The book they didn't write
The book they didn't write

Medical ghostwriting is a well-documented phenomena, revealed repeatedly in scientific articles, reviews, abstracts, posters, CME units, and even entire journals.

You can now append clinical textbooks to this list.

The textbook, “Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care,” by Charles Nemeroff and Alan Schatzberg (American Psychiatric Publishing, 1999), was in fact, ghostwritten, according to a public letter issued last week by the Project on Government Oversight (POGO), a non-profit organization dedicated to investigative journalism.

The real author of the textbook was Sally Laden, working for Scientific Therapeutics Information (STI), a medical communications company, who was contracted by GlaxoSmithKline (then SmithKline Beecham) for the work.  In the preface of the book, STI is only credited only for “editorial assistance.”

For use of their names, Nemeroff and Schatzberg received about $18,000 in royalties on the book, which was largely purchased by SmithKline Beecham and given away to family doctors.  Commenting for the New York Times, David Kessler, former commissioner of the Food and Drug Administration, was astonished:

To ghostwrite an entire textbook is a new level of chutzpah. . . . I’ve never heard of that before. It takes your breath away.

While the most common target of blame for ghostwriting has been the pharmaceutical industry, POGO has directed its ire on those who have been funding academics like Nemeroff and Schatzberg with public monies.  In their letter, addressed directly to Francis Collins, Director of the NIH, POGO claims that both researchers have collected more than $23 million in NIH funds since 2006, with another $2 million awarded just this year.

Likewise, others have pointed their finger at academia.

According to a 2005 study published in NEJM, a full 50% of medical school administrators responsible for negotiating clinical trial arrangements with industry reported that they would allow the sponsor to draft the manuscript.  A further 11% were unsure.

And in a study published this year in PLoS Medicine, only 20% of academic medical centers in the United States have policies explicitly prohibiting ghostwriting. The authors, Jeffrey Lacasse and Jonathan Leo, argue that the lack of explicit authorship guidelines permits academics to engage in complicit and mutually beneficial relationships with industry sponsors, relationships that may be ultimately harmful to public health.

Academic medical centers enable the pharmaceutical industry to covertly shape the medical literature in favor of commercial interests.

It is time for more disclosure of external interests in academic writing, and some of this responsibility clearly rests with academics and the institutions that house and support them.

Physician, it’s time to heal thyself.

Correction: December 9, 2010

On December 8, 2010, The New York Times posted a correction on the story.  Below is the fulltext:

A headline on Nov. 30 with an article about SmithKline Beecham’s role in the publication of a book about treating psychiatric disorders overstated SmithKline’s actions. While documents show that SmithKline (now known as GlaxoSmithKline) hired a writing company for the book, they do not indicate that the company wrote the book for the authors, Dr. Charles B. Nemeroff and Dr. Alan F. Schatzberg. The article also described incorrectly, in some editions, events outlined in a letter from the writing company to Dr. Nemeroff. The correspondence proposed a timeline for the writing company to furnish the doctors and SmithKline with draft text and final page proofs for approval; the letter did not say that the company had already provided those materials for final approval. And the article misstated the context under which Dr. David A. Kessler, the former commissioner of the Food and Drug Administration, commented about the book’s production. The letter and other documents were described to him; he did not personally review the documents.

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Phil Davis

Phil Davis

Phil Davis is a publishing consultant specializing in the statistical analysis of citation, readership, publication and survey data. He has a Ph.D. in science communication from Cornell University (2010), extensive experience as a science librarian (1995-2006) and was trained as a life scientist. https://phil-davis.org/

Discussion

7 Thoughts on "Physician, Heal Thyself: Medical Ghostwriting Uncovered in a Clinical Textbook"

While the NY Times’ story on this claims the book was “never in wide circulation,” there were about 26,000 copies sold. That’s a pretty good sales level for any book of this type, I think.

It’s especially disturbing that it took over 10 years for this ghostwriting to come to light. Who knows how many medical books out now have been ghostwritten? One person interviewed said, “This is only the tip of the iceberg.”

It’s not clear from this article whether the publisher knew the textbook was ghostwritten. If the publisher was not involved in that arrangement, would there not likely be a breach of contract involved, since most publishing contracts ask authors to warrant that the work is “original” and not the product of anyone else? One wonders also how the TX form was filled out to register the copyright. This was evidently a “work made for hire” by GlaxoSmithKline, which would then be the legal author and have to be represented as such on the TX form.

This book absolutely was not ghostwritten. We have on file a trail of more than 500 edits suggested by 5 peer reviewers and the authors. Notes on the edited pages and gallies (remember those?) are in the authors’ handwriting. Every single correction was included in the final book and there is no evidence that anyone tried to influnce the process. The grant was to a third party company which employed a pharmD to assemble text and tables provided by the authors from works they had done previously and to check facts. This a practice we employ an all books with heavy psychoparm content. We usually pay for these services ourselves, but in this case acknowledged (disclosed) the grant.

The authors were under contract with us which binds them to be responsible for the content. Review of the process and their recent statements confirm that they stand by the content. Further, independent peer reviewers found no bias toward any product in the book, and we confirmed this again, just recently.

This whole flap is a good example of how you cannot trust the accuracy and honesty of blogs or the New York Times. It also underscores the need to broaden the distance between corporate sponsorship and scholarly publishing–all publishing for that matter.

I’m with the Communications office at the American Psychiatric Association. The New York Times story was in error. The book was not ghostwritten.
Please note the correction published yesterday by the New York Times:
A headline on Nov. 30 with an article about SmithKline Beecham’s role in the publication of a book about treating psychiatric disorders overstated SmithKline’s actions. While documents show that SmithKline (now known as GlaxoSmithKline) hired a writing company for the book, they do not indicate that the company wrote the book for the authors, Dr. Charles B. Nemeroff and Dr. Alan F. Schatzberg. The article also described incorrectly, in some editions, events outlined in a letter from the writing company to Dr. Nemeroff. The correspondence proposed a timeline for the writing company to furnish the doctors and SmithKline with draft text and final page proofs for approval; the letter did not say that the company had already provided those materials for final approval. And the article misstated the context under which Dr. David A. Kessler, the former commissioner of the Food and Drug Administration, commented about the book’s production. The letter and other documents were described to him; he did not personally review the documents.

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