… this one from Canada. As with Allen Frances, so with just-retired University of Laval medical school professor Fernand Turcotte:
… Fernand Turcotte had not been retired long from his job in the faculty of medicine at the University of Laval when he came to an unsettling conclusion.
“I realized that the things I had been teaching my students for 35 years were not true,” says the silver-haired former Quebec City professor.
“What I thought were the contributions of my specialty to the health and well-being of humanity in fact served to further poison people’s lives.”
Turcotte’s getting at something Donald Light has argued. Light says that (I’m quoting an Inside Higher Education piece I wrote about this last year)
the market for prescription drugs – in the United States and throughout the world – has become a lemon market, indeed “the largest and most dangerous market in lemons in modern society.”
Turcotte puts it this way:
[T]he medical industry is suffering from an “ethical bankruptcy,” in which well-meaning doctors don’t have the time to synthesize all the information coming at them from pharmaceutical companies.
Studies suggest a doctor would have to spend roughly 600 hours per month reading academic journal articles just to stay up to date with the latest findings.
“The average doctor feels guilty about falling behind on his reading, and this creates a fear of incompetence,” Turcotte says. “This makes them more welcoming of whatever suggestions, no matter how ridiculous, that come from consensus conferences.”
He charges that many of these conferences, where medical consensuses are formed, are tainted by conflicts of interest.
In some cases, papers presented at these conferences – and related articles published in leading medical journals – were found to have been written by ghostwriters paid for by pharmaceutical companies.
It all adds up to major over-prescription of needlessly expensive drugs.
Turcotte’s afraid Canada is going to look like us soon. Which would be pretty gross. He’s translating Nortin Hadler’s Worried Sick: A Prescription for Health in an Overtreated America, into French as fast as he can.
February 22nd, 2011 at 8:11PM
“the market for prescription drugs … has become a lemon market…” And it happened under the eye of the FDA. Dr. Turcotte might agree with his countryman Marshall McLuhan about the changes that occurred during his academic career – and mine. The industry hijacked the conversation within psychiatry, and changed the subject from disinterested professional standards to a venal spectacle of opportunism. The very way we think about clinical management shifted from judicious and conservative to go-go and reckless, fueled by pointless FDA seals of approval for drugs that are lemons, even if they can beat placebo in mindless clinical trials. The role models shifted from senior physicians possessed of probity to cheerleading KOLs who are bought and paid for. Even the forum of continuing medical education was hijacked. So was the forum of medical journals through ghostwritten and slanted articles that changed the way we think and the questions we ask. The best term for this change is McLuhanesque. There is plenty of blame to go around but the lion’s share should go to the leaders of our professional and scientific societies in medicine, and especially in psychiatry, since the mid 1990s. They sold out. La trahison des clercs.