President’s Column

I am a pharmaceutical whore. I do not follow the advice of our president, Dr. Paul Appelbaum, who suggests that we refrain from accepting the trinkets—the pens and the calendars emblazoned with the logos of the pharmaceutical products—and instead ask for reprints of controlled studies from peer-reviewed journals of the products in question.

I do just the opposite. Pharmaceutical reps who visit my office know that I am eager to receive only what we call “the toys” and that I will not even glance at the latest “controlled study.” I take the toys and give them to my children in New York City, who consider it cool to serve Risperdal popcorn to their East Village friends. All right, I admit it: I keep the Prozac pens because they write better than a Mont Blanc. And I go to the dinners at the best restaurants in Providence, because I like a good veal chop. I sit with like-minded friends, and we do our best to be ungrateful guests by quoting studies from “refereed journals” about a competing drug that we have heard about over a prime steak the month before.

Yes, I am a whore. Mea maxima culpa. But I won’t accept the articles. I know that in the fine print at the bottom of each one of them, there is the modest disclaimer that “this study was financed by an unrestricted grant from the XYZ company.” And I know that the pages of the refereed journal in which these articles appear are filled with full-page color ads from the very pharmaceutical companies that sponsor the research. And I know that the researchers who write these articles depend on pharmaceutical largesse for their livelihoods and for the support of their academic departments.

Dr. Appelbaum’s article is a wonderful apologia for APA and its relationship with the pharmaceutical companies. What it boils down to is, “We take their money because we need it.” The costs to APA of publishing the American Journal of Psychiatry would soar. We do our best to monitor the scientific validity of the breakfast symposia, because if we didn’t allow them to buy their way into our meetings, they would hold them elsewhere, without our scrutiny and control. Have you ever attended a breakfast symposium sponsored by a pharmaceutical company that touted the superiority of its competitors?

Now, let me get this straight. I should not accept ballpoint pens from pharmaceutical companies, but APA can accept millions and millions of dollars each year? Yes, I’m a whore, but just a two-bit whore. APA does it with class.