Pharma Support Is Complex Issue

This letter is in response to the column on APA's budget in the November 7, 2008, issue by APA President Nada Stotland, M.D., titled “Money: How Do You Want Us to Get It, and How Do You Want Us to Spend It?”

Recent trends in psychiatry's global retreat from collaboration with the pharmaceutical industry are reminiscent of the whole 1990s Ritalin panic—due to the mishaps of a few, everyone must suffer.

I am certain it is not necessary to review the long-term ramifications of the APA withdrawing pharmaceutical support. Among them, physicians will eventually prescribe state-of-the-art medications without necessarily a full understanding of pertinent pharmacology, uninsured patients will lose financial support where needed, hospitals will lose opportunities for continuing education, and it will all trickle down to everyone's taking a cue from upper echelons. As Dr. Stotland wisely pointed out, we will all be scrambling for money (not to mention morale). This is very sad indeed.

What is of concern is how we, as psychiatrists, can reduce such a complex relationship—that between medicine and industry—to its least desired outcome, namely commercial bias and undue influence. Take the example of pens and little sticky notes for the office. Does their withdrawal do justice to the well-trained colleague who has endured the rigors of residency and beyond? Should we hold off until we take a more careful look at environmental factors influencing a doctor's choice of medication?

I am hoping APA will opt to continue ongoing collaboration with the pharmaceutical industry. It will be up to its membership to advocate for creative, ethical, and meaningful relationships with industry.