The author of “The Medical Model in Mental Health” has stated [a number of times] that his book “provides evidence that psychiatry is among least influenced by industry of medical specialties”.
“The Medical Model in Mental Health” provides only two references in relation to the potential for Psychiatry to be biased by industry [and both references, in Chapter 5, appear to have been sourced from an American Psychiatrist, Dr George Dawson, MD].
This text book, in no way, provides evidence to support the assertion that UK Psychiatry is “among least influenced by industry.” It is important to be clear about this.
Dr Margaret McCartney has said, in her BMJ column ‘No Holds Barred’ that “Doctors should call out bollocksology when they see it”. Well this emphatic statement by Dr Huda is a prime example of bollocksology.
Here are some of the paid opinion leaders in UK psychiatry [I have used information available in the public domain to construct visual summaries of the competing interests of some key opinion leaders. I have done so in the spirit of the relevant guidance of the Royal College of Psychiatrists].
One of the sources he provided on twitter directly refutes his claim: https://twitter.com/SameiHuda/status/1209479976585695232
“Yes it’s in the book the paper which John has said he bought. If u r interested in actual evidence the paper is Marshall et al 2016 Mayo Clinic Proceedings 91:84-96. Conflict of interests also frequently occur in eg psychotherapy research by the way”
According to the study he provided as proof: 15 specialties take less than psychiatry per doctor. Only 10 take more, mainly surgical specialties whose primary service is surgery, not prescribing.
Thank you for sharing this. I hope that this published Text Book does not have more errors like this.
I gave a review of this Text Book here
kind wishes
Peter Gordon
Thanks Peter, I appreciate the link. I have not read the book, but I appreciate the review. I did read an interview where he talks about the book and he seemed to use quite a bit of distraction by analogy. I think it is easy to make a good case for psychiatry in theory, but the ideal theoretical case seems impossible to live up to in clinical practice. I would equate Samei’s case for the profession to the theoretical ideal (which make for good public relations), while Samei’s attitude and contempt for patients on twitter is more akin to the reality. It also seems a mistake to compare psychiatry to general medicine. While drugs for BP etc are also approved based on surrogate health outcomes, they are at least often verified to improve an objective health outcome like all-cause mortality later, while it seems that isn’t that case with psychotropics. It seems if depression is an illness with considerable morbidity and mortality, the treatment should at least improve these outcomes. But I think psychiatry and industry have abandoned any attempt to prove that ADs reduce mortality risk. Since I doubt it is for a lack of trying, I think patients and skeptical physicians need to assume the worst.