is? Physician access. We have come to a point where availability is becoming a crucial physician trait.
When specialists come to my office to introduce themselves (and generate referrals), the first thing I look for is how soon a patient can get in. It doesn’t matter how good a doctor you are if you don’t have access.
Related posts:
- Medical ghost-writing influences doctors to prescribe more drugs
- Increasing caps = drop in physician access
- USA Today op-ed: Poor physician access worsens emergency department crowding
- Physician costs exceed revenue
- How much access should patients have to their medical record?
- Would you sacrifice privacy and modesty for improved access to doctors?
- MinuteClinics: Reflects "the sorry state of primary care in America"
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What about Ghost Authoring? How many authors listed actually contributed substantively on a medical paper? Many a Department Chariman has padded his cv with credits to papers he had no hand in composing.
As far as funding, I agree that commercial sponsorship often introduces an unacceptable bias. But without the pharmaceutical industry, where would the funding for many studies originate? It’s a puzzlement.
When someone suggested a restaurant to Yogi Berra, he replied:”Nobody goes there anymore – it’s too crowded.”
Re #1 I completely disagree with you Kevin. As an editorial consultant myself, I can say that all manuscripts are sent for review without the cover page so that I don’t alter my opinion based on the reputation of the author. While you’re idea may prevent ghost writing it is more likely to allow ‘crap’ to be published because someone well known is on the list. I also agree with doc99, that the literature is filled with senior authors that have little or no contribution other than a final check for punctuation. To change this practice by punishing the Journal is ridiculous. At some point the authors have to live and die by their own ethical and moral standards. Re #2 it’s true the two biggest determinants of referral pattern are proximity and availability. I don’t think it’s a bad thing though because most specialists are expert at >90% of the work that comes through the door. Even if a referring doctor doesn’t think the specialist is the best, I know that the GP will still think they’re more than capable of the job at hand.
Sizzler is far more available than Smith and Wollensky’s Steakhouse (in NYC.) I’ll leave it to you as to which provides the better product.
You can have the best bedside manner and the available appointments, but if you don’t have convenient parking, it’s all for nought.
You don’t know whether to be outraged or wonder why we don’t do this in the USA.
http://tinyurl.com/6fgqyw
Links to a UK Daily Mail article.
English hospitals, and some medical practices for that matter, put their appointment lines on their equivalent of 900-number service.
So this guy calls to set up an appointment, gets put on hold, and is billed £127 for waiting.
Yet another embarrassing scandal for medicine and the pharmaceutical industry. It is my belief that the cozy relationship between drug makers and: a) practicing physicians through “detailing,”, and b) involvement in research sponsorship (and article writing!) is fundamentally flawed. I recall a Scientific American article by Robert Chialdini, expert on persuasion, on the effectiveness of drug rep visits, even when the doctors deny it. Another author described the pharmaceutical industry as sending out “armies of leggy blonds” to persuade doctors to use their drugs.
Why are there no university ethics investigations against the “non-authors” uncovered in the JAMA article? This is academic fraud.
These people are university professors. If a scientist had done something like this, their career would be over.
“Ghost-writing” of scientific articals is the norm — it is not at all unusual. Do you think the “key-opinion-leader” who has > 300 publications on his (her) cv actually analyzed all the data, understood the statistical analasis and wrote the articles? Do you think the esteemed Professor with 17 books to his name at the famous University actually did the research, the analysis and wrote the books? The Merck thing is all media hype. I work in the pharmaceutical industry and have written several (many?) articles for our investigators which they then reviewed. They were given any data that they requested (few do). All were asked to comment extensively (we really wanted their opinions) and in a few cases, they did and we revised the text accordingly. (My name was on the papers also, rarely first or last– but I admit, some medical writers do not get authorship). However, what Merck did was not unusual and I don’t think all the big-shots who are the “Principal Investigators” would have it any other way!
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