UD’s friend Roy Poses at Health Care Renewal takes a look at Russell Portenoy, a professor at Yeshiva.

In the last few decades, Portenoy has been busy making the world safe for opioids, insisting that millions of Americans can take them with little to no risk of addiction. He has also been enriching himself through consulting and speaking for pain pill manufacturers.

Portenoy isn’t alone. Here’s another advocate:

[In 1998, one doctor] said he understood that a patient would simply ‘go to sleep’ before stopping breathing. While asleep, he said, the patient ‘can’t take a dangerous dose. It sounds scary, but as far as I know, nobody anywhere is getting burned by doing it this way.’

This is the functional equivalent of John Willke on rape.

****************************

Plenty of academic doctors continue to exploit the legitimacy their academic positions give them to shill for pain pill pharma, but what’s intriguing here is that Portenoy now expresses some regrets:

‘I gave innumerable lectures in the late 1980s and ’90s about addiction that weren’t true,’ Dr. Portenoy said in a 2010 videotaped interview with a fellow doctor.

Not just not true. They helped create the stupendous pain pill addiction epidemic in this country.

*****************************

It seems obvious that we should, as Roy says, be skeptical of “people paid by narcotics manufacturers advocating increased use of these drugs, no matter how distinguished, scholarly, or influential these people appear to be.” But in the equally destructive matter of anti-psychotics for children, Joseph Biederman, who continues on the Harvard faculty, seems to have met with no skepticism at all – at least none that could stop him as he almost singlehandedly caused a 40-fold increase in the use of these dangerous drugs.

While he appeared a grandfatherly academic, Dr. [Sidney] Gilman, 80, was living a parallel life, one in which he regularly advised a wide network of Wall Street traders through a professional matchmaking system. Those relationships afforded him payments of $100,000 or more a year — on top of his $258,000 pay from the University of Michigan — and travels with limousines, luxury hotels and private jets. … Dr. Gilman made a sharp shift in his late 60s, from a life dedicated to academic research to one in which he accumulated a growing list of financial firms willing to pay him $1,000 an hour for his medical expertise, while he was overseeing drug trials for various pharmaceutical makers. … Colleagues now say Dr. Gilman’s story is a reminder of the corrupting influence of money. The University of Michigan, where he was a professor for decades, has erased any trace of him on its Web sites, and is now reviewing its consulting policy for employees, a spokesman said.

[Gilman] has been ostracized by the university, and the consequences are broader still as a debate over the propriety of professors’ receiving payments from financial firms has been rekindled.

“What is the argument for sanctioning your full-time faculty, using your brand name, to advise the financial sector?” said Dr. Garret A. FitzGerald, a cardiovascular researcher at the University of Pennsylvania, who has been outspoken about conflicts of interest. “What’s the public good there?”

Oh pish posh. What’s the public good of Michigan’s president, Mary Sue Coleman, collecting huge sums from corporate boards for doing little other than attending meetings that cut into the time she can devote to the university? Was she distracted by her corporate boarding when she insisted on the catastrophic hiring of Rich Rodriguez?

Colleagues can nod their heads sagely about the corrupting influence of money, but really. When the president of Gilman’s university is as subject to greed as Goldman Sachs executive compensation rubber-stamper Ruth Simmons was, why should Gilman have felt uneasy about his own acquisitiveness?

… for insider trading (“Among researchers, physicians, government officials and corporate executives, the lure of easy money in health-care insider trading has become epidemic.”), you might want to pay attention to the sort of people likely to get arrested and embarrass you the way Sid Gilman has embarrassed the University of Michigan. I hate to be the one to tell you, but the endless futzing you’ve been doing with your conflict of interest forms for professors ain’t gonna cut it. You need to be able to see these guys coming.

The Gilman/Martoma story, and the related Benhamou/Skowron story, reveal, for those who wish to see, “the deeply compromised, fundamentally flawed research system in which academic figureheads serve as puppets for industry interests.” Of course, these two are just the really big money stories – hundreds of millions in profit, or avoidance of loss; Gilman’s $1,000 an hour fee for the care and feeding of his hedgie. If you want to be reminded of the zillions of smaller stories (these aren’t always about insider trading; they’re about mercenary professors as other sorts of corporate puppets), click on this blog’s conflict of interest category.

So – how do you see ‘em coming?

First: Here’s what you shouldn’t do. Don’t do this retrospectively. Don’t think that by reviewing the traumatic life stories, and the pleading-for-mercy-in-front-of-a-judge statements, of people already in jail you can detect who among your faculty is, even as we speak, breaking insider trading laws. They all say the same thing. They have no idea how they lost their moral compass but they’re sure it’s around here somewhere. They thought they were dealing pretty well with their mother’s death but actually it turned them into bitter twisted nihilists. Don’t bother with this.

