{"id":68741,"date":"2016-10-18T12:50:15","date_gmt":"2016-10-18T16:50:15","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=68741"},"modified":"2016-10-18T12:56:29","modified_gmt":"2016-10-18T16:56:29","slug":"accountability-iv","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2016\/10\/18\/accountability-iv\/","title":{"rendered":"accountability IV…"},"content":{"rendered":"\n

"He who controls the narrative, controls the debate."<\/font><\/em><\/strong><\/p>\n

It was after retiring when I first became aware of how unreliable the information I had about the psychiatric medications I was being asked to prescibe as a volunteer physician had become. So I went to the medical resources traditionally available to me. I bought the latest textbooks, read the PDR, began to read review articles and the original articles reporting on the clinical trials of the drugs themselves. I got to know ClinicalTrials.gov <\/font>and Drugs@FDA<\/font>. I read the blogs available at that time – furious seasons<\/font>, soulful sepulcher<\/font>, carlat<\/font>, etc. And I read about Conflicts of Interest and learned about Speaker’s Bureaus, Key Opinion Leaders [KOLs], and Senator Grassley’s findings of payola. It was a sadly disillusioning landscape. <\/p>\n

That had never happened to me in Medicine. I had the conviction that when I hit a bump in the road I could hit the books and find my way. And this time it didn’t happen. I couldn’t find an anchor, some still point that I could count on. In a forty year medical career, I had counted on the academic literature to be a guide and it just wasn’t there this time. The chairman of the department I was affiliated with was removed from his post for unreported pharmaceutical income. The same was true for the President of the American Psychiatric Association. Such goings on in Medicine were unparalleled in my experience.<\/p>\n

Flash forward six or seven years. It’s taken me that long to accept that things just aren’t like they used to be. In the past, I could count on the academic medical literature because of a covenant of integrity<\/font><\/em> that was part of medicine’s academic tradition – embedded in its historic narrative. But there’s something now that really is different, and I credit Alastair Matheson<\/font> for making it clear, though he did it in slightly different context [see rebranding…<\/a>]. This is now part of academic medicine’s narrative:<\/p>\n

"Conflict of Interest is not a problem if it is acknowledged."<\/font><\/strong><\/em><\/p>\n

That’s what is different now. And by the way, it’s an absurd declaration. Of course it’s a problem. How could it be otherwise? In the past, that covenant of integrity<\/font><\/em> was the unseen force that allowed me to count on the literature. It’s not there any more, or maybe sleeping very soundly. And the time for lamenting its absence or trying to force it to come back has passed. It’s a time to accept that we’re in a different place now, and have to make adaptations to the world we actually live in. To hold people accountable directly. That false statement is currently controlling the narrative. That’s why we need for the FDA to actively certify, actively offer surveillance, actively intervene. The implicit checks and balances of historic medicine are no longer operating as they have in the past.<\/p>\n

It makes me sad too, but it is what it is. Thus, the Petition<\/a>…<\/div>\n","protected":false},"excerpt":{"rendered":"

"He who controls the narrative, controls the debate." It was after retiring when I first became aware of how unreliable the information I had about the psychiatric medications I was being asked to prescibe as a volunteer physician had become. So I went to the medical resources traditionally available to me. I bought the latest […]<\/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_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-68741","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/68741","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=68741"}],"version-history":[{"count":4,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/68741\/revisions"}],"predecessor-version":[{"id":68745,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/68741\/revisions\/68745"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=68741"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=68741"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=68741"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}