Incredible medical research

In the late 1980s, I suffered from undiagnosed bleeding that four gynecologists concluded was caused by hormonal imbalance. One of those four doctors prescribed Premarin, a Wyeth manufactured hormone pill that has been in use since the 1940s. I took Premarin three times a day. Within a few months of regularly taking the medication, I had to undergo surgery to remove a lump in my left breast. I was 24 years old. Sorry to be so graphic but I want you to know why the following information is of special interest to me.

Between 1998 and 2005, some 26 articles were published in various medical journals extolling the benefits of hormone drugs. In 2002, a massive federal study in the U.S. found a link between hormone drugs and certain illnesses that include breast cancer, heart disease and, in the case of older patients, dementia. Please note the timeline. Three years following the finding, articles de-emphasizing the risks involved with hormone replacement therapy were still appearing in medical journals.

Wyeth, manufacturer of Premarin, would subsequently be slapped with over 8,000 lawsuits by women who claimed to have developed illnesses as a result of Wyeth’s hormone drugs. In “Medical Papers by Ghostwriters Pushed Therapy” published on August 4, 2009, the New York Times reported:

The court documents provide a detailed paper trail showing how Wyeth contracted with a medical communications company to outline articles, draft them and then solicit top physicians to sign their names, even though many of the doctors contributed little or no writing.

One of these articles was published with the name of Michelle Warren in the byline. Warren is a professor of obstetrics and gynecology at Columbia University. While acknowledging the assistance of a four-person team in writing the article, Warren did not disclose that two of the four were employees of Wyeth and two were hired by DesignWrite, the medical communications company mentioned in the quoted portion of the New York Times report.

In fact, NONE of the articles disclosed the role of Wyeth. And none mentioned ghostwriters either. All of the articles were published giving the impression that the persons whose names appeared in the various bylines were the ones who actually did the research and the writing.

Of course, Wyeth claims they were all accurate. But tell me – TELL ME – how those 26 articles can be construed as objective, fair and scientific in the real essence of the word when the very reason they were prepared and published was to boost sales.

And what do these documents say about the credibility and respectability of doctors? We already know how drug companies compete for doctors’ favors and good graces by spending millions wining and dining them, paying for their junkets and showering them with expensive gifts as a public relations and marketing gimmick to get them to prescribe certain drugs. This has been the subject of another controversy within the American Medical Association but we know that the practice is pervasive in the Philippines as well.

And now documents show that doctors lend their names too and position themselves as drug endorsers by capitalizing on their professional title, their image and their position in respectable institutions.

What is the effect and just what is the extent of the damage? Doctors regard these medical journals as bibles of the medical community. They represent the ultimate truth and authority. And what they say can change how a doctor views certain drugs and change his prescribing habits as well.

Isn’t it ironic? Drug company sponsored research studies that favor their products are embraced by doctors as their own findings and, in effect, these doctors influence the trends and practices in the medical community.

What is the medical community then? What has it become? A handmaiden to the drug companies? Or, to put it in a more graphic way, is the medical community truly an independent scientific community or is it owned, wholly or partially, by the drug companies?

What does all this say about the credibility of medical journals? Just how credible are they with such editorial policies that have made possible the publication of so many articles that were not, in any sense of the word, unbiased?

And why do the doctors do it? For money? For fame because it is a status symbol to be published in highly-respected medical journals? Or is it an ego thing – this wanting to pretend to be competent researchers and exceptional writers which, in truth, they are not?

So many times, on print and on the web, I’ve written about why we shouldn’t heed every published scientific and medical research and modify our lifestyles accordingly unless we know for a fact that they were not written or commissioned by drug companies pushing their products. And now it has come to a point when I’m tempted to say, “I told you so.” Well, I am giving in to the temptation. I. TOLD. YOU. SO.

And yet, for failing to make disclosures, are these doctor masquerading as scientific researchers and writers any worse than their peers who appear on print and television ads telling the public, with all the apparent and implied authority of their medical garb and their names and titles splashed prominently, why one brand of medicine or toothpaste or infant milk formula is better than others?

The way things go, I might not even believe my own doctor should I be so unfortunate as to need to visit him for a consultation. Or, perhaps, I’d ask him first which medical journal he reads and which particular article or articles influenced his opinion. Then, I’d do some digging first as to whether they are tainted articles before accepting his diagnosis.

For all the claims at scientific progress, and technology that allows fast and easy access to information, I sometimes feel that we still live in the Dark Ages. Ah, what a screwed world.

Special thanks to Jon Limjap (kapenilattex.com) for pointing me to the most recent New York Times article on ghostwriting.