Instead, gaze about you at your medical faculty and ask the following question: Who’s the greediest of them all? The very greediest? I’m not talking about people who want to live well. Everyone wants to live well, and long may we prosper. I’m talking about faculty members whose acquisitiveness, ostentation, and status anxiety are notorious — the subject of jokes and stories and general incredulity. These guys are liable to be deeply in debt as they buy more and more and more and more. You want to have them in for a chat about their corporate ties.

… (close to 900 million dollars in fines of one sort or another; placed under a monitor’s oversight; executives indicted for securities violations, various lawsuits, etc., etc.), so we know Laurie Glimcher really works for the hundreds of thousands in compensation she gets from the corporation. Keeps a good eye on its extensive anti-competitive practices.

Or, you know, I mean, I’m being ironic. Glimcher seems to know how to be a good soldier, and which of us wouldn’t be a good soldier, collecting that sort of compensation for doing very little? Indeed for apparently inquiring very little into the actual operations you’re supposed to be directing?

Now that she’s dean of Weill Cornell Medical College, Cornell defends her directorship against suggestions of conflict of interest by insisting on the importance of such university/corporate partnerships.

But what is the nature of the partnership here? Under her watch, Bristol-Myers Squibb was for years was one of the most law-breaking anti-competitive corporations around. Under her watch, one executive after another quit in disgrace.

… says Sid Gilman on his University of Michigan medical school page.

You said it. Ever since his insider trading charge, Sid’s been too busy with lawyers to make time for students:

Dr. Sidney Gilman, a neurology professor at the University of Michigan Medical School … was chairman of the safety monitoring committee overseeing the clinical trials of the Alzheimer’s drug.

[Hedge fund manager Mathew Martoma, also charged,] met Gilman some time between 2006 and 2008 through paid consultations, the SEC complaint says. “During these consultations, Gilman provided Martoma with material, nonpublic information about the ongoing trial,” the SEC complaint said.

In mid-July 2008, “Gilman provided Martoma with the actual, detailed results of the clinical trial” before an official announcement on July 29, 2008, the SEC said.

And wow did these guys make a lot of money. Most lucrative insider trading scheme ever.

Details, in case you want to try this yourself.

Martoma allegedly found out from Sidney Gilman, a leading Alzheimer’s investigator at the University of Michigan, that bapineuzumab–then owned by Wyeth and Elan–had failed a key study. Not only did the hedge fund sell all of its shares in the two companies, they shorted the developers as well. And they made a killing when the share price for both cratered on the news. Gilman, who reportedly was connected to Martoma through an expert networking firm that paid him $100,000, is now cooperating with the feds.

Here’s Sid in happier days, sleeping and perchance dreaming of making a killing and then having to try to save his ass by cooperating with the feds.

****************************

Update: A fellow University of Michigan professor comments.

Gilman’s conduct raises fresh questions about firms that match investors with experts in subjects that could move stock prices, said Erik Gordon, a University of Michigan business professor who follows the pharmaceutical industry.

“If the allegations are true, it’s reprehensible conduct for someone who has misused a position of trust,” said Gordon, who added that he doesn’t know Gilman. “This is crookery of really the lowest possible ethical standards. It doesn’t get much lower.”

One does wonder… Here’s a much-venerated man with, you figure, oodles of income. Why do it? Why be so greedy as to risk ruining your life — when you don’t need the money?

… solved.

… or they’ll never disclose.

And that’s what Rose Hackman, a Columbia University student, has done with regard to tight-lipped Business School professor Glenn Hubbard, star of the film Inside Job.

Columbia Business School dean Glenn Hubbard is … featured in [the film] “Inside Job.” In interviews in the film, Dean Hubbard is asked about his extensive ties to the financial service industry, including a 2004 paper written with the then-Goldman Sachs chief economist, William C. Dudley (now president of the Federal Reserve Bank of New York), in which Hubbard praised credit derivatives as enhancing economic stability, reducing volatility, and making recessions less frequent and severe. According to the New York Times, Warren Buffett has called these same practices “financial weapons of mass destruction” that are widely acknowledged by many economists as having helped trigger the crisis.

Following the film’s release, along with other single-school initiatives, Columbia Business School nominally addressed critics by establishing a committee headed by Hubbard’s vice dean, Christopher Mayer. The result was a pledge by the committee to go beyond University transparency requirements. The pledge asked Business School faculty to declare all outside activities on an online CV, linked to each faculty member’s individual website.

