I have some concerns regarding the depiction of psychiatrists who provide pharmaceutical education in the community by Dr. Sreenivasa Desai in his August 20 letter to the editor. Because he has been exposed to some biased presentations, he feels all such speakers are tainted and are making “a career out presenting lectures supported by drug companies.” I, too, have gone to presentations in which the speaker clearly had only briefly reviewed the slide set and was willing to repeat whatever he had been told by the sponsor.
The most effective way to eradicate such practices is to contact the pharmaceutical representatives who sponsored the talk and make concerns known. The last thing the sponsor wants is a clinician coming away with a negative impression of the company's product. Too often, attendees go for the free food and pay little attention to the lecture, colluding in the situations Dr. Desai described.
When invited to give a presentation sponsored by a pharmaceutical company, I follow the following procedures:
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I speak only about medications with which I have extensive personal experience prescribing to my own patients.
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After receiving the slide set from the company, I review all of the slides to assure accuracy and my own ability to present the data fairly and informatively.
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Generally I cull at least half of the company's slides and replace them with ones that I create specifically for the lecture. My slides may include reviews of other pertinent studies, teaching materials in basic pharmacology, and clinical information from my own practice experience. The process of creating an informative objective set of slides usually takes several weeks.
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Once I'm at the site, I make very clear to all in attendance that the discussion will be unbiased and fair. I always review all the drugs in the class under discussion. Yes, I say positive things about the sponsor's drug—I would not have agreed to do the talk if I had not had a positive experience with the product. At the same time, I am very clear about the downside of the sponsor's product.
There is a role for community-based education efforts about the medications we prescribe, and if at all possible psychiatrists should take the lead in providing this information. We are in the best position to comment on the efficacy, safety, and clinical issues involved with these products in a fair and complete fashion. When done correctly, these presentations serve everyone: the presenter, who creates the lecture; the attendees, who can discuss clinical issues in person with someone who has experience with the drug; and the sponsor, who is able to observe firsthand the issues of importance to clinicians.
