Drug whores and hired guns - tales from the golden age

The Carlat Psychiatric Report

There are names for what Dr. Daniel J. Carlat once was, and he does not hesitate to use them: "Drug whore," he suggested calmly. "Hired gun."

"There's really no nice way to say it. If you're being paid to offer an opinion you're not all that confident that you believe, you're corrupt," he said.

Six years ago, Carlat, a psychiatrist and textbook author who trained at Massachusetts General Hospital, found himself in demand by drug companies. Like a great many prominent psychiatrists, he was offered generous sums to give instructional talks about medications at lunches and dinners with his colleagues: $500 or more per "lunch-and-learn," $1,000 or more per dinner. He did it for about a year, speaking mainly about antidepressants, for a total of $30,000 or so beyond his salary of about $120,000.

But then his conscience rebelled.

A drug salesman chided him one day for showing "less enthusiasm for our product" than usual and "I had a kind of epiphany," said Carlat, also on the faculty of the Tufts University School of Medicine. "I realized the obvious -- that I was being paid to say good things about drugs, regardless of what my actual opinions were."

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