Polite Dissent

There has been a good deal of concern voiced about bias in the doctors responsible for publishing certain guidelines or carrying out certain studies. With pharmaceutical companies funding most of these studies and guidelines this is a legitimate concern.

It used to be that the federal government sponsored most of the studies, but they’ve been cutting back funding (nothing new, it’s been happening for several administrations now). Drug companies are picking up the slack and fund many of the big studies and guideline groups. This wouldn’t be so bad if the involved physicians and organizations were upfront about it. Instead, they’ve been secretive about their funding, and then defensive when questioned.

Since I live ten-miles from Peoria, this quote caught my eye:

Christopher Seymour, executive director of the National Lipid Association, a group that promotes cholesterol control and is largely funded by drug companies, has six of the nine guideline doctors on his board.
“Who in America is going to write these guidelines if you don’t go to the thought leaders? Should I call Dr. X in the middle of Peoria? What gives them credentials to be on my board?” he asked.

Because apparently there are no good doctors in the mid-west; you have to live in New York, Boston, or LA to be a “thought leader.” Give me a break. Most of these “thought leaders” haven’t actually touched a patient themselves in decades. I know this guy is just defending his organization, but being condescending and demeaning doesn’t help at all.

Luckily, the AP reporter had enough sense to talk to a cardiologist in Peoria.

But at the University of Illinois in Peoria, they think quite a lot of Dr. Frank Gold, who in 30 years as a cardiologist has taken no consulting or lecture fees from industry.
“I’m squeaky-clean,” he says, and “would jump at the opportunity” to serve on a guidelines panel. “There are tons of people like me, and they’re even in places like Des Moines, Iowa.”

I’ve never dealt with Dr. Gold myself, but I’ve heard many good things about him from patients, medical students, and other doctors.

Bias is a definite concern in published guidelines and reports. The best option is for the various groups to be upfront about any ties to the drug companies. In today’s health economy, the only way some important studies are going to get done are with pharmaceutical company funding. This is an unfortunate fact, but true. Still it is the responsibility of those involved to be truthful about it.