We do some good things in our healthcare systems everyday. I know this. It isn’t all bad. BUT, often I want to throw up my hands in frustration. I see so many problems, complicated ones like the new DSM-5, arising from money being the driving force in the delivery of healthcare and so many layers linking fortune-making to lack-of-care!
In Martha Rosenberg’s, Dissident Voice | 5/28/12 Report, “Psychiatrists Seek New Patients at Annual Meeting“, she exposes some past, present and future connections between the psychiatrists who write the DSM manual and are completing an update, DSM-5 and financial gains from the pharmaceutical industry.
From Rosenberg’s report, “This is the year the APA, (American Psychiatric Association) puts the finishing touches on DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, a compendium that determines what treatments insurers will cover, what disorders merit funding as “public health” threats and, of course, Pharma marketing and profits. Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-5′s authors have Pharma links.”
This is the fox not only guarding the hen house, but building it! And the culture of healthcare in the US is directly and/or indirectly supporting it. As I understand it, this statistic is unchanged from previous publication (DMS-4) and AFTER, APA mandated disclosure of ties to Pharma and $$$ limits that authors could receive, (10,000/year and 50,000 in stock holdings)! I mention this because many committed patient advocates and healthcare professionals are working hard to get transparency into the mainstream and I worry that it’s effectiveness will be limited by an infinite variety of smoke and mirrors that will emerge if our system continues to be driven by fortune-making.
According to New Scientist Reporter, Peter Aldhous 3/13/2012 article, “Many Authors of psychiatry bible have industry ties”,
“Transparency alone can’t mitigate bias,” says Lisa Cosgrove of Harvard University, who along with Sheldon Krimsky of Tufts University in Medford, Massachusetts, analysed the financial disclosures of 141 members of the “work groups” drafting the manual. They found that just as many contributors – 57 per cent – had links to industry as were found in a previous study of the authors of DSM-IV and an interim revision, published in 1994 and 2000 respectively.
As a nurse, I hate making medication decisions that get caught up in all of this, but any time a nurse gives a PRN anti-anxiety or PRN anti-psychotic for behaviors that could be prevented, minimized and/or managed with counseling, more staff, slower pace, more time for relation-building, that is exactly what happens. It is very disheartening to be providing our skills and compassion in the midst of polarizing agendas. This, one example of overmedication that is a symptom of the much deeper problem of fortune-making in healthcare. More about how this can play out in my recent post, “Staffing & Overmedication on a Dementia Unit: Numbers, Continuity and Emotional Intelligence can Make All the Difference“.
From a ‘systems’ perspective, it seems that fortune-making has become ingrained in our vision of healthcare. We need to take on the big tall order getting greed out of it. Otherwise it infiltrates everything. Profit? Sure. Afford to provide care? Absolutely! But, getting rich off of other people’s suffering? No thanks!