Telling the truth: a poor career move?

The classic image of the scientist and the physician is that of the strong intelligent person who will tell the truth at all costs and everyone will praise them. Unfortunately, this is not always the situation and stories abound of persons telling the truth about a drug, a clinical trial or a medical practice and then being ostracized and/or punished.

This is a partial repost of an article written by Ben Acre of the blog BadScience

It’s worth paying attention to medicine, because when it goes wrong, people suffer and die. But how do we know when things are going wrong? This week the BMA produced areport on whistleblowers. Of the 384 doctors they surveyed (with a dismal response rate of 12%, we should be clear): 40% said they would be too frightened of repercussions to report concerns about patient safety. Of those who had spoken out on an issue, one in ten were told this could have a negative impact on their careers. But are they being melodramatic? And what if life for whistleblowers was better?

A study published in the New England Journal of Medicine this week follows up 26 whistleblowers from the pharmaceutical industry. In the US, they know how to motivate people: speaking out is well remunerated, and if you help the government bring a successful case, you keep a significant chunk of the settlement for your own pocket.

The money is big. In September last year,for example, Pfizer paid $2.3 billion to settle allegations – backed by evidence from 6 whistleblowers – that they illegally marketed a painkiller called Bextra which has since been withdrawn. The 26 people in the NEJM study this week received an average of $3 million for their trouble, with the range going from $100,000 to $42 million.

They say money wasn’t the issue – and to be fair most were already on high wages – raising motives like personal integrity, a responsibility to protect public health, and a fear of getting caught themselves, if they became complicit in the thing they were blowing the whistle on. Nearly all had tried to fix things internally first by talking to their boss, or filing an internal complaint.

But did the money help sweeten things? Almost all were placed under enormous pressure by their companies from the outset. 13 reported stress-related health problems including shingles, psoriasis, autoimmune disorders, panic attacks, asthma, insomnia, temporomandibular joint disorder, migraine headaches, and more. 6 reported divorces, severe marital strain, or other family conflicts.

The majority were clear, furthermore, that the money was no compensation for the years of conflict, and the lasting damage to their careers. Only 2 were still employed in the pharmaceutical industry. One said he “should have taken the bribe”, another said if she’d “stayed and took stock options” she “would’ve been worth a lot more”. For at least eight, it was devastating. “I just wasn’t able to get a job,” said one. “It went longer and longer. Then I lost [my home]. I had my cars repossessed. I just went — financially I went under… I lost my 401[k]. I lost everything. Absolutely everything.”….

much more via Ben Acre BadScience

here is a link to the full report in the New England Journal of Medicine

here is a story on the topic from NPR


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