Low Hanging Fruit: Psychiatry ripe for fraud

Last week, the New York Times reported on subpoenas naming psychiatrists, one of whom is Dr. Joseph Biederman, the so called father of the childhood bipoloar movement. Biederman's financial ties to drug manufacturers have caught the attention of long time whistleblower champion, Senator Charles Grassley. The Times noted that psychiatrists make less in base salary than other medical specialists, and many supplement their income with speaking engagements and consulting gigs. Biederman receives large amounts of funding from drug manufacturers and simultaneously conducts research on bipolar medications. Also last week, Grassley requested that the American Psychiatric Association give an accounting of its finances.

Grassley, like most people, seems to have been previously unaware of the relationship between pharma dollars and everyday psychiatric decisions. In his letter to the APA last week, Grassley said, "I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions." He's talking about the role the APA plays in influencing its members about the effectiveness of certain drugs. People assume that the APA and its counterparts are neutral, but they often have a financial stake in what they recommend.

Hopefully, Grassley's timing will derail Biederman's push to medicate and label very, very young children with bipolar disorder.

Watching that effort reminds one of the ADD movement in the 1990s. Pharma manufacturers funded parent support groups for ADD; those groups organized to lobby the APA hard for less stringent diagnostic criteria in the DSM (Diagnostic and Statistical Manual of Mental Disorders). The result - tons of kids qualified under the less stringent guidelines and were labeled with ADD. Another result - lots of new customers and mega sales for ADD drugs.

Prediction - Despite this current flurry of interest, people with mental health issues will continue to be ripe fruit for fraudsters. Docs want dollars; pharma wants customers. People with disabilities don't have the resources or the political clout to demand the kind of scrutiny required to keep the APA and its counterparts vigilant. Grassley makes a good start here, but a few subpoenas are not going to make enough of a lasting change to keep people with disabilities safe.