55 doctors, $14 million: Hidden industry ties taint psychiatric manual

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big-pharma-money(NaturalHealth365)  When receiving treatment for any condition, one of the least desirable situations is having to doubt your doctor’s intentions.  While you might trust some physicians, can the same assurance be extended to the doctors whose guidance, potentially influenced by Big Pharma, forms the basis for your doctor’s decisions?

For example, the DSM, or Diagnostic and Statistical Manual of Mental Disorders, serves as the reference for identifying criteria and treatment approaches for mental illnesses in the fields of psychology and psychiatry.  Periodically updated in alignment with modern scientific insights and input from numerous physicians, the latest version is the DSM-5.  A team of researchers aimed to investigate the influence of external funding on the selection of doctors involved in crafting this recent diagnostic manual.

We are going to look at the outcomes of this study to get an idea of how much influence lobbyists and companies have on the doctors who create the treatment guidelines physicians use every day.

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The DSM is intended to bring together scientists, researchers, and practitioners of various mental health disciplines to evaluate, identify, and treat mental health disorders.  While diagnostics and identification are largely undisputed science, the treatment area can be quite broad.

The problematic aspect involves external funding, particularly from pharmaceutical companies producing costly psychiatric drugs.  If these companies financially incentivize doctors to view their medications favorably, it becomes challenging for those doctors to provide unbiased consultations for the DSM.

Mental health treatment and diagnosis represent a significant market for pharmaceuticals, with considerable financial contributions reaching doctors.  Permitting treatment decisions to be influenced by financial motives is not only hazardous but also raises ethical concerns.  This is exactly why the research we are examining today was conducted.

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Follow the money: Doctors received over $14 million in external industry funds

Since 2013, the Physician Payments Sunshine Act has provided federal authorization to ensure transparency in all payments directed towards research, universities, and doctors, making them openly accessible to the public and government.  The Bureau of Medicaid and Medicare has established an openly accessible database of doctor payments, encompassing not only monetary transactions but also non-monetary items such as food, trips, tickets to events, and other gifts.

The researchers utilized the database to retrieve information on all payments, returns on investments associated with their work, gifts, and additional compensation unrelated to their direct labor for doctors contributing to the DSM between 2016 and 2019.  Extracting names from the credits and copyright details of the DSM-5, they identified a total of 168 doctors who participated in the panels responsible for crafting the latest DSM.

Of those 168 doctors, 92 met the inclusion criteria.  Of these, 55 (60%) received payments from Big Pharma totaling over $14.2 million from 2016 to 2019, raising concerns about potential conflicts of interest in the development of the DSM-5-TR.  The researchers identified that while some of these doctors only received a small remuneration of $50-250 worth of travel or food expenses, some received significant payments in the form of “other” payments, consulting fees, lecture fees, and presentation fees.

Why disclosure matters

Before their involvement in crafting the DSM-5, a majority of the participating doctors failed to disclose their external connections within the pharmaceutical network, and despite their payments being recorded in the access database, the lack of complete transparency in the DSM’s creation did not mandate the disclosure of potentially conflicting interests.

This poses a significant concern as doctors compensated by pharmaceutical companies may advocate treatments that align with those companies’ products, even if not optimal.  The worst-case scenario involves recommending medications without proper scrutiny or ones proven to carry significant side effects, which may not otherwise be the preferred choice for a given condition.

Should you trust your diagnosis?

With all of this information and a healthy dose of understanding of the amount of money that flows from Big Pharma into doctors’ pockets, you are probably questioning whether or not you should believe any diagnosis or treatment.

The good news is that if you have a holistic doctor, they likely prioritize your well-being.  However, if you’re consulting a doctor within a large practice handling numerous patients daily, and you feel rushed towards a particular medication without adequate discussion, it might be prudent to pause and consider seeking a genuine second opinion.

This doesn’t imply disregarding your physician’s guidance; rather, it suggests exercising caution if you encounter a doctor who does not take the time to listen to your concerns and promptly prescribes a new – perhaps even unproven – medication.  While not all doctors in such situations aim to promote a medication for the kickbacks they receive from pharmaceutical companies, this trend is on the rise.

Reestablishing trust in medicine

The simplest solution to all of these questions would be to make Big Pharma lobbying illegal or at least crack down on it significantly across the board.  Conflicts of interest are rampant within the medical community, and whenever a doctor contributes to something as monumentally important as the DSM, all of their financial interests should be scrutinized and laid bare before they say a single thing about the treatment or diagnosis of any condition.

Furthermore, consultation for the DSM should only occur within doctors or research universities and hospitals that do not have ties to Big Pharma or any other company that gives them kickbacks.  If you are a political person, it would not be a bad idea to call your congressmen and women to voice your opinion on transparency in medicine.

Change can happen, but it requires us to all be vocal about how we will not stand for Big Pharma corruption to dictate the medicines that we are given or the diagnosis that we are told to believe.

Sources for this article include:

BMJ.com
Childrenshealthdefense.org

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