But Hubbard’s position as economic advisor to the former presidential hopeful Mitt Romney still remains absent from his online Columbia profile. His ties to the Analysis Group, a consultancy firm which has placed him as an expert defending financial industry players, also remains absent.

The University of Wisconsin has endured the taptaptap of bad news about one of its faculty for years, and for years it has closed its ears to it.

It’s our old friend Thomas Zdeblick, object of a federal investigation into his remarkably lucrative relationship with Medtronic.

Investigators … found that two papers Zdeblick co-authored were among 11 in which Medtronic employees, including those in the company’s marketing department, were secretly involved in drafting and editing, a practice known as ghostwriting.

Both papers were published in the Journal of Spinal Disorders & Techniques where Zdeblick has served as editor-in-chief since 2002. That role was the subject of a 2009 Journal Sentinel/MedPage Today investigation that found the journal frequently published favorable articles about Medtronic products under Zdeblick’s watch. The story noted that Zdeblick’s financial relationship with Medtronic was not disclosed by the journal.

Many more gory details here. The picture the investigation draws is one of rampant conflict of interest destructive of patient health and research integrity. An Emory professor to whom Medtronic gave $25.5 million protests that the money had absolutely no effect on the articles he wrote about its products.

*************************

The Zdeblick scandal jumps to Reuters. Perhaps now, with the release of the Senate’s definitive report, this story will get the attention it deserves. The University of Wisconsin will no more respond to it than Donna Shalala’s University of Miami will face up to what it has in Charles Nemeroff. It will take international coverage of practices at schools like Wisconsin for the conflict of interest that corrupts academic medicine in the United States to change.

**************************

Two of the featured Medtronic beneficiaries are at the University of Louisville.

… discover what we already know; but it’s important to get this confirmation. Makers of anti-psychotic drugs (scroll down for all posts) target Medicaid psychiatrists in DC.

Medicaid psychiatrists …received a disproportionate, share of industry largesse, receiving two-thirds (66%) of gifts and payments. In 2008 (the most recent data available), antipsychotic use by Medicaid recipients was especially high in the nation’s capitol, with approximately 1 in 10 recipients receiving a prescription — a rate five times higher than the total national population.

A large proportion of Medicaid recipients are children under the age of 18. Antipsychotics can cause sedation, weight gain, diabetes, and other adverse effects.

It’s an absolutely perfect storm from the manufacturer’s point of view. A large vulnerable population. Doctors who may not be among the most highly trained.

“Antipsychotics are clearly being used in patients who are not psychotic,” said Adriane Fugh-Berman, MD.

The clouds are gathering at the University of Texas medical school, as its new corporate acquisition, Ronald DePinho, president of the cancer center, produces yet more bad publicity.

DePinho, the very model of the modern money man, does not see why conflict of interest should apply to him (since it would mean temporarily giving up certain income flows), or why his wife – hired on his faculty – shouldn’t get special treatment…

This chick, Kristen Juras, a law professor at the University of Montana, came down hard on the campus newspaper when it inaugurated a sex column. Said it had to be stopped because it was ‘embarrassingly unprofessional’ and reflected badly upon her as a faculty member.

That was a couple of years ago.

You really want unprofessional? Unprofessional is setting yourself up as a private consultant to write articles favoring your clients, and then using the cover of your university appointment to give your hackwork legitimacy. It’s failing to disclose that your work is paid independent work for a client – tailor-made to promote that client’s legislative interests – and has nothing to do with the university which has you on its faculty.

When Montana’s governor complained to the university’s president that one of his faculty was misbehaving in this way, it irritated the president. He was caught off guard. You could say he was embarrassed.

Juras’ written study contained no disclosure saying her conclusions were her own and not the university’s views, nor did she seek prior consent from her dean to use the university name in working as a consultant, [the president] said.

Now of course Juras is screaming about free speech… A confused woman.

This first paragraph from today’s Brown University newspaper isn’t quite correct. It should read “co-ghosted.” Because not only did Brown’s Keller put his name on a fraudulent study, he seems to have allowed his good friend Glaxo to write the article for him. “Keller acknowledged in 2006 that over the years, he had received tens of thousands of dollars from GSK and its affiliates.”

Brown University stands in fervent solidarity with Martin Keller.

After all, this sort of corruption is a drop in the bucket for Brown, whose last president signed off on the Goldman Sachs bonuses, and whose board of trustees is a Rappaccini’s garden of shady hedgies.

Brown has grown a certain money culture; in it, special relationships with friends like Glaxo Smith Kline and Goldman Sachs bloom. That’s Brown.

