Wednesday, March 11, 2009

Psychiatry: Looking in the Mirror?

A recent editorial in the American Journal of Psychiatry--

--is notable for a number of features. First, it is signed by every editor of the journal and also by every member of the editorial board. That is very unusual for editorials in medical journals. So obviously it is supposed to indicate a serious discussion that has the buy-in of all involved parties.

Next, the editorial frankly admits the problem (thoroughly documented here in too many posts to summarize) of conflicts of interest among academic psychiatrists and the resultant loss of trust in the specialty as well as medicine more generally. Here and there a minor quibble or excuse is inserted, but the overall tone of the editorial is, folks, we have a real problem here, no more pretending that it's all OK.

Finally, the editorial presents the bald and unwelcome solution--if we are going to free ourselves from the tentacles of industry entanglements, we have to stop expecting the industry to foot the bill for our various dalliances. No more having our professional societies and all our CME paid for by the drug companies. We need to step up and to be willing to pay for a heftier chunk of our own professional obligations.

In all these ways the editorial seems to be a serious statement of the need for reform in one medical specialty that has been especially subjected to unwelcome publicity. For a more cynical take see that of my fellow blogger and academic psychiatrist, Dr. James Bremner:

As he responds as a psychiatry insider, it's hard to disagree with what he says. Form your own opinion.

Freedman R, Lewis DA, Michels R, et al. Conflict of interest: an issue for every psychiatrist. American Journal of Psychiatry 166:274-277, 2009.

1 comment:

Doug Bremner said...

If you were recruited to be a new chair in a department of psychiatry, what kind of rules would you make?