Doctors Behaving Badly: "Nothing dishonest" about ghostwriting, says professor caught with faked article

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August 19, 2009

If DesignWrite, the medical communications firm that has been ghostwriting articles on behalf of drug giant Wyeth, were an elementary school student, it would have a stack of papers heavy with gold stars.

Dr. Gloria Bachmann, the associate dean for women's health at the Robert Wood Johnson Medical School in New Brunswick, N.J., told the company it had written an "an A plus article" after it wrote a review article that Bachmann agreed to sign. The article appeared with hardly a word changed in The Journal of Reproductive Medicine.

Now the Milwaukee Journal Sentinel reports that Dr. Leon Speroff, a former professor of obstetrics and gynecology at Oregon Health Sciences University, was equally pleased with DesignWrite's work.

"You did a super job of writing this paper - succinct and makes the points very well," Speroff said in a May 2001 e-mail.

What is it about ghostwriting that makes seasoned professionals with years teaching at esteemed universities sound like kindergarten teachers? Is it the sheer thrill of seeing all that research synthesized and streamlined with all those gray areas brightened and caveats erased with few well-turned phrases?

Unfortunately for patients everywhere, the subject of Speroff's paper wasn't peanut butter Play-Doh or words that rhyme with "cat."

Speroff signed on as the author of "Inconsistency in Epidemiologic Findings on Postmenopausal Hormone Therapy and Breast Cancer." In partnership with the University of Wisconsin, DesignWrite had persuaded Speroff and other researchers to write five articles in 2001 to appear in a supplement to the journal Women's Health in Primary Care.

Wyeth, maker of the world's best selling hormone-replacement therapy (HRT) drugs, paid for the writing to help combat concerns about breast cancer and other side effects of HRT, but that fact was not disclosed until John Fauber and Meg Kissinger of the Journal Sentinel uncovered it in their Aug. 15 article.

The articles came shortly before a long-term $1.5 million arrangement between Wyeth and UW to educate doctors and patients around the country about hormone therapy. The initiative promoted the benefits and softened the risks of drugs that produced sales of more than $1 billion a year.

The five articles alone reached up to 128,000 doctors and other clinicians who could get medical education credit by reading the reports and taking a quiz...

...Michael Platt, president of DesignWrite, said in an e-mail the articles were scientifically accurate and the doctors had editorial control over the content. UW reviewed and approved the articles for balance and objectivity, he said in an e-mail.

At the time the articles were published, he said, it was not the norm to disclose the names of those who "provided editorial assistance to physicians."

He also said it was an acceptable industry practice to offer a courtesy review to the drug company.

Speroff's defense was, once again, straight out of kindergarten. Although this time, he was acting like the student and not the teacher, saying that everybody is doing it, so why not him?

Why is it when these researchers are caught with a drug company's hand playing them like a puppet, they pull the "standard practice" line? Standard for whom? Certainly not for the patients taking the pills and presumably not for the journal editors accepting the articles for publication. Perhaps this is something Sen. Charles Grassley, R-Iowa, should ask in a hearing. Speroff told the Journal Sentinel he had nothing to apologize for:

"There is nothing dishonest about it."

I tend to agree with Dr. James Stein, a University of Wisconsin cardiologist who told the Journal Sentinel he had turned down two offers in the previous week to sign ghostwritten articles for drug companies. Why not do it if everybody else is?

"Frankly, it's plagiarism ... If an undergraduate did this, he would be expelled."