This letter is in response to the column on APA's budget in the November 7,
2008, issue by APA President Nada Stotland, M.D., titled "Money: How Do
You Want Us to Get It, and How Do You Want Us to Spend It?"
Recent trends in psychiatry's global retreat from collaboration with the
pharmaceutical industry are reminiscent of the whole 1990s Ritalin
panic—due to the mishaps of a few, everyone must suffer.
I am certain it is not necessary to review the long-term ramifications of
the APA withdrawing pharmaceutical support. Among them, physicians will
eventually prescribe state-of-the-art medications without necessarily a full
understanding of pertinent pharmacology, uninsured patients will lose
financial support where needed, hospitals will lose opportunities for
continuing education, and it will all trickle down to everyone's taking a cue
from upper echelons. As Dr. Stotland wisely pointed out, we will all be
scrambling for money (not to mention morale). This is very sad indeed.
What is of concern is how we, as psychiatrists, can reduce such a complex
relationship—that between medicine and industry—to its least
desired outcome, namely commercial bias and undue influence. Take the example
of pens and little sticky notes for the office. Does their withdrawal do
justice to the well-trained colleague who has endured the rigors of residency
and beyond? Should we hold off until we take a more careful look at
environmental factors influencing a doctor's choice of medication?
I am hoping APA will opt to continue ongoing collaboration with the
pharmaceutical industry. It will be up to its membership to advocate for
creative, ethical, and meaningful relationships with industry.