THINK IT'S GREED? IT MIGHT BE PDMD: A PUBLIC SERVICE ANNOUNCEMENT

Ethics & Medicine, Fall 2009 by Keller, Marc E, Bieler, Bert M

Clinical research scandals. Drug company bribes. You've probably heard horror stories about doctors and their industry ties. You may even criticize these doctors as "bad" or "unethical." But did you know they are actually suffering from a treatable disorder? Profit Driven Medicine Disorder (PDMD) affects thousands of doctors in all specialties. Fortunately, the Coalition to Raise Awareness of PDMD (CRAP) is committed to getting doctors the help they need.

All doctors deserve to be well- compensated for their skills and dedication. However, physicians and researchers with PDMD feel an overwhelming urge for profit and prestige that improperly influences their research and patient care. But it's not their fault. Health professionals with PDMD can't control their behaviors and decisions. And due to widespread lack of understanding and stigma, most doctors with PDMD suffer in silence and secrecy.

Doctors with PDMD:

* regularly accept money or expensive gifts from pharmaceutical companies

* serve as paid speakers for specific drugs and treatments

* conduct Big Pharma-funded clinical research

* manipulate, suppress, or fabricate clinical trial data to help companies sell more drugs

* put their names on ghostwritten papers or sell their raw data to commercial organizations.

Why do Doctors get PDMD?

No one knows for sure why some doctors get PDMD, while others don't. Like other mental illnesses, PDMD reflects biological dysfunctions in the brain. Scientists believe that family background and life experiences are also involved, and they are beginning to discover certain genes that make doctors vulnerable to PDMD.

Of course, we cannot forget about stress. When doctors do not feel like they are receiving the level of respect or compensation owed to them, it may result in PDMD. Life events such as purchasing a home or automobile, or getting married and having children, can also trigger symptoms in individuals predisposed to PDMD.

How Does PDMD Affect Your Profession?

Profit Driven Medicine Disorder affects all doctors and researchers - even those who are not specifically suffering from the disorder. According to a national survey conducted by CRAP, seven out of ten doctors agreed that the disorder has a negative impact on their profession. Each time an instance of PDMD is reported in the news, the public loses trust in the medical field. PDMD can also cause ineffective and unsafe drugs to be rushed to the market, or kept on the market, in the interest of industry profits.

Is There Help?

There is hope for people with PDMD. In fact, most doctors who seek treatment for PDMD see significant improvement. The first step is to talk to a mental health specialist about symptoms. Once PDMD is diagnosed, there are various treatment options. Some patients have found relief through cognitive-behavioral therapy (CBT), which helps sufferers understand how PDMD influences their thought patterns. CBT can also help patients resist temptations, such as invitations for industry- sponsored drug dinners, or research grant offers.

Prescription medications have also been shown to help relieve PDMD. Of course, these can only be prescribed by a licensed practitioner. Keep in mind that a medicine may take a few weeks to start working, so doctors undergoing treatment for PDMD should remain patient.

Many doctors find that treatments are most effective when they have a network of trusted people to keep them on track, especially if they feel their symptoms returning. Local PDMD support groups are a great way for sufferers to connect with each other and offer assistance. These support groups already exist in many cities across the country, and with the help of CRAP, more are popping up all the time.

It is important to remember that there is no single "right" treatment. What works for one person may or may not be the best choice for someone else. Ask your health care provider to explain why a particular type of treatment is being recommended, what other options are available, and what you need to do to fully participate in your recovery. And don't lose hope: tremendous advances in the understanding and treatment of this debilitating illness are emerging.

PDMD Stories

"I would analyze my data, over and over, until I found something positive to say about an ineffective and expensive drug. I knew it didn't make any sense, but I was terrified of losing my funding and my perks. I thought I would wind up poor and on the streets if I didn't grab every dollar offered to me by the drug companies. Sometimes I felt so anxious that my hand would tremble when I endorsed the honoraria checks. I thought I was going crazy - until I found out I had PDMD and started treatment." - David, anesthesiologist

"At first I was too embarrassed to get help, but I'm glad I did. I was so relieved to put a name to my problem and discover that there are other people like me. I took the medicine my doctor gave me. I'm also working with a counselor to cope with my PDMD. It wasn't easy, but I'm back to working for the health of society, not Big Pharma's bottom line." - Kelly, psychiatrist