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Thursday, July 14, 2011

Should Researchers Criticize their Peers in Public?

The Chronicle of Higher Education recently reported that University of Pennsylvania psychiatrist Jay Amsterdam has accused his department chair and four colleagues of publishing an article that was (a) ghost written by a contractor for GlaxoSmithKline and (b) biased in favor of the GSK antidepressant Paxil. Amsterdam complained that the article "was biased in its conclusions, made unsubstantiated efficacy claims, and downplayed the adverse event profile of Paxil." He contends that "data from his study was effectively stolen from him, manipulated, and used in a ghostwritten article" designed "to advance a marketing scheme by GlaxoSmithKline to increase sales of Paxil."

I'm writing this post without any insider knowledge about what's going on in the Department of Psychiatry at the University of Pennsylvania. Dr. Amsterdam's faculty profile, last updated 16 months ago, shows him to be a specialist in treating depression. The Chronicle post reports that he has been on leave since August. Clearly, there's been conflict and turmoil within the department.

In the medical profession, part of our claim to authority and trustworthiness (since I'm a physician, I say "our" not "their") is that we will police ourselves and expose unacceptable performance by colleagues. Over the years we've fallen down on this job. Our tendency is to circle the wagons rather than point the finger!

Whatever the outcome of the investigation that's been undertaken, Amsterdam is setting an important example: speaking truth to power is a fundamental right and responsibility. Another recent example is the spine care experts who published a similar critique of work by colleagues on a Medtronic product that they see as biased and misleading. (See this article from the New York Times on the topic.)

Conservative professionals will warn that publicly airing intraprofessional conflicts will lead to an overly active anti-professional swing in public opinion. Unfortunately, they're right. I wish there were a less going-to-extremes way for public process to proceed. In small groups, with face-to-face contact, it's possible, But in a pluralistic society of 300 million, it's not.

(You can see Dr. Amsterdam's letter of complaint the Project on Government Oversight website.)

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