Alison Bass asks: Is psychiatry more corrupt than other medical specialties?

Alison Bass, a critic of pharma and author of the bestselling and wonderful book Side Effects A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, does a post today on her blog, pondering the above question in the title of this post. It’s well-worth reading and it’s time I introduce Alison to those of you how don’t know her. This is her bio on her blog:

Bass is an award-winning journalist and long-time medical writer for The Boston Globe. Her articles and essays have also appeared in  The Chicago Tribune, The Miami Herald, The Village Voice, Psychology Today, Technology Review, Readers Digest and numerous other newspapers and magazines around the country. A series she wrote for The Boston Globe on psychiatry was nominated for a Pulitzer Prize in the Public Service category, and she has received a number of other journalism awards for her work, including the Top Media Award from the National Mental Health Association and two Media Awards from the Alliance for the Mentally Ill. In 2007, she won a prestigious Alicia Patterson Fellowship for her investigative work. She is a Senior Lecturer in Journalism at Mount Holyoke College and an Adjunct Professor of Journalism at Brandeis University.

And this is the excerpt from her post today.

At a talk I gave Wednesday at George Washington University, someone in the audience asked why there seemed to be an inordinate number of psychiatrists on the take to the drug industry. Was it something about the specialty of psychiatry itself or the individuals involved? I have often pondered the same, especially since this is not simply an anecdotal observation. In 2007, The New York Times examined the payments made to all doctors in Minnesota in the years since that state passed one of the first laws in the nation requiring the public disclosure of payments from the pharmaceutical industry. Based on that investigation, Times reporters concluded that as a specialty, psychiatry topped the list in lucrative drug company payments.

So what’s going on? A couple of things, I think. First off, there’s a reason why drugs like Paxil, Zoloft, Prozac and Lexapro are top sellers: it’s easier to expand the criteria for who might benefit from these drugs. After all, almost everyone has experienced depressive or anxious symptoms at one time or the other, so if the makers of these drugs can reach psychiatrists and persuade them to prescribe pills for such universal symptoms, we’re talking real profits here. And what better way to influence psychiatrists’ prescribing behavior than to put their most prominent colleagues — the key opinion leaders (KOLs) — on your payroll?

Secondly, as someone who came to the talk astutely noted, psychiatrists have been squeezed by managed care into the role of pill prescribers. Unlike other medical specialties, doctors in psychiatry don’t get adequately reimbursed for treating the whole patient — by doing psychotherapy, for instance — so all they can do these days is prescribe drugs. In a sense, psychiatrists are gatekeepers for the pharmaceutical industry, much like surgeons (who put in stents and other devices) are gatekeepers for the medical device industry. (read the rest here)