Tuesday, August 25, 2009

Why Are We Doing This? A Reminder

As the news about the recent ghostwriting revelations continues to ripple out, an interesting post appeared on a blog called "University Diaries," aimed at reform in higher education I gather:


The blog posting contains interesting allegations regarding one Roger (or Rogerio) Lobo, at one time chair of Obstetrics and Gynecology at Columbia University med school. (I've not sought any documentation of these old charges beyond what's on the blog, hence the "allegations.") Seems the good Dr. Lobo was caught up on a scam some years back, when an article appeared with him listed as first author claiming that intercessory prayer had greatly increased the rate of success in an infertility clinic. Eventually the research "methods" were completely debunked and one of the "investigators" was actually indicted for fraud. Columbia circled the wagons and defended Dr. Lobo, since as he noted he had not really had anything to do with the research itself--he agreed to have his name put on the paper only after all the "research" was completed and without seeing any of the raw data. Remember, this was what was said in his defense. Supposedly all this blew over and the journal did not even see fit to formally retract the paper--but by coincidence, Dr. Lobo was no longer chair of his department.

Now, says the blog, guess who is listed as one of the Wyeth ghost authors willing (for a fee) to put their names on ghost-written papers praising Wyeth's Prempro. Yup, none other than good ol' Dr. Lobo.

This is all very interesting but what most caught my eye were some of the comments posted to the blog in response to this:

"Must say, I remain baffled as to why medical schools are so scandalously different from other parts of the American university – so indifferent to the origins and legitimacy of their faculty’s work, and to their conflicts of interest... I’ve only begun to understand that there’s a kind of systemic, overlooked fraudulence about many medical faculties. The sort of thing that spawns Michael Jackson’s drugmeister, Arnold Klein — still on UCLA’s faculty far as I can tell…"

"More than a quarter century ago, when Nicholas Wade and William Broad published their disturbing book, Betrayers of the Truth, describing some of the most egregious and notorious cases of deceit and fraud in science, a very disturbing pattern emerged: Medical schools were spawning a disproportionate number of crooks, liars, and cheats. Despite the famous oath physicians take to do no harm, a shocking majority of frauds in science were MDs, rather than Ph.Ds. ...I haven’t seen a more recent comparison. But, considering how many medical schools have lowered some of their ethical standards, I suspect the discrepancy has grown much worse. I’ve often watched with dismay as medical school academics lie and misrepresent their research data repeatedly with impunity. I’ve seen much less of that in non-medical fields of research."

"[About] a PhD grad student who wantonly created his data used in several published research papers, I thought: O.K. Clearly not all of the science frauds are MDs.
But then I read deeper into the article and saw that this fraud had earned his MD six years ago. He then went back to get his PhD — apparently in creative fiction.
Louisiana State University won’t comment whether the fraud will lose the PhD earned last year with the help of that bogus data. However, a spokesman said he’s not going to be stripped of his MD. I’m not surprised. It’s becoming clearer and clearer that medical schools have much lower ethical standards than the other sciences.
Nobody who jeopardizes the health and lives of patients by publishing fraudulent clinical data should be allowed to practice medicine. That should be clear. But it’s not, at least to those who train, license, and discipline physicians in America."
PS--on the LSU student and his misdeeds see: http://www.the-scientist.com/blog/display/55917/

So this is a handy reminder as to why us "pharmascolds" are in this game to start with. You guys over at ACRE, now do you get it? Here is what we are up against. There are reports of scandals among academic physicians, and what is the reaction of our fellow academics in other disciplines? "Oh my heavens, what a shock, to find physicians acting in this manner"? Not at all. The reaction is-- "Ho hum. So what did you expect anyway? After all, these bozos work in the medical school."

A little bit of history: In the middle of the 19th century, many U.S. universities, starting with Harvard and going on down the list, had medical schools officially affiliated with them. But it was widely understood that the med school was a completely different breed of animal from the "real" university. The med school was a proprietary operation that existed to make money. Students were admitted with no college degree and sometimes without even a high school diploma, they bought tickets to attend lectures, and if they sat through the right number of lectures, they got their MD degree. The "professors" of the medical school were basically practitioners from town who wanted to pad their incomes by selling those lecture tickets, the proceeds from which they got to pocket, and whose academic credentials would never have gotten them in the door of the university proper.

Then, starting with schools like Harvard and Penn in the 1880s and culminating with Johns Hopkins in the 1890s and finally the Flexner Report of 1910, medical education reformed itself. The moneychangers were thrown out of the temple of academe; being a med school professor was newly seen as a full time job--indeed, a relatively low-paying one--and not as a cushy way of moonlighting for cash; and standards of medical education rose to the level that gained universal respect by the middle 20th c.

So are we now witnessing the return of proprietary medicine--the med school newly emerging as a blight on the university scene because of its low ethical standards and unabashed pursuit of cash? The one thing doubtful about this picture, sadly, is whether the rest of the university can give itself any ethical airs, or whether the selling-out of educational values and ethical integrity is pretty much across the board.

Thanks to Doug Bremner's blog for the tip on this post:


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