President’s Column

I regard Dr. Appelbaum as a shining light of our profession, but in his presidential column of July 5 titled “Throw Them Out?,” he misses the point of objections by some APA members to the incestuous relationship between our organization and pharmaceutical companies.

Not only psychiatry, but all of medicine is under scrutiny about these relationships. The editorial pages of the New England Journal of Medicine and Lancet have deplored the damage that they cause to organized medicine and have called loudly for change. Even among some of my psychiatric colleagues, there is a perception that the recommendations of experts, and even the fruits of research, have to be regarded with skepticism because of the potential bias induced by financial and professional ties with drug companies. But we are told, nevertheless, that accommodation to the status quo by APA is practical and wise: that drug company-supported educational programs are necessary, that the selection of material is completely independent, and that APA would be unable to carry out many of its essential functions without drug company financing.

In accepting such rationalizations, we risk losing our most valuable asset: our reputations for independent judgment and the uncompromising devotion to patient care above all other concerns. By indebting ourselves to these commercial interests, we will lose the public’s trust in our professional objectivity, not to mention losing some of our self-esteem.