Sunday, April 24, 2005

"Passionate CEO" Who "Fights the Dragons"

The Philadelphia Inquirer for Sunday 04-24-2005, features an interesting piece by Thomas Ginsberg on the CEO, Sir Tom McKillop, at AstraZeneca, which has its US HQ near me, in the Delaware Valley. The article will probably be available here for a week or so after the above date, then I expect may disappear into the giant maw of pay-per-view and sundry search engine caches.

Recall that AZ is one of the recent drug companies--Merck is another--alleged to have participated in "ghost authoring," a practice the ethics of which many have questioned both in this blog and elsewhere. Hence, before returning to Sir Tom and the Inquirer, I suppose I'd like to ask the remedial question: should there be a "bright line" between scientific authorship, interpreted in plain old old-school fashion as "something I worked up, researched it myself, and then wrote it up," on the one hand, and some investigator lightly buffing a Medical Education Company's prose and proclaiming him/herself "first author"?

(The MEC in the AZ case advertises itself here. They were founded on "a vision of excellence.")

If there's a bright line, how is crossing it to be prevented? What sanctions can or should be imposed? (The Journal of General Internal Medicine may have recently come up with one, at least one that will give pause to this particular putative author.) And what can the old-school "gentlemen's clubs" journals, many of them run by collegiate societies, do to make that bright line as, well, bright as it clearly needs to be?

In the case of AstraZeneca, I doubt its approach was any different than many other pharmas. (Not sure which is more chilling: this is anomalous, or this is business-as-usual.) And I doubt, though cannot truly know yea or nay, whether Sir Tom knew about the "attempted plant" in JGIM, on which Dr. Adriane Fugh-Berman recently blew the whistle.

Yet some of the Inquirer reporter's notes and observations, in an article that sports the headline "Aggressive Stance," bear repeating here, since the last time I checked with Jack Welch, CEOs of large companies set the tone for the organizational behavior under them.

Here are some of the "dragons" that this gentleman, in a recent interview, sought to "lance."
  • "Drug safety advocates are sputtering 'nonsense.'"
  • "Regulators are creating 'imbalance' in risk-vs.-benefit decisions."
  • "Americans are catching 'the European disease' of excess caution...."
And so on. I have many good friends who work, or have worked, in pharma. It is completely understandable how pharma top management comes to think unflatteringly about FDA hold-outs, Sid Wolfe, and even this blog. Fish gotta swim, birds gotta fly. We're all just doing our jobs.
But a couple big questions linger.
One, where do authors, in academia or the private sector either one, get the idea that it's de rigueur to slap their name on a MEC-authored paper? Put another way, do they have no idea what might happen to them if someone like Dr. Fugh-Berman blows the whistle?
And two, what are we to make of the last quotable quote from the Inquirer piece on Sir Tom?
  • A favorite book is Konrad Lorenz's classic tome, On Aggression....
Let's not stop quite there, though. In point of fact, that AZ's Sir Tom, chemist-turned-CEO, finds the Lorenz oeuvre "fascinating" would be a splendid starting point for all sorts of interesting ongoing discussions. Lorenz's analysis of social organization and ritual behaviors would be a useful context for understanding why organizations risk shooting themselves in the foot.
Worth pondering and discussing a lot more, methinks. Here is a gentleman who actually appears to want out from Big Pharma, but not until he's shored up his one company's pipeline and its market fortunes. He's right to be fascinated by the work of other students of aggression.

No comments: