Monday, August 19, 2019

Comments by PortiaChalifoux

Showing 5 of 5 comments.

  • Psychiatrists are licensed by individual states to practice in only the state(s) in which they hold active licensure. The way to eliminate psychiatry in the US is by successfully pressuring the respective licensing bodies to rescind and cease issuing licenses to those who present credentials (certification and psychiatric residency completion) in support of practicing psychiatry. Moreover, CMS must disenroll all psychiatrists and make them ineligible for reimbursement for any medical codes (ICD9, ICD10, DSM 5) which are psychiatric. The Joint Commission must be persuaded to establish practice standards which do not allow for the credentialing of psychiatrists, the involuntary treatment of patients (with the exceptions of people lacking capacity – dementias, medication induced alteration of consciousness, trauma and the like), and treatments which have an unacceptable harm/benefit ratio (ECT, antipsychotics, restraints, etc).

    This requires a very different care infrastructure, and it would require the de-medicalization of emotional distress interventions. However, a robust public health infrastructure which has the power and resources to positively impact the social determinants of health would go a long way into realizing this.

    As to Pies, Lieberman and the other lying liars who lie, do know that they are looked upon with disdain by physicians in general. Psychiatrists are known for their weak clinical skills, their failure to grasp diagnostic reasoning, and their passive-aggressive professional communication. They are known for their 9-5 hours, their do anything for a buck ethos and their affinity for serving as bought and paid for “expert witnesses” in the criminal justice system again preying on vulnerable patients.

    If any physician other than a psychiatrist practiced using the four pillars of psychiatry: deception, coercion, non science-based treatment and misdiagnosis, that physician would be stripped of licensure after losing a huge malpractice suit. That it continues to be TAU for psychiatry is criminal.

  • (I submitted this same comment to Alison’s blog, and it is under moderation at this time)

    Your points are important ones. However, Charles Ornstein of ProPublica and the AHCJ helpfully tweeted the link to the DOJ GSK evidence, and in perusing some of it, I found:

    Over 43 million dollars worth of missing misbranded Paxil and Wellbutrin. It’s unknown whether patients already took these medications.

    There will be no enforcement of the 5 year limited agreement for GSK to follow its stated policies and procedures.

    The DOJ agrees not to criminally prosecute.

    The FDA was a victim.

    There is no provision for identifying, notifying and helping harmed patients/victims.

    GSK identified and went after “targets” of all kinds: academic institutions (Harvard, Rockefeller U and Columbia are on the 1st tier, I’m sure they’re happy to read;, “thought leaders” – physicians who contracted to do the illegal offlabel marketing – and many are named in the evidence; peer reviewed journals – again by tiers of influence – JAMA and the NEJM are up there along with Science and Nature; likely prescribers – those physicians who adamantly deny that they EVER could be influenced by pharma marketing – heh; and patients of all ages – who were getting the DTC advertising via TV, women’s magazines, their doctors’ offices and all over the internet.
    http://www.justice.gov/opa/gsk-docs.html

    This morning, Richard Horton, The Lancet editor, tweeted to ask me to find GSK references to it as a Tier 1 marketing target for bupropion sr. I did so and tweeted it. (It’s on p 25 of the 5th pdf in the complaint evidence)

    There is a lot contained in the primary documents that hasn’t been reported. I hope it gets some attention from journalists.

  • If “egregiously derisive” isn’t defined, how would one know whether a breach has been made?

    Like porn – you know it when you see it?
    Not acceptable. Mad In American needs basic blogging and commenting guidelines. That’s standard on the vast majority of interactive websites.

    Again – borrow from the best – take a gander at the NYT:

    “We are interested in articulate, well-informed remarks that are relevant to the article. We welcome your advice, your criticism and your unique insights into the issues of the day.

    Our standards for taste are reflected in the articles we publish in the newspaper and on NYTimes.com; we expect your comments to follow that example. A few things we won’t tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence and SHOUTING.

    You can read a complete Readers’ Reviews Posting Policy here.”

    Call your buddies at the Nieman Foundation – I’m sure they’d be happy to steer you to some. http://www.nieman.harvard.edu/NiemanFoundation/Audiences/JournalistsAndWriters.aspx

    How about the AHCJ? http://www.healthjournalism.org/resources-jump.php

    Or the Berkman Center. http://cyber.law.harvard.edu/

    You’re in Cambridge, aren’t you? These are all local resources excepting the NYT.

    What isn’t working is the extant non-policy policy. It is uneven, appears discriminatory, doesn’t further discussion, and ironically, it doesn’t support civility.

    PS There is a civility resource sponsored by MassHumanities which just started this spring. http://www.youtube.com/playlist?list=PL708ADB1FA2311F57

  • What’s problematic is that the commenting policies aren’t discretely and operationally defined. Moderation appears to be applied unevenly. Equating civility to “a quality of Bob’s” is fine, but it doesn’t provide guidance about content.

    Why not look at a few commenting/moderating policies that you like and which appear to promote robust discussion without targeting individuals? (NYT, perhaps?)

    In terms of hijacked comment threads: one commenter suggested having an open thread to allow people to bring up issues which are time sensitive, but which do not follow individual blog post content. That would work well as an interim fix until your forum feature is available. Who knows – maybe it would become a preferred venue for a “convo of the day”?

    I perceive that bloggers get a very moderation light hand when they hijack threads or misrepresent the content and intentions of some commenters with whom they disagree. For us readers, the obvious two class approach is disheartening and anger provoking. It strikes too close to home for the gross power imbalances that exist between those grappling with mental illness and those making a living from it.

    I hope that in the effort to bring on board first rate thinkers, movers and shakers, that all writers are held to the same standard of civil discourse.