Another "Key Opinion Leader" Sees the Light

The Milwaukee Journal-Sentinel continues its excellent series on academic medical centers' conflicts of interest with Pharma:

http://www.jsonline.com/features/health/43933562.html

Here we read about cardiologist James Stein of the University of Wisconsin. He describes for the newspaper's John Fauber how he became "hooked" as a young faculty member on the speakers' fees provided by the drug companies for talking about statins, starting at $500 a pop and going eventually to $2000-3000--and how long it took him to realize that he was being used by the industry and that the independence that he fondly imagined he had retained was in his own head only. He first started donating all his speakers' and consulting earnings to charity, and then curtailed all income from Pharma except for actual research grants.

Roy Poses in his Health Care Renewal blog (http://hcrenewal.blogspot.com/2009/04/another-key-opinion-leader-confesses.html#links) adds some shrewd comments about the extent to which the industry actually creates many of its so-called "key opinion leaders." Perhaps the KOLs are not people who become independently famous and then are picked up by the companies at a price. Maybe at least some of the KOLs are young, impressionable and malleable folks that the industry decides it can bend to its will. The industry can then make its stable of starlets into KOLs through arranging exposure at all the major national and international meetings, and generally by throwing around its weight and its money. I am reminded of a chilling statistic that David Healy came up with some years ago, that articles in psychiatry ghostwritten by industry hacks end up being cited in the literature three times more often than honestly authored papers. This speaks to the ability of the industry to get its message, and its messengers, out there in the public eye in most whatever way they desire.

Latest Integrity Awards: NY Times Profiles Three Newly-Pharm-Free Academics

It's been a while since this blog issued an integrity award, so I am happy to confer that honor on Drs. Peter Libby (cardiology, Brigham and Women's Hospital); Kelly Brownell (obesity medicine, Yale); and Eric Winer (breast oncology, Dana-Farber Cancer Institute). They were profiled in today's New York Times: http://www.nytimes.com/2008/04/15/health/15conf.html?_r=2&ex=1365998400&en=af5a4553709a6ccb&ei=5088&partner=rssnyt&emc=rss&oref=slogin&oref=slogin

Each previously accepted speakers' and consulting fees from the drug industry, but recently decided that the stigma and the threat to their own reputations and objectivity were too great and began to accept no payments for contacts with industry. They varied in their levels of ethical commitment to this course; Dr. Brownell was eloquent in speaking about his own fears of loss of objectivity, while Dr. Winer indicated some lingering resentment that changing social attitudes about Pharma money had forced him to have to make this decision.

The changing attitudes are the main news story here. Added to news earlier in the week of companies offering "voluntarily" to release information on gifts and payments, the fact that these highly placed academics, who in the past were happy to take industry money, now feel that the wind has significantly shifted, may be some of the best evidence yet that the shift is actually occurring.

Kolata G. Citing ethics, some doctors are rejecting industry pay. New York Times, April 15, 2008.