Editorial Note: This is the start of a series that will likely run through to the End of the Year. For those of you who like Murder Mysteries, this is one. Please comment, speculate and help put a new source of harassment and intimidation properly on the map.
This post accompanies a talk I gave at the Hay on Wye HowTheLightGetsIn Festival this May, called The Persecution of Heretics. The talk can be seen here and an accompanying article, a variation on this post, is here.
When you click on the video it will invite you to register with The Institute of Art and Ideas. It’s free to do so and life is much easier if you do.
There are two articles that cover the content of the video – Medical Partizans and Academic Stalking available here.
No one ever expects the GMC
Behind the apparent Biblical Authority of the Clinical Trial Literature in medicine lies an Inquisitional like apparatus run by company PR agencies and agencies whose job it is to manage the perception of science, linking in academics, aimed at silencing dissent and ensuring that prescribing doctors continue to prescribe. It focusses most clearly on anyone who suggests that a Brand name drug might have significant adverse events.
Such a person will be harassed in a range of ways, including being referred to the General Medical Council (GMC). There is a need for the full details of the many ways harassment can be carried out to see the light of day.
At the time the talk was being given, unknown to me, I was again being referred to the GMC.
The stake at which the heretic ends up is in the broad light of day but the persecutor hides in the shadows. In this case is it the local Health Board, clinical colleagues, the relevant Royal College, the GMC itself, one of the major pharmaceutical companies or the Government? Watch this space.
What you think is going on
For millennia we have struggled with death and disease. In the 1950s, there was a huge increase in the number of truly effective medicines and this has played a part in improving life-spans and quality of life, in particular among children. These new drugs supported the creation of the National Health Service as treatments that work will make populations healthier and more effective at work and the provision of services offering treatments that work will pay for themselves and will make a country better able to compete with others.
Although almost all new treatments emerged without a clinical trial in sight, following the thalidomide crisis in 1962, clinical trials were put in place as a way to evaluate treatments. The established wisdom now is that clinical trials reveal the truth about medicines – they are the gold standard method of evaluation – and that once a trial confirms that a drug works, doctors should give them, and guidelines should enforce the giving, and health systems should make these treatments available at whatever cost as if effective they essentially pay for themselves.
Another safeguard put in place was that even though prescription only was a status for medicines invented to control addicts, all new drugs would be made available on prescription only. This puts doctors very clearly centre stage.
The view that medicine should be evidence based and that doctors should adhere to the evidence has become increasingly solidified in recent years. Linked to this an ever increasing proportion of the population is on an ever greater number of medicines for ever longer periods of time.
Meanwhile, treatment induced death has become one of the three leading causes of death and it now takes decades before doctors recognize a link between serious life threatening adverse events and treatment where such recognition used to be much quicker.
The medical literature has become ghost-written with close to the entire literature stemming from clinical trials of on-patent drugs ghost-written and the raw data from those trials is inaccessible. Nobody – not even the regulators – gets to see it.
In the face of this, the standard response from medicine has been that the problems lie within the pharmaceutical industry and that the only issue for doctors is one of conflicts of interest and this problem can be solved if doctors declare any conflicts they have.
Whatever about the pharmaceutical industry, doctors are good people who are trained to make sure you get the right treatment and the General Medical Council (GMC) takes care of those few doctors who might pose a risk to your health.
Latterly with the realization that clinical trial data has been concealed, there has been more of a push for access to Clinical Study Reports – the written in the company account of what its study shows. Doctors and medical researchers apparently don’t want to or can’t be trusted to have access to patient level data for reasons of confidentiality.
While there are some things we are not happy about happening within the pharmaceutical industry, medical journals and individual doctors have the belief that they are effectively drawing attention to problems and that individual doctors attempting to raise issues will find their colleagues supportive.
What is going on
In fact adverse events now take 10-20 years from the time they are reported first to the point where it is accepted they can happen. Randomized controlled trials have become the Gold Standard way to Hide adverse events and the blind adoption of trials is a mistake of historic proportions. The National Health Service meanwhile is on its way to being transformed into a system to deliver clinical trial patients to pharmaceutical companies.
It is extraordinarily easy to intimidate doctors. One simple clinical misstep can provide an opportunity for a complaint against a doctor. And clinical practice inevitably gives rise to missteps. Once it does, the GMC can be used as a weapon to persecute heretics.
