Harvard Professor of Medicine, Jerry Avorn, Points to the Same Phenomenon that I Repeatedly Do — We Cannot Unquestioningly Trust Clinical Medicine Guidelines because the People Writing them Are Often Profiting from their Financially Biased Recommendations

© 2013 Peter Free

 

13 June 2013

 

 

Citation — to the report that medicine Professor Jerry Avorn uses as a probable example of medical integrity gone awry

 

Martin J. Abrahamson, Joshua I. Barzilay, Lawrence Blonde, Zachary T. Bloomgarden, Michael A. Bush, Samuel Dagogo-Jack, Michael B. Davidson, Daniel Einhorn, W. Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B. Hirsch, Paul S. Jellinger, Janet B. McGill, Jeffrey I. Mechanick, Paul D. Rosenblit, Guillermo Umpierrez, and Michael H. Davidson, AACE Comprehensive Diabetes Management Algorithm — 2013, American Association of Clinical Endocrinologists, Endocrine Practice 19 (2): 327-336 (March-April 2013)

 

 

What Dr. Avorn wrote

 

In the New York Times, two days ago:

 

 

It would take dozens of hours each week for a conscientious primary care doctor to read everything he or she needed in order to stay current — a dizzying and impractical prospect.

 

To remedy the problem, many medical groups issue clinical-practice guidelines: experts in a field sort through the reams of clinical research on a medical condition and pore over drug studies, then publish summaries about what treatments work best so that physicians everywhere can offer the most appropriate, up-to-date care to their patients.

 

While this sounds straightforward, the process can go astray.

 

Take, for example, the recommendations issued recently by the American Association of Clinical Endocrinologists on caring for patients with diabetes.

 

Several of the now promoted drugs are expensive newcomers that lack the track records of clinical effectiveness and safety held by the older, potentially displaced treatments.

 

The changes were made, ostensibly, to give physicians more treatment choices for their patients.

 

But there is also concern that they could have been influenced by another factor:

 

the manufacturers of some of these new drugs financially supported the development of the guidelines,

 

and many of the authors are paid consultants to some of those companies.

 

© 2013 Jerry Avorn, Healing the Overwhelmed Physician, New York Times (11 June 2013) (paragraphs split and the last one reformatted)

 

 

Encouraging bias does not help the scientific process

 

When greed and narcissism successfully add themselves to the already statistically difficult scientific process, society is going to have problems in gathering trustworthy data and coming to rationally defensible conclusions about it.

 

During my lifetime, the Medical Establishment’s ethical de-evolution into an almost purely money-making enterprise has dragged that ostensibly healing profession’s credibility downward.

 

 

The moral? — Medicine, an establishment that is rapidly sliding into moral muck

 

When a panel of medical guideline-creators can openly get away with being simultaneously paid collaborators with the entities that directly profit from what the guidelines are selling — an obvious problem with scientific and medical integrity has been generated.

 

One would think that people would be up in arms.  But not so.

 

Our inescapably materialistic culture seems to think that Greed and Duplicity are synonymous with righteous soul.