Conflict
of Interest: It’s Not Just For Doctors Any More
(plus a newly added link to a “must-read”)
By
Leonard
Zwelling
http://www.nytimes.com/2013/12/28/business/academics-who-defend-wall-st-reap-reward.html?_r=0
And you thought it was just academic
medicine that embraced being “truth tellers for hire”. Not a chance. Did you
really think our colleagues in business schools would allow us to have a
monopoly at the trough of unseemly play for pay? Then you haven’t ever met a
finance, economics or accounting professor. I have. They are just like you and
me, susceptible to being persuaded by the power of the dollar.
The article above was on the front page
of the NY Times on Saturday December 28. It described how members of the
intelligentsia in the rarified air of business academia have adopted (they may
well have originated it) the latest way for academics to augment their salaries.
They become experts with opinions that are yours for the buying.
To increase your local pride, exhibit A
in the piece by David Kochieniewski was one Craig Pirrong a finance professor
at none other than the University of Houston. As I understand the claims, there
are many in the business and academic community who believe that the vigorous
speculation that has gone on in commodities markets in products like fuel and
food have pushed up prices for the rest of us. Academic thought leaders (don’t
you love that term? who pronounced them the leaders in how anybody else is
thinking? I thought that was Oprah’s job) have railed against the concept that
speculation fuels price inflation in papers and in front of legislative bodies
while they are on the payroll of the very industries seeking to allow the
speculation to continue.
The details are not really crucial
although they are well document in the NY Times article. What this is really
about yet again is the limits of what society will tolerate in the behavior of
those America has rewarded with good salaries and comfortable lives (that would
be academics) for the privilege of thinking, writing and teaching for a living
as opposed to doing hard physical labor or competing in the rat race that the
rest of the country does every morning. (I know, we have our own rats, but they
dress better—sometimes).
I have written about the particular
problem that the Presidents of MD Anderson seem to have with this concept. There
are many other members of the Anderson faculty who benefit from being high
salaried “thought leaders” and also enjoy cashing in by trading their
putatively unbiased opinion for cash, trips and logo-strewn pens. (The pocket
of their white coats look like the shirts of professional tennis players or the
sides of NASCAR racing machines).
I have heard the many arguments about how
essential these relationships between academia and industry are. The drug
companies supply the CME that no one else will. If we don’t develop these
relationships, our patients will be denied “treatment” with the next phase 1
drug. (Phase 1 therapy is NEVER treatment according to what I was taught about
clinical research. A phase 1 study is for dose finding.) Poor people will not
get free drug if the pharmaceutical reps do not stock doctors’ office supply
cabinets with the latest overpriced statin. And surely, we will all starve if
the detail girls with legs up to their armpits, the latest in décolletage and the
rolling pharmacies in the trunks of their expensive cars don’t bring in lunch
for the practitioner’s staff or noon conference for the fellows, the
conflictees in waiting.
Hog wash!
Academics have been granted a wonderful
privilege. We can pursue our intellectual interests and be held accountable not
for the results we generate so much as for their validity and contribution to
human knowledge. We are supposed to be doing scientific research to generate
unambiguous and unbiased knowledge, not results for hire. When we undermine
that bond of trust between society and academe by selling our opinion, whether
in business or medicine, we are destroying the foundation of the western system
of the pursuit of the truth that began thousands of years ago in Egypt, Greece,
the Middle East and Rome.
Or, rephrased: you can’t really know if
speculation raises the price of oil if your purchased opinion on the subject raises
the price of the petroleum options and you can’t make cancer history by pushing
a failed drug on national television.
Remember why we supposedly went into
medicine? It was to do good, not to profit. We in academics have the most
critical of positions for our statements influence the generalizability of
knowledge. Unlike a doc in private practice on the take from big pharma whose
thoughts being influenced by free food may only affect the care of a hundred
patients, the thoughts of academics being bought by industry can affect
millions. Nowhere in the world—ever—have academics been better rewarded than
the academic physicians of the United States. Let’s just agree that greed is
not good and buy our own lunches, pens and coffee cups and free our opinions
from the influence of marketers trying to prop up the value of their
shareholders’ investment.
That’s their job. It’s not ours.
A Must-read for all oncologists:
http://www.nytimes.com/2014/01/05/sunday-review/why-everyone-seems-to-have-cancer.html?ref=opinion
