Dr. Guttmacher is the clinical director of the Rochester Psychiatric Center and a clinical professor of psychiatry and medical humanities at the University of Rochester School of Medicine and Dentistry.
I learned all this the hard way many years ago. After completing a fellowship at the National Institute of Mental Health researching panic disorder, I returned to Rochester. A new antianxiety medication was being extolled by leading American psychopharmacologists. I was quickly identified as a "key opinion leader" and made very nice side money lecturing on the medication's use.
But after a couple of years, it dawned on me that this medication had a very short half-life in the body. Patients were withdrawing every morning and escalating their dose to maintain its effect. A second-year medical student could have seen that. How had this blindingly obvious fact escaped me? I realized then that the company was much better at its work than I was. I stopped giving drug company-sponsored lectures, stopped seeing reps, and have slept better since.
What should we do about corporate influence? The responsibility begins with prescribers. We physicians must retake control of our education and seek out unbiased sources of information. We must be willing to assume the true cost of attending meetings. We must turn down the freebies. We should curtail or stop using drug company samples. Hospitals and doctors' offices must ban drug reps. Medical schools need to toughen conflict-of-interest policies. Patients deserve full transparency.
Ultimately, our obligation should be to maximize the wellbeing of our patients, and to operate in their interest and not our own.