Hey wait! We didn’t say you could actually track the patients to see whether our device works. We’re going to destroy your academic career now, because we told you what to do, you knew that your job was to provide university cover for our claim that the device works, and your university needs to know that you went off half-cocked like the madman you are and actually tracked your patients to see if the device actually worked.

The University of Saskatchewan’s Daryl Fourney is in big trouble. A big powerful company is filing complaints against him with his employer, and now the New York Times has noticed. After all, a 2010 article by one Chopko totally contradicts Fourney’s findings.

In response, Dr. Fourney noted that Dr. Chopko’s positive 2010 report failed to disclose his financial ties to Vertos; Dr. Chopko, who is Vertos’s director of physician education, described the omission as a “clerical error” and said it would be rectified.

Pesky clerical error! When it comes to conflict of interest, UD, who follows the topic, can tell you that this specific little fuckup occurs with astounding frequency in the scientific literature. I’m sure it will be rectified, along with the study protocol, which will once again specify that you must under no circumstances follow up with your patients beyond the point where we tell you to stop.

The wildly controversial prostate-specific antigen test (PSA) continues to be the subject of studies and debates. Does it help prevent prostate cancer, or is its use actually destructive, subjecting people to unnecessary surgeries? Results and opinions vary too widely, at the moment, to conclude anything with certainty.

Yet the expression of opinions about it would seem fundamental to medical school professors involved in the issue, and you’d think a respectable school like the University of California Davis would encourage its faculty to be part of the debate.

Yet Davis, already dealing with one med school fiasco, now has another, because a dean there got so angry at a professor’s published disapproval of PSA that he told him

he would be punished in two ways. First, he would lose his position in the doctoring program [a special training program he'd put together], and second, he would lose the funding support for a Hungarian student exchange program that he organized.

Why so angry?

Well, money’s involved. The doctor decided to write an anti-PSA opinion piece when he realized that a seminar at Davis was “primarily a sales pitch about the prostate specific antigen (PSA) test, and that its main message was that men should get tested regularly beginning at age 40.” University seminars aren’t supposed to be homes for hucksters, especially when what they’re selling might hurt people. I mean, of course it happens, as in this case at the University of Toronto; but it’s not supposed to happen. Not to mention that professors have a right to say what they like without deans and university lawyers making threats against them, as they did in this case.

Stanford’s got a bit of a problem on its hands. It’s the sort of problem you get when you’re an exceedingly entrepreneurial university and you’ve got your hands and your professors’ hands in a lot of businesses.

Remember the problem they had with Alan Schatzberg’s investments and Alan Schatzberg’s research? It just doesn’t look good for empirical analysis when you stand to make gazillions on its outcome… So Stanford spends half its time tweaking its conflict of interest rules…

And another thing. Take NU Skin, an outfit that, among other things, sells face-whitening cream to women in the Philippines who want to look white, and an outfit with which Stanford’s had a long relationship (meaning NU Skin gives Stanford big money to do anti-aging research). NU Skin’s in serious trouble with the FDA for this and that — the usual stuff, questionable marketing tactics, questionable claims… And Stanford’s name’s being dragged into it… NU Skin’s scientific claims for its products rest on its association with Stanford researchers, and NU Skin talks up that association in its advertising.

So, seeing the shit about to hit the fan, Stanford has done a cease and desist letter

asking the company to stop using a university researcher’s name in its advertising, adding new scrutiny to the skin product maker’s business claims and practices.

According to a copy of the letter emailed to Reuters, Stanford geneticist Stuart Kim is listed as a “Nu Skin Partner” in developing its ageLOC anti-aging products, though he has nothing to do with the company. Nu Skin touts its skin creams and pills as using innovative technology to “reset” genes that promote a more youthful look and feel for its clients, according to its website.

“Neither Dr. Kim nor Stanford is a ‘Nu Skin Partner’ and neither has anything to do with the company,” states the letter, signed by Steven Rosen from Stanford’s Office of the General Counsel.

Which isn’t true, I’m afraid. Kim did do research with NU Skin money (he doesn’t anymore), and while that doesn’t make him what you’d call a “partner,” I guess, it certainly doesn’t rise to nothing to do with the company. To make matters even less factual, Stanford indeed continues its long association with NU Skin via the work of other faculty researchers.

As this guy, an outraged NU Skin investor (its stock value has withered like a ninety year old kneecap) points out, Stanford had to issue another letter directly contradicting this one and admitting that the school has plenty of NU Skin in the game:

Not only does the university cite their longstanding relationship with the company, they essentially apologize for creating any misunderstanding that a relationship did not exist.

It is rather bad form to take millions and millions of dollars from someone, and then when that person has a run-in with the law to disown him. But these are the dilemmas inherent in the entrepreneurial university business model.