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AMA’s New Sunbeam Crisis: The AMA Federation’s “Trojan Horse”

Posted on | February 25, 2016 | 3 Comments

TheprocessionofthetrojanhorseintroybygiovannidomenicotiepoloSource:Wikipedia

Mike Magee

In August, 1997, the leadership of the AMA ignited an existential crisis by agreeing to loan their imprimatur to the Sunbeam corporation. The imprimatur, along with an AMA endorsement, was to be assigned to Sunbeam products in nine home-care categories including heating pads, vaporizers and blood pressure cuffs. In return, the Florida based company, led by the notoriously aggressive Al Dunlap, was to provide millions in royalties.

As soon as the deal was announced, all hell broke lose. Consumer advocates, legislators, and AMA members openly criticized the deal. Within a week, there was a highly critical New York Times editorial. That was enough for the AMA Board to intervene, launch an independent internal investigation, fire their executive vice president and four other staffers, and ultimately settle with Sunbeam for breaking the contract at the cost of $10 million dollars.

That is how seriously the AMA took the integrity of their imprimatur. All the more surprising then, that they have allowed pharmaceutical manufacturers to access the power and might of that very same imprimatur through their own organizational back door. The “trojan horse” that has facilitated entry is none other than the AMA Federation’s vaulted specialty societies.

The AMA’s unwillingness or inability to provide strict quality control over its now 121 specialty societies was revealed as a result of the publicity surrounding Nobel Prize economist Angus Deaton’s finding that the survival curve in middle aged, white American males had curved downward over the past decade as a result of prescription opioid abuse, most especially of OxyContin.

OxyContin is produced by Purdue Pharma, a one drug firm begun as Purdue Frederick Co. in 1952 by Academic Medicine’s favorite philanthropist, Arthur M. Sackler, MD. Sackler was the father of modern pharmaceutical marketing, whose feats were well catalogued in the biography accompanying his posthumous induction into the Medical Marketing Hall of Fame in 1997.

Sackler’s game book was remarkably consistent over the years. By following these five steps, he became one of the lead designers of the modern Medical-Industrial Complex.

Step 1. Create a quasi-medical organization for legitimacy.

Step 2. Provide funding to the organization to sponsor quasi-academic vehicles (journals and CME programs) to publish supportive articles, and then re-educate practitioners toward the medicalization of your target condition and the need for treatment of this condition with your therapy.

Step 3. Expand the number of professional and consumer organizations to create momentum, demand, and implied consensus.

Step 4. Integrate these programs with mainstream intelligentsia by ample funding in high end medical journals and generous philanthropic support of brand institutions, so that by simple name association, you reinforce your own brand’s integrity.

Step 5. When over-prescribing ignites a backlash, generously and magnanimously participate in the corrective steps, which you yourself made necessary.

Exactly how and when the Purdue Pharma “trojan horse” penetrated the venerable AMA Federation has been well documented in prior publications. What is abundantly clear is that the area of pain management is clearly over-represented and ethically compromised within the AMA Federation. Beyond the historic societies that cover psychiatry, neurology, anesthesiology, emergency medicine, physical medicine and rehabilitation, and oncology (all of whom have strands devoted to pain management), there are also The American Academy of Pain Medicine (1983), The American Academy of Hospice and Palliative Medicine (1988), the American Society of Addiction Medicine (1988), and The American Society of Interventional Pain Physicians (1998).

The prior series, the Man-made Opioid Epidemic, documented the fundamental absence of any meaningful quality control checks on the AMA’s own Federation members. In a recent AMA blog post, AMA Presidency Steven J. Stack, M.D., writes, “We have a defining moment before us—the kind of moment that we will look back on in years to come as one in which we as a profession rose to the challenge to save our patients, our families and our communities during a time of crisis.”

He then encourages physician members to cooperate with prescription drug monitoring programs and improve their education of how best to approach opioid prescribing. Where should they turn for such education? Stack suggests, “The AMA has gathered more than 100 state and specialty-specific education resources in a one-stop shop for the best and most up-to-date education that organized medicine has to offer. Be sure to take advantage of these materials.”

These include the very same Sackler-infused, Purdue-dominated, OxyContin-fueled characters who ignited this whole mess to begin with. These are the inventors of “pain – the 5th vital sign”, the marketers disguised as CME providers, the malleable state medical board leaders, the patent holders of delayed release technology which they assured rendered OxyContin “addiction proof”.

What then should President Stack and the AMA Board of Trustees do instead? As with the Sunbeam crisis, they should fund an immediate, thorough, internal investigation directed at their own management standards and the ethical integrity of their state and specialty societies. Individuals and associations found to be directly responsible for this modern day Sunbeam crisis should be permanently severed from the organization.

The AMA has a systemic problem that requires immediate attention. If left unaddressed, it poses a much greater risk to the organization than Sunbeam ever did. Questions that the AMA Board of Trustees need to address include:

1. As with 501C3’s, should each national member be required to submit a full financial report, including educational offerings, and complete list of sponsors each year?

2. Should leadership of participating member organizations be required to complete and sign-off on a conflict of interest online program each year to maintain membership?

3. Should Federation member websites be required to include a “sponsor” heading in their navigation bar displaying a complete list of commercial sponsors/advertisers which provided financial/in-kind support for operations, CME funding, public affairs funding, and/or journal advertisements, for the past 5 years, including donations to the member organization and any associated Foundations?

4. Should the results of that annual declaration be available on the AMA public website?

5. Has the AMA ever decertified a Federation National Medical Society? Which, when, and why?

6. Should the AMA establish formal Quality Assessment of their Federation members focused not on membership, but on educational, financial, and ethical performance?

Comments

3 Responses to “AMA’s New Sunbeam Crisis: The AMA Federation’s “Trojan Horse””

  1. AMA’s New Sunbeam Crisis: The AMA Federation’s “Trojan Horse” – Donald M. Hayes Blog
    February 25th, 2016 @ 5:41 pm

    […] post AMA’s New Sunbeam Crisis: The AMA Federation’s “Trojan Horse” appeared first on […]

  2. Denise Link
    February 25th, 2016 @ 5:53 pm

    Geeze, and they proclaim that APRNs are dangerous and a risk to the public health. No data to support that, just a proclamation.

  3. Rodolfo Vickrey
    March 12th, 2016 @ 12:55 am

    Delegates themselves were in two camps. One group wanted an extensive investigation with outside attorneys. Others pronounced themselves happy with the investigation already conducted by AMA lawyers and requested “closure” so the group could move on.

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