{"id":50292,"date":"2014-10-01T19:08:47","date_gmt":"2014-10-01T23:08:47","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=50292"},"modified":"2014-10-01T21:08:35","modified_gmt":"2014-10-02T01:08:35","slug":"paul-thacker","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/10\/01\/paul-thacker\/","title":{"rendered":"Paul Thacker&#8230;"},"content":{"rendered":"\n<ul>\n<div align=\"justify\" class=\"small\"><em>It was the best of times, it was the worst of times..<\/em>.<\/div>\n<div align=\"center\"><sup><em>A Tale of Two Cities<\/em>, <em>Charles Dickens 1859 <\/em><\/sup> <\/div>\n<\/ul>\n<div align=\"justify\" class=\"small\">It was 2008 and I had been retired for five years. A friend and I had built a house and I&#8217;d been involved in a project running down the living artifacts from the time before the Cherokee had been removed from this part of the world &#8211; the bent trees they used to mark important places that still dot our forests. And then I started reading about the department of psychiatry I was affiliated with in the New York Times of all places&#8230;<\/div>\n<p><a href=\"http:\/\/www.nytimes.com\/2008\/10\/04\/health\/policy\/04drug.html?pagewanted=all&#038;_r=0\" target=\"_blank\"> <\/a>          <\/p>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/www.nytimes.com\/2008\/10\/04\/health\/policy\/04drug.html?pagewanted=all&#038;_r=0\" target=\"_blank\">  Top Psychiatrist Didn&rsquo;t Report Drug Makers&rsquo; Pay<\/a><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">New York Times<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">By GARDINER HARRIS<\/div>\n<div align=\"center\" class=\"middle\">October 3, 2008 <\/div>\n<p>          <\/p>\n<div align=\"justify\">One of the nation&rsquo;s most influential psychiatrists  earned more than $2.8 million in consulting arrangements with drug  makers from 2000 to 2007, failed to report at least $1.2 million of that  income to his university and violated federal research rules, according  to documents provided to Congressional investigators. The psychiatrist, Dr. Charles B. Nemeroff of Emory University,  is the most prominent figure to date in a series of disclosures that is  shaking the world of academic medicine and seems likely to force broad  changes in the relationships between doctors and drug makers&#8230;<\/div>\n<\/blockquote>\n<div align=\"justify\" class=\"small\">I had resigned from the full time faculty some twenty-five years earlier when the DSM-III came and the department [and psychiatry] changed so radically. I neither fit nor wanted to fit into the then new biomedical model, though I continued to teach in the psychoanalytic program. But I had no knowledge of what I was reading about in the news. And that&#8217;s when this blog started as I learned a lot of things I sometimes wish I didn&#8217;t know about &#8211; what had happened in psychiatry after I left. I knew it had become unrecognizable. I knew I had cloistered myself in my practice. But I was oblivious to the corruption, and I haven&#8217;t seemed to be able to to stop talking about it since. Today, there was another article that brought back those days of discovery for me.<\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"><a target=\"_blank\" href=\"http:\/\/www.latimes.com\/business\/healthcare\/la-fi-physician-payments-sunshine-20140930-story.html\">Government reveals $3.5 billion in industry ties to doctors, hospitals<\/a><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">LA Times<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">By Chad Terhune and Noam N. Leve<\/div>\n<div align=\"center\" class=\"small\">September 30, 2014<\/div>\n<p align=\"justify\">Opening  the book on long-hidden industry relationships, the federal government  revealed nearly $3.5 billion worth of payments and other ties that U.S.  doctors and teaching hospitals have with drug and medical-device  companies. These financial details, published Tuesday under a  requirement in the federal health law, have been sought for years by  patient advocates and lawmakers from both political parties concerned  about conflicts of interest in the medical profession.<\/p>\n<p align=\"justify\">Initially, the new federal website&nbsp;includes 4.4 million payments made during the last five months of 2013. More data will be published next summer. Officials  said the data cover financial transactions involving about 546,000  physicians and 1,360 teaching hospitals across the country. Consumer  advocates hope the increased disclosure will ultimately help curb  unethical practices by some doctors who prescribe medications and  devices after receiving large sums from manufacturers, possibly putting  patient care at risk.