Since returning from Mayo Clinic and the annual WomenHeart Science & Leadership Symposium for Women with Heart Disease training, I’ve done many public presentations on the subject of heart disease – the #1 killer of women in North America. My talks are pretty well all the same. When I tell the story of my own heart attack misdiagnosis, it never changes.  When I talk about emerging research from Mayo and other experts on women’s risk factors for developing heart disease, it’s always the same list.  When I discuss surprising symptoms and signs that you might be having a heart attack – well, you get my drift.

This is a normal public speaking reality for those who have a specific message to deliver or a unique area of expertise to share.  Same talk, same slides, different audiences.

Just ask psychiatrist Dr. Manoj Waikar, adjunct professor at Stanford University, who moonlights as a public speaker for the largest American psychiatric drug maker, Eli Lilly. 

This company has been in the news since the FDA issued a warning to the 7 million diabetics who take its drug Byetta, after its use was found to threaten kidney function.

And in January 2009,  Lilly pleaded guilty in court and paid $1.42 billion (yes, that’s ‘billion’ with a B) in fines and penalties to settle charges that it had for at least four years illegally marketed Zyprexa, a drug approved for the treatment of schizophrenia, as a remedy for dementia in elderly patients. (In fact, in the past five year, Eli Lilly, Pfizer, Bristol-Myers Squibb and four other drug companies have paid a total of $7 billion in fines and penalties. Six of the seven companies admitted in court that they marketed medicines for unapproved uses).

But I digress. Last year, Eli Lilly paid Dr. Waikar to give 51 talks to his fellow physicians – week in, week out, all year long at $1,500 a pop. That’s $75,000 a year.  Just show up, and the drug company cheque is in the mail.

Oh, wait. That’s the difference between my presentations about women’s heart disease and Dr. Waikar’s presentations shilling Eli Lilly drugs like Zyprexa and Cimbalta:

I volunteer to do my talks for free, and he doesn’t.

In his response to a New York Times interview, Dr. Waikar disclosed that he did receive fees for speaking to other health care professionals about disorders like schizophrenia and depression, which can be treated with Zyprexa and Cimbalta respectively. His website also indicates he has done “speaking, consulting or advisory work” for other drug companies, including AstraZeneca, Bristol-Myers Squibb and Pfizer. His website (punctuation, spelling and construction are his) also claims:

“i am as passionate about teaching as i am about caring for and advocating for my patients. I’ve been teaching in some way or another since i was in high school. Speaking for pharmaceutical companies combines my two passions in a manner that i find very satisfying & compelling & makes the taxing travel & resulting fatigue worthwhile. Long after the program is over & my compensation has been handed out i stand by my word to maintain contact with fellow physicians at my programs who contact me to consult on a challenging patient or have follow up questions about medications i spoke about. When travel time is taken into consideration it is seldom ‘worth’ it from a purely financial perapective. But that’s not at all why i speak and money isn’t at all why i went into medicine & then psychiatry.”

Gee, that’s nice.

But how does Stanford University feel about Dr. Waikar’s cozy friendship with his Big Pharma employers? Many academic medical centres – including Stanford – have barred their professors from giving such industry-sponsored speeches because drug makers prepare and control all content of the talks.

But this prohibition applies only to Stanford’s full faculty members, and so adjunct professor Dr. Waikar has been off the radar screen, free to deliver as many drug company slide presentations to his peers as he likes. Adjunct professors are part-time, non-salaried, non-tenure track faculty members, paid per class and employed elsewhere.

Dr. Bernard Lo, the director of the medical ethics program at the medical school of the University of California, San Francisco, told the New York Times that because drug companies control the content of such speeches, they should have only their own employees give such talks.

“Your own work has to be your own work.”

Read the New York Times article about Dr. Waikar’s drug company-fuelled  speeches.

See also:

• Harvard Cozies Up with Big Pharma
• Is Your Doctor a “Thought Leader”?
• Bad Doctors Earning Good Money from Big Pharma
  
• Pfizer Paid For Doc’s Helicopter Speaking Tour to Push ‘Off-Label’ Drugs
• Doctor’s Kiss & Tell Tale: My One-Year Career As a Drug Rep