Monday, February 16, 2009

A Straw Man Argument


Vague Complaints..

A Reponse to Frank Cerra's piece in the Daily:

"However, I want to state clearly that this University, our Medical School and all health sciences schools must have industry relationships."

Of course they do, Frank. This is a straw man argument and you know it.

There must be complete disclosure of those relationships. There must be limits placed on what is acceptable behavior.

And when the public begins to understand how much some people at the U (and elsewhere) are being paid by the pharmaceutical industry and the medical device manufacturers, there will be some embarrassing questions.

And that is the point of the exercise. Sunshine is the best disinfectant, Frank. You're a doc and you should know that.

Continuing medical education should NOT be funded by industry. PERIOD, end of discussion. If it is not clear to you why this should be, then all I can say is to remind you: "First, do no harm."

"The Daily asserts that the initial recommendations were "groundbreaking" and revised recommendations are "too soft." I disagree. The revised recommendations are significantly more stringent than a majority of U.S. medical schools and offer a practical and pragmatic way to manage this complex, evolving issue."

The Daily article by Emma Carew adequately addressed this point. The people ranking these policies - the ones who gave us a "D" - apparently don't think much of the revisions.

"Finally, I expected more fairness, more facts, and less innuendo from the Daily than the coverage over the past several weeks."
"More facts and less innuendo?" Frank, you are the one using innuendo here. What, exactly do you mean by this? Has the Daily been guilty of misstating any facts? What might these be?

Do you believe that anyone who does not agree with you is somehow not being fair?

Why was the so-called draft not distributed to all medical school faculty members for comment? I spent the better part of a day in email contact with Dean Powell trying to convince her to release the draft to all faculty. I pointed out the fast shuffle on CME softening.

Dr. Powell subsequently claimed in an email sent to all med school faculty that the decision to go forward with a watered down version of the document was the consensus of the medical school faculty. How can this possibly be, if not all of us saw it and had an opportunity to comment on this revision? There were people on her own panel who were unaware of this weakened document. Her statement about a consensus is at variance with the facts.

Why did only one department chair send the document out? Continuing to deny the absurdity of the behavior in the medical school during this conflict of interest fiasco will not make the problem go away. The Daily is not the only news organization that finds this behavior inappropriate. The Star-Tribune editorialized that this situation is bizarre and the medical school atmosphere clubby. That certainly has been my experience.

If the members of the committee were unaware of Dr. Furcht's past behavior, then how could they avail themselves of his great expertise in this matter? He obviously did not volunteer information about his past activities and the Star-Tribune had to pry it out of the U.

As Margaret Soltan pointed out in her blog, University Diaries:


Update: Already this morning the people of Minnesota perceive the brilliance of Dean Powell's reasoning. From a comment on the article:

[W]ho better to fix the system than someone who has had experience with its flaws?

UD proposes we call this the Hannibal Lecter Executive Strategy. Not only was Lecter, as an object of FBI interest, experienced in the Bureau's flaws. As someone who killed and ate people, Lecter had an insider's understanding of other people who kill and eat people.

Apparently Frank Cerra also subscribes to the Hannibal Lecter Executive Strategy.

From the Star-Tribune:

"Frank Cerra, the university's senior vice president for health sciences, said Friday he was familiar with the case but couldn't recall details. He said Furcht's experience could help inform the conflict-of-interest committee's work."
Even though the faculty didn't know about Furcht's experience, Frank?

And now, Dr. Powell is on a committee that is to discuss the decision of her own committee? And Dr. Cerra, who has already prejudged the situation is also to vet the new policy? Is the concept of conflict of interest totally foreign to the medical school AND the AHC, Frank?

As Mark Twain famously said: "Denial, it ain't just a river in Egypt." Perhaps he first thought of this while on the Mississippi in Minneapolis?

1 comment:

Rogue Medic said...

I agree with what you wrote, except for, Continuing medical education should NOT be funded by industry. PERIOD, end of discussion. If it is not clear to you why this should be, then all I can say is to remind you: "First, do no harm."

This is clearly not a minor point to you, but just above that you wrote, Sunshine is the best disinfectant. How do you reconcile these positions?

You mention, First, do no harm, but this is a saying that is more than a little misleading. Can anything be harmless? There was an excellent piece in JAMA on this topic.

A Piece of My Mind:
James D. Shelton
The Harm of "First, Do No Harm"
JAMA, Dec 6, 2000; 284: 2687 - 2688.

I assume you have access through your university. If not, I can send you a copy. I do not receive any money from any drug companies and never have. I'm just a paramedic.