A Drug Rep Speaks Out

Hi website visitors,

A colleague sent me a link to a controversial YouTube video that does, in my opinion, contain some truth. It may be on the strong side, and might offend some individuals. However, I am convinced that there is a conflict between the needs of marketing and the needs of science, and that the drug companies are definitely in the business of marketing. This conflict potentially contaminates research done in an attempt to get some chemical approved as an “antidepressant” or whatever by a drug company.

Take a look at the video and see what you think, by CLICKING HERE! And if you love it, or totally hate it, feel free to comment as well.


Minutes Later: I started get replies to this posting almost immediately. For example: “Thanks for the video today on big pharma! Chrissy ”

You are welcome, Chrissy!

Here is another, from Pat

David, I agree and saw another video a few weeks back. It was a guy who disclosed that when psychotherapy became popular back in the 60’s and 70’s, some psychiatrists found themselves losing patients to psychologists, counselors, and similar. He said that Big Pharma pushed psychiatrists to push use drugs, as an easy way to help patients.

That sounds like a reasonable explanation to me, and seems to agree with what you write, and what this woman says in the video. I almost sent that video link to you, but decided that you get so many email, and did want be overwhelming. Does what I write seem valid to you?

Thanks, Pat

Hi Pat,

Thanks so much for your note! I agree that there are strong financial factors that massively influence the way emotional problems are treated, and the way drug companies conduct and publish their research.

A new psychiatrist right out of residency can sometimes earn vastly more money by treating patient with brief drug-management sessions, as the insurance companies will sometimes reimburse moat a much higher rate for a brief drug management session than for a full hour of psychotherapy. For example, you can see six patients in an hour with ten minute drug management sessions scheduled back to back, and make way more money than you can make by seeing patients for an hour of psychotherapy. In addition, the new forms of psychotherapy, such as the TEAM-CBT my colleagues and I have created, require a tremendous amount of training, dedication, and aptitude. And then, if you are effective, you are “punished” when your patients rapidly recover after five or six sessions and, quite understandably, end their treatment. So you are constantly having to market yourself for new patients, especially in an area like California where there are tons of therapists of various persuasions looking for patients.

One of our finest TEAM-CBT psychiatrists, Matthew May, MD, recently discussed his practice during a hike with me. Matt was a little bit discouraged because so many of his patients–most, in fact–were recovering so rapidly that he could not keep his practice full, and he was genuinely worried. Fortunately, the problem was quickly solved. I emailed our training group and everyone started sending him referrals, because we all know how phenomenal he is, so now he is more than full again! But I am often sad, and sometimes angry, about the dominating effect of big money on the treatment of depression, anxiety, and so forth. My comments here are just the tip of the iceberg, and I apologize if I have not been clear, or if I sound like a nut! I probably am a nut, but sometimes I have some good ideas, too, I think.

In spite of the financial issues, the greatest reward in the world for me is seeing patients rapidly and totally recover. That is such a high. It is like being witness to a miracle.

So I’m glad I made the choice I made, early in my career, to give up a full-time psychopharmacology career to focus on learning and developing the awesome, and mostly drug-free treatments we have today for individuals struggling with depression, anxiety, and conflicted personal relationships. I would have hated a career writing prescriptions for medications that, in my extensive experience, were, for the most part, not terribly effective, no matter how lucrative that might have been.

Finally, I do not wish to cast any negative shadow on fellow psychiatrists who do have a psychopharmacology based practice. Most are very compassionate and skillful individuals with extensive training doing their best for the patients they serve. I have never been against psychiatric medications, but have always felt they are emphasized a little too heavily, and that sometimes individuals simply do not get the psychological help and support they need.

And I know Pat, that you can probably resonate with this message. I appreciate your support, Pat!