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Dr. Schulz on media abuse

After I pulled the trigger on this one, I logged on to University Diaries. Lo and behold, Margaret Soltan had a post that blew Dr. Shulz's op-ed away. For a good example of her SOS style, please see:

(The above is actually a link, click to see article - browser probs?)

Our psychiatry department head, Dr. Charles Schulz, has an op-ed in the Pioneer Press:

Docs and drug companies -- manage the relationship, don't destroy it Charles Schulz

Much has been written over the past few years about the relationship between doctors and the pharmaceutical industry. So I would like to disclose the following right now: I have worked with multiple companies over the years on sponsored research and as a consultant, and I continue to do so. During this time I have published a number of papers regarding this work -- including some pertinent negative results concerning the drugs these companies make.

A recent Pioneer Press report noted I have received less money from industry in the last year. Why? Because nothing is more important to me than the reputation of the Department of Psychiatry at the University of Minnesota Medical School, and I am concerned that the media portrayal of all physician-industry relationships as bad could affect public perception.

What the media stories do not mention are the advances that have been made because of these relationships, which are managed carefully by institutions such as the University of Minnesota, where the Institutional Review Board approves all studies for human subjects and the Sponsored Projects Administration negotiates all contracts with industry.

Physician-researchers need to partner with industry to develop new treatments. It is the system we have in place. The National Institutes of Mental Health do not fund development of new compounds in psychiatry; their focus is on funding basic science and mechanisms of action after approval.

When it comes to clinical research to improve and develop medicines and bring them to market, it is industry that funds that work. And the research to develop new drugs is very expensive, costing $800 million and even up to $1 billion to get a drug discovered and available for patients.

When I consider the field of psychiatry, the advances made because of new medicines -- studied in research institutions and developed by pharmaceutical companies -- have been enormous and life-changing. Before we had effective medications, one out of two hospital beds was taken by a mentally ill patient. We no longer warehouse psychotic patients and drug them with opiates to "manage" them. Now, we have better ways. Better medications.

Because of the partnerships between physicians and industry and the medications that have resulted from these relationships, many psychiatric patients were able to leave institutions. Now, because of the advances in psychiatric medicine, patients in our department -- who are mothers, fathers, sons, daughters and friends -- can be treated as outpatients. Many have jobs, support families and contribute to society.

Are the psychiatric drugs we have now perfect? No. All drugs have side effects, and the drugs I prescribe my patients are no different. The leading edge of our research now focuses on predicting which medications, which compounds, will be effective for our patients. The goal remains to help people live independently, or with the fewest restraints on their freedom. In our department, we develop programs that integrate efficacious medications with effective psychosocial treatments. There are always new discoveries to be made, and it is truly unfortunate that the public is hearing only one side of the story from the media.

Do physician-industry relationships need to be managed? Absolutely. Has the increased scrutiny in the past couple of years resulted in constructive changes? Yes. But the answer is not to break these ties completely. My patients of the future are counting on them.

Charles Schulz, M.D., heads the Department of Psychiatry at the University of Minnesota Medical School.

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Dr. Shulz,

Your argument that "the media portray all physician-industry relationships as bad" is a straw man.

You are well aware, I am sure, of the serious abuse of this relationship by the leaders of your field in academic medicine. I will not cite chapter and verse.

If nothing is more important to you than the reputation of the Department of Psychiatry at the University of Minnesota Medical School, then why don't you do something positive about the foot-dragging on the Conflict of Interest policy at the University of Minnesota medical school? As you are well aware, the goal of such a policy is NOT to sever all industry/university relationships but rather to place them on, shall we say, a little higher ethical plane than they have been in the past.

That two years have elapsed since this process was begun is an indication, apparently, of the importance our leaders place on this topic. Another indication is the selection of a violator of our present COI policy as one of the co-chairs of the original committee tasked to begin this revision.

Actions speak louder than words, Dr. Schulz. Or defensive op-eds in newspapers...

My late uncle was a psychiatrist and a damned good one. He would be heart sick over recent developments in academic psychiatry. Please show some leadership in turning this situation around.

Sincerely,

Your U of M colleague, Bill Gleason

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