<\/p>\n<div align=\"justify\">Physicians and academic medical centers  defend industry collaboration as essential to advance research into  life-saving treatments. They have also questioned the accuracy of the  government data. The  Physician Payments Sunshine Act was included in the Affordable Care Act  that President Obama signed in 2010 amid growing demands for more  openness in the U.S. healthcare system, which historically has shielded  doctors, hospitals and other medical providers from much public  scrutiny&#8230;<\/div>\n<\/blockquote>\n<div align=\"justify\" class=\"small\">Aside: I still wince when I read things like &quot;<em>Physicians and academic medical centers  defend industry collaboration  as essential to advance research into  life-saving treatments<\/em>&quot; and I want to protest. The only physicians I know mounting that defense are the ones getting paid. I sure don&#8217;t think that. But I recover more quickly than I used to. It seems like everything I do is easily caricatured &#8211; psychotherapist, <em>charlatan<\/em>, psychiatrist, <em>biomedical nut<\/em>, physician, <em>industry stooge<\/em>, blogger about industry misadventures, <em>pharmascold<\/em>, psychoanalyst, <em>lost in fairy tales<\/em>. Cherokee Trail Tree finder and Carpenter were both a lot easier on the ego. But one can get used to being a multifaceted straw man. <\/div>\n<p align=\"justify\" class=\"small\">Those revelations of 2008 were the worst of times because I found out about the rampant corruption in the <em>academic psychiatry pharmaceutical industry<\/em> alliance. I had become a recluse after my own experiences and I felt guilty for not seeing what was happening in my own back yard. On the other hand, it was the best of times because it explained what had happened in my professional world that was so confusing, and it opened the door to trying to contribute to doing something about it. But looking back, 2008 was a confusing year, to say the least.<\/p>\n<div align=\"justify\" class=\"small\">One of the essential characters in this story was investigative journalist Paul Thacker who was working as a staffer for Senator Chuck Grassley who busted the prominent psychiatrists in 2008 and who introduced the Sunshine Act that came to fruition today [<a target=\"_blank\" href=\"http:\/\/www.chicagotribune.com\/business\/ct-sunshine-act-1001-biz-20141001-story.html#page=1\">Obamacare Sunshine Act sheds light on $3.5B paid to doctors<\/a>]. Paul Thacker is the unsung hero in both of these stories. Back in 2013, he wrote a retrospective about what happened in the lead up to the 2008 revelations and the release of the physician pharma payment database &#8211; just out. I won&#8217;t try to summarize it &#8211; just put down the link and his ending. It&#8217;s there for the reading full text on-line and it&#8217;s a great story:  <\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/ethics.harvard.edu\/blog\/slow-pace-success-do-something-congress\" target=\"_self\">The Slow Pace of Success in a &quot;Do Something Congress&quot;<\/a><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">Harvard University<br \/>    Edmond J. Safra Center for Ethics<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">by Paul Thacker<\/div>\n<div align=\"center\" class=\"small\">February 20, 2013<\/div>\n<p align=\"justify\">&#8230;<\/p>\n<p align=\"justify\">It took more than five years to get it done.<\/p>\n<p align=\"justify\">Now that it&rsquo;s all over, I can tell you it was worth it. This bill  will bring some balance back to the relationship between doctors and  industry. We need them to work together &mdash; industry needs the insight  from expert physicians to create the next generation of drugs and  devices, and doctors need these products to save lives. But we cannot  tolerate companies buying off doctors who put profit before patients.<\/p>\n<p align=\"justify\">Years from now, I think people will look back on these reforms &mdash; the  Grassley\/Kohl Sunshine Act &mdash; and realize that they made academic  medicine better. Few people will know about the staff behind the scenes  making it possible. Even fewer will truly appreciate the long hours and  great deal of stress we went through.<\/p>\n<div align=\"justify\">Even when Congress gets something done, it takes an incredibly long time and years of dedication.<\/div>\n<\/blockquote>\n<div align=\"justify\" class=\"small\"><img loading=\"lazy\" decoding=\"async\" width=\"136\" vspace=\"4\" hspace=\"4\" height=\"136\" border=\"1\" align=\"right\" src=\"http:\/\/0.gravatar.com\/avatar\/01817450656fd09fa2b0a939c28d9eee?s=136&#038;d=http%3A%2F%2F0.gravatar.com%2Favatar%2Fad516503a11cd5ca435acc9bb6523536%3Fs%3D136&#038;r=G\" \/>I am personally indebted to him for wiping the vasoline off of my own lenses. I hated seeing what he showed us, but am grateful that it finally saw the light of day. Senator Grassley gets loud Kudos for his work in Congress and the moral strength to pursue it, but Paul Thacker was the one who did the leg work and the head work to make it all happen. I&#8217;m absolutely sure that he opened a lot more eyes than just mine with his work, and with his later exposures of ghostwriting when he was with POGO. He reminded us of a medical ethic that had gotten lost in a lot of circles along the way. We owe him so much more than he claims for himself&#8230; <\/div>\n","protected":false},"excerpt":{"rendered":"<p>It was the best of times, it was the worst of times&#8230; A Tale of Two Cities, Charles Dickens 1859 It was 2008 and I had been retired for five years. A friend and I had built a house and I&#8217;d been involved in a project running down the living artifacts from the time before [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-50292","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/50292","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=50292"}],"version-history":[{"count":21,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/50292\/revisions"}],"predecessor-version":[{"id":50313,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/50292\/revisions\/50313"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=50292"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=50292"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=50292"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}