Wonderful though the GMC can be, its role is asymmetric. It will not take action against doctors working for pharmaceutical companies who put out grossly misleading information about the lethal hazards of the latest blockbuster drug. It won’t take an action based on its own Good Prescribing Practice against doctors who without seeing the data put their names to ghost written articles that are part of a marketing strategy to encourage doctors to prescribe drugs that are ineffective and dangerous.
Far from being trained in one of the major determinants of clinical practice, doctors have no training in how pharmaceutical companies market drugs, no knowledge of how to investigate adverse events and they are becoming ever less able to hear awkward messages coming from patients.
The pressure on doctors is vastly greater than they are aware and this can distort well-meaning people into not very nice people. Faced with a patient or a colleague questioning whether treatment is likely to have caused an adverse event or not, from cognitive failures on statins to suicidality on antidepressants, doctors feel threatened and are liable to turn nasty. Try it and see.
The beauty of being a blogger with no link to the medical profession is, or can be, quite a powerful weapon.
For instance, I could write about a certain healthcare professional alleging malpractice or alleging links to the industry.
Chances are my post will be deemed as that of just a blogger with an opinion, ie; not worth pursuing through the courts as an act of defamation.
There have been instances where healthcare professionals have taken umbrage to what bloggers write, in those instances the professionals who have objected have drawn the subject matter to themselves by objecting to what was wrote.
Leonie Fennell v Patricia Casey springs to mind.
Leonie, a blogger, made observations about Irish psychiatrist Patricia Casey. Threatening letters were sent to Fennell via Casey’s lawyers.
Fiddaman v Benbow (GSK)
I, myself, felt the wrath of GSK’s lawyers when I made comparisons to a former GSK employee. The employee, Alistair Benbow, was unhappy that I had insinuated that he was lying – GSK also took umbrage to me using their logo in a video slide show I created. The whole affair went viral and the focus was put on Alistair Benbow.
I highlight these two blogger instances to show how effective bloggers can be opposed to someone within the medical profession making the same observations.
If, for example, you (David Healy) made the same observations as Leonie and I and you chose to write about it then you would be in a situation where (because of your name/fame and profession) you could be sued.
Lawyers would much rather target high profile figures because those same high profile figures will have a much bigger readership and/or the monetary gain for the alleged victim would be easier to ‘negotiate’ with an out of court settlement…should it ever get to the stage of court proceedings that is.
It’s a deterrent, it’s almost like a written law that has never actually been written.
The GMC cannot come after the likes of myself or Leonie Fennell but they can bare their teeth at medical professionals who write publicly.
Lawyers can, if they wish, send out threatening letters to bloggers but those they are representing will become the main focus and not the person making the observations.
When Leonie received threatening letters, she wrote about it. When I received a threatening letter I also chose to write about it.
The social networking websites republished these letters thus making the stories much bigger than what the lawyers would have wanted. Their intent, as far as I can see, was to test the water, to see if they could use intimidation as a means of getting the blogger to cease and desist.
It’s a privileged position to be in.
A blogger is only answerable to himself/herself, he/she has no editor looking through proposed articles and deleting potential defamation action.
Professionals who go public with their thoughts have it tougher though, much tougher.
Yes, Please see the link provided on the NIH (National Institute of Health) here in USA that correlates the increased risk of Benzodiazepines and Dementia. Pretty scary stuff. More easily digestable forms of this study or synopsis can be easily found by inputting “Benzodiazepines and increased risk of Dementia. How many of us have been virtual labs with our Psychotropic immersed brains since approximately 1980. I use that as a starting point, as was on the cusp of post Tri-cyclic, MAOI, era and advent of SSRI, SNRI, and we can not forget the anti-psychotics….look at Risperdol, and all the negative effects. I could go on and on, but these new findings are truly disturbing.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460255/
It’s a strange world, and getting stranger. The last few times I’ve been to my family doctor, I’ve begun to wonder: who’s pushing HER around?
She’s begun to say things like “you have three months to get your cholesterol down through diet and exercise, or I’ll have to put you on statins.” Have to? Or, last year, when I had a trivial symptom, and an EKG produced a trivial finding, she sent me off for tests. A thorough exam and a decision to do nothing would have been reasonable — and closer to her old modus operandi. A “stress-echo” would have been precaution at its finest.
