The Skeptical Professional's Guide to Rational Prescribing

The raging COVID-19 pandemic has shaken our trust in science. This volume reviews the evolution of misconduct and fraud in science, the many steps taken to alleviate the problem, and the likelihood that it will continue, given our profit-driven healthcare system. Contents are set in a clinical context, wherein misconduct and fraud affect rational prescribing, a process that depends on balancing the risk-benefit ratio of treatments, whether pharmacologic or psychotherapeutic. The clinical consequences can be significant, in that the efficacy of treatments can be vastly overplayed, adverse effects minimized, and costs to the healthcare system increased if corrective measures are not taken. Key Features . Discusses the various aspects of cheating in publications: spin, protocol changes; failure to publish negative studies, including current data on the publishing industry and its issues, like the menace of predatory journals, poor peer review, coupled with lack of early education in ethics, and its significant impact on rational prescribing. . Assesses the impact of misconduct and fraud on clinicians and healthcare professionals as they attempt to balance the risk-benefit ratio which is supported by multiple contemporary studies. . Presents shocking data on bribes to physicians, journal editors and other key opinion leaders, exposing the ultimate root of the problem which lies in the economics of the healthcare system, badly in need of repair.

Dr Dean has his residency training in psychiatry at the University of Cincinnati. He then volunteered for the service in the US Army Medical Corp and was stationed at the 2nd General Hospital in Landstuhl West Germany from 1965-1968, followed by 13 years at the Hennepin County Medical Center in Minneapolis, Minnesota. He had a short stint in private practice, then joined the Minneapolis VA Medical Center in 1987. In 2012 he retired from clinical practice but has remained a voting member of the Institutional Review Board and the Pharmacy and Formulary Committee. He has won 7 Teacher of the Year awards from the Department of Psychiatry at the University of Minnesota Department of Psychiatry, where he developed and taught courses in clinical neuroscience and psychopharmacology. His primary research interests have been in tardive dyskinesia, diagnoses, psychotropic medications, and the history of psychiatry.

Table of Contents Introduction: Historical Roots and Recurrence Chapter 1: Regulations, the Growth of Pharma, and Diagnostic Expansion, 1951-2003: A Wealth Trifecta Chapter 2: Industry Payments to Physicians: Research and Education or Bribery? Chapter 3: Direct-to-Consumer Advertising: Origins, Extent, and Consequences Chapter 4: Publication and Citation Bias, Spin, and Sponsorship: Tilting the Risk-Benefit Ratio Chapter 5: Fraudulent Authorship: Guests, Ghosts, and Honorary Authors Chapter 