Confessions Of A Medical Ghostwriter

Here’s a fascinating peek into the shadowy world of medical ghostwriting by an 11-year veteran of the practice. Linda Logdberg, writing in the current edition of the open-access medical journal PLoS, discusses how the increasingly troubling aspects of her job pushed her to quit:

..the ethical issues began to tap me on the shoulder: perhaps the most memorable example of this was a contraceptive product that caused severe, unpredictable vaginal bleeding in some women. My job was to draft a monograph that would profile the product’s benefits, one of which, according to the client, was that although the bleeding could be severe, it was at least something that women could anticipate. In other words—the bad news is that a meteorite will strike you, but the good news is—a meteorite will strike you!

This kind of doublespeak became more and more troubling, and my career came to an end over a job involving revising a manuscript supporting the use of a drug for attention deficit-hyperactivity disorder (ADHD), with a duration of action that fell between that of shorter- and longer-acting formulations. However, I have two children with ADHD, and I failed to see the benefit of a drug that would wear off right at suppertime, rather than a few hours before or a few hours after. Suppertime is a time in ADHD households when tempers and homework arguments are often at their worst. So I questioned the account executive at the large agency that had hired me. In particular, I wanted to ask the physician author their view of the drug’s benefits. Attempts to discuss my misgivings with the meded contact met with the curt admonition to “just write it.” But perhaps because this particular disorder was so close to home, I was unwilling to turn this ugly duckling of a “me-too” drug into a marketable swan.

She ultimately decided to “burn…[her] medical writing bridges” and talk to reporters at The New York Times, who were working on an investigative article about pharmaceutical companies marketing to doctors. Shortly after The Times piece was published in November, 2002, Logdberg writes:

I received a polite letter from an executive of the meded company asking for all the materials back and reminding me of my confidentiality agreement. I also received a direct threat of legal retaliation in a phone call from my former contact at that agency.

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  • http://pulse.yahoo.com/_HKYENGQW4RE63ATVYSFZ56MVTQ Michael S. Altus, PhD, ELS

    Odd.

     

    The ethically principled explanation that Linda Logdberg,
    PhD, provides in her article differs sharply with the shameful explanation that
    she provided to Carl Elliott, MD, PhD, in his book, White Coat, Black Hat:
    Adventures on the Dark Side of Medicine (Beacon Press, 2010).

    According to her article (Logdberg L [2011] Being the Ghost
    in the Machine: A Medical Ghostwriter’s Personal View. PLoS Med 8(8): e1001071.
    doi:10.1371/journal.pmed.1001071), Dr. Logdberg left academia for the following
    reason:

    “Ironically, though, it was the ethics of authorship that
    sent me fleeing academia. I ran afoul of a colleague in my last research
    position, who assumed that postdocs would draft his grant renewal application.
    I commented offhandedly one day, ‘Well, I for one would never write something
    and have someone else sign his name to it—that would be unethical.’ Dr. X told
    me that that was when he realized that it would not work out for me to continue
    there, as my attitude was unacceptably insubordinate. Faced with the need for a
    job, I resigned and answered an ad in The
    New York Times for a company that needed medical writers. This began a
    series of freelance and in-house jobs with a range of medical communications
    companies.”

     

    But Dr. Logdberg gave a much different explanation to Dr.
    Elliott (White Coat, Black Hat, page 35) about why she headed for the New York
    Times job ads:

    “By training,
    she is an anatomist. Logdberg stumbled into medical writing while she was
    working unhappily at a Columbia University affiliate hospital near New York. ‘It was a terrible job, weighing
    rats and cleaning rat cages,’ she says. ‘I worked with a crazed Orthodox Jew
    with a PhD in biochemistry who never bathed. He was very smart but he wouldn’t
    give the police department his building security code to reset after he was
    robbed, because ‘Why should I give my personal information to a goy?’ In 1991
    Logdberg saw an ad in the New York Times
    for a medical writer. She left her research job and spent the next sixteen
    years as a writer, often working for medical communications agencies.”

    I had garnered a great deal of respect for Dr. Logdberg when
    I read her interviews with The New York Times (Madison Ave. has growing role in the
    business of drug research. Nov. 22, 2002; http://tinyurl.com/4xojf3c) and on an episode, “Science and
    Health: Science for Sale?”
    of the PBS television program, NOW (http://tinyurl.com/ykbktzv). When I read
    her comment on page 35 of White Coat, Black Hat, in which I am quoted on page,
    33, I retained my respect for her ethical stance but believed that she comments
    were shameful. Now that I read that Dr. Logdberg explained her departure from
    academia in two very different ways, I am not sure what to believe.