Instead this turned out to be a lulu of a test where the “stress-echo” (results perfect) was followed by a big nuclear medicine scan with contrast (also perfect). I shared the waiting room with two people on scooters who obviously had congestive heart failure and a world of complex problems. They eyed me curiously as we chatted. The bill was about $7500 after Blue Cross discounts, of which my share was $2000. (Guess that’s my vacation for the year, and then some.)
When I griped a bit, this really intelligent, confident, down-to-earth woman sort of scuffed her feet and mumbled like a sixth-grader who’s been sent to the principal’s office: something about how she “had no choice” due to my “atypical chest pain” and “abnormal EKG” and “at your age…” WTF? One factor is the huge new $750 million building they recently opened, just humming with big scanners. The mortgage on that baby definitely needs to be paid.
Another has been the buyout of lots of medical practices by the hospitals themselves, which is supposed to create an “integrated” and “accountable” system. A third might be malpractice suits — but those have been around for decades and are actually going down in our area. So who is this fast-changing system “accountable” to? The investors? The insurance company? The scanner company? Some govt agency tasked with assuring the “quality” of the whole mad privatized patchwork?
Only one thing I know — it ain’t you or me.
Another excellent article describing how psychiatry defends itself and the problems inherent in medical solutions to social problems. Thank you for your community service.
Of course they will do whatever it takes to silence their critics.
And if they are willing to cheat with their ‘Clinical trial results’, then of course they are willing to falsely accuse critics.
If you look at the pharmaceutical business as a whole, I’m pretty sure Pablo Escobar rolls over in his grave saying he sold the wrong kind of drugs!!
The idea about the asymmetry in the GMC response is a really important one.
A sentiment which originated from the crew of Allied bombers during WWII is: “They could tell when they were over the target when they could see, hear and feel the flak.” Another way to say this is that “If you’re not catching flak, you’re not over the target.”
As someone who has been investigating, observing and reporting on the pharmaceutical industry for nearly 20 years, I have to say I feel like an inept bomber. I’ve never been close enough to catch any flak (ie: no one seems to be shooting at me) or maybe they are, but if they are, I’ve never really felt in any danger.
I have not recognised the fact that I am to a victim of persecution, and we all become a part of a Wheel of persecution:
I’m persecuted by the media and their way of portaying me for a sudden burst of violence.
I persecute GSK for their pill that made me violent.
GSK persecute doctor Healy for his attempts to tell the truth about the pill.
I’m so curios to see what means GSK would use if they Went after me, the global Company versus one lone end user of their Product?
There is definitely a huge control exerted by the pharmaceutical industry and by medicine. One of the problems when capitalism, expansion, and monopoly become the cardinal virtues.
They could use this friendly and transparent interview for starters…………..
A polite British interviewer with JP Garnier about Seroxat
https://uk.video.search.yahoo.com/video/play;_ylt=A2KLqIjbtyxUNhQAdh52BQx.;_ylu=X3oDMTBzNWN0ZjRuBHNlYwNzcgRzbGsDdmlkBHZ0aWQDBGdwb3MDMjY-?p=seroxat+youtube&vid=0203f2987b0e18edd3b34211adfef3d6&l=5%3A52&turl=http%3A%2F%2Fts4.mm.bing.net%2Fth%3Fid%3DVN.608010250923278407%26pid%3D15.1&rurl=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Dk_p89zIddjk&tit=JP+Garnier%2FBBC+Radio%2FAndrew+Witty+-+The+Seroxat%2FPaxil%2FAropax+issues+remain+unresolved.&c=25&sigr=11ac96c8i&sigt=12mj6maj7&age=55500903530&&tt=b
“We are done with this topic”
When I had withdrawn from SSRI’s and was writing about it I was approached by Good Housekeeping magazine for an interview, I agreed if I could agree it before going to print and gave the interview.
The copy they wanted to print missed out anything about suicidal ideation, the withdrawal effects, etc etc etc. I said if they want to tell my story they could but in full. They didnt publish. Says it all. Censorship all around.
Good for you standing your ground! People need to know the dangers. I was recently diagnosed with a condition called SIADH, which essentially means low sodium levels, and was directly caused by Duloxetine at low dose. The withdrawals are horrendous. My current Psychiatrist re-diagnosed me from Major Depression to Bipolar, basing it on my extreme reactions to SSRI, SNRI, anti-depressants. Too many Primary Physicians are still prescribing these powerful medications for folks who come in describing a temporary funk.