Monday, December 12, 2005

"One Horrible Debacle," Indeed: Topol Fired

Dr Eric Topol, an internationally known cardiologist at the Cleveland Clinic, a member of the Institute of Medicine, has been an important skeptic about Vioxx (rofecoxib), a drug recently withdrawn from the market by Merck amidst questions about its cardiac adverse effects. We recently posted about how Merck executives tried to discredit Topol, as revealed by Topol's trial testimony last week (see our posts here, here and here.)

After the New England Journal of Medicine published an editorial suggesting that Merck had suppressed data about the adverse effects of Vioxx in a landmark 2000 article, Topol said, "This is one horrible debacle in American medical history. I've never seen the likes of this."

Only a few days later, Topol was fired from the positions of Chief Academic Officer of the Cleveland Clinic and Provost of the Cleveland Clinic Lerner College of Medicine, of Case Western Reserve University, according to the Cleveland Plain Dealer. Although Topol "deserves a lot of credit" for the founding of the medical school, the newspaper reported that there had been recent "tension" between Topol and Cleveland Clinic CEO Dr. Delos "Toby" Cosgrove.

The New York Times talked to Topol, however, who suggested that the real reason he was fired was his testimony against Merck. Topol said,

The hardest thing in the world is just trying to tell the truth, to do the right thing for patients, and you get vilified. No wonder nobody stands up to the industry.
A Clinic spokesperson countered that Topol's firing was just part of an administrative reorganization, "the organization made the decision that position was no longer needed." There was no word of who, if anyone, would now be in charge of the medical school.

(Note: Via the blog GoozNews, the Wall Street Journal just reported serious allegations about Dr. Cosgrove's conflicts of interest related to a company named AtriCure, in which the Cleveland Clinic has a minority interest.)

Thus in the last week we have heard about two major cases involving retaliation against health care whistle blowers. We just posted about the plight of Dr. Aubrey Blumsohn, who was suspended from Sheffield University for telling the press how he had to fight a pharmaceutical company for the integrity of his clinical research (most recently here.)

The plight of whistle blowers is becoming increasingly dire. If Eric Topol can be fired for critical comments about a drug, who will be able to say anything that displeases the powers that be in health care?

Medicine cannot function if physicians cannot speak their minds. Medical research cannot function if scientists cannot freely express their opinions.

The process is even closer to "collapsing into rubble" than Dr. Curfman thought last week.

If we do not speak out for Blumsohn and Topol now, will anyone speak out later when they come for us?

[Update: MedRants doesn't agree.]


InformaticsMD said...

"The organization made the decision that that position was no longer needed."

How convenient, what qestionable timing this represents, and what an extreme appearance of impropriety this timing raises.

My eyeballs are going to forcefully explode out of their sockets from every neuron in my brain saying "unbelievable."

Anonymous said...

As a medical whistleblower myself I have seen firsthand the reprisals that are brought to bear against the "offender." This has been true of the military medical establishment as well as in the civilian sector. This is the "dirty little secret" that organized medicine has kept from the public.