My Mother’s Advice for Spring Break 1982 Still Holds True Today

Despite having been made to read at least a dozen Shakespearean plays by the time I was ready to pile into a paneled Jeep with four other Sacred Heart seniors on spring break, I did not recognize that my mother’s parting words to me (“to thine own self be true”) were those of the bard himself.

It’s spring break for colleges, and my mother’s words are ringing in my ears. If you agree that the cost of health care is too high and want to have a new reason to be outraged, read on.

I opened my own biomedical communications business about a year ago, and I often seek work as a medical writer. I almost made a very big mistake this week.

I make it a practice to read a news log called MedCenterToday. Between that practice and my mother’s words, I’ve managed to dodge trouble. I’ve been following stories about a dirty little practice called medical ghostwriting that impacts your health care bottom line.

Let me explain exactly what medical ghostwriting is in today’s context. Medical ghostwriting can work several ways, but I’ll pick one scenario to examine since it’s the one most pertinent to me this week: A medical education and communications company (MECC for short) writes a grant application to bid to advertise (although they will package it as continuing medical education for doctors) a pharmaceutical company’s product. Let’s call that product Better More Expensive Pill. The pharmaceutical company says, why yes, by all means, we will give an Exorbitant Amount of Money to you for this work. Then the MECC turns to one of its M.D. or Ph.D. serfs that it pays less $50,000 a year to write for the company and says, write a first draft of a medical journal article touting Better More Expensive Pill. In this article, make sure you reassure the reader that Better More Expensive Pill does not cause Most Dreadful Unwanted and Potentially Fatal Side Effect so that doctors reading the article will prescribe the pills. And oh, by the way, please contact doctors at the Top Medical School to put their name on the paper you wrote and we will give them a little kickback. Then once you are finished with the article (and please hurry because you need to start on another one), we will contact the pharmaceutical company and collect for the article (and oh, you probably shouldn’t know this since we pay you so little, but they are paying us $25,000 for your paper).

Now do you see why this is so heinous given the cost of medical care today?

This week I almost interviewed for a job at a MECC. The job description said that I would be writing “continuing medical education,” which you know your doctor has to get each year, at a cost of about $1000 a course, to maintain his license.

While there is clearly a market for continuing medical education that is legitimate (educating your doctor about improvements in medical care since the time of his graduation), that does not justify the creation of businesses in the name of continuing medical education that are veiled advertising agencies for pharmaceutical companies.

No, I did not go through with the interview once I pieced together what was going on.

The cost of medical care is too high. As a consumer I am willing to embrace innovations and pay for them, but I do not want to pay for the dirty little tricks that industry tries to turn along the way to make a profit for executives at the expense of sick people. Medical schools do a fine job with continuing medical education, and third party for-profit companies don’t need their share of the pie.

The stories that have been written about MECC’s involvement with a marketing campaign for estrogen for menopausal women despite the risk of breast cancer is one of the best examples of what can go wrong, as are the tales of medical school docs taking big paychecks from industry to further the cause of a therapy.

It has been suggested by some writers that the authors involved in medical ghostwriting should face criminal charges. One cartoonist suggested they should sign autographs in bookstores. Senator Grassley is committed to bringing change and transparency to medical schools where these practices have been known to exist. Even some pharmaceutical companies are trying to take three giant steps backward--Pfizer and Glaxo Smith Kline have stopped providing grants for MECC’s.

Now I have an extra hour on my hands because of that interview I canceled this morning. I’ll think twice in the future about becoming anyone’s serf, because my mom and Shakespeare told me to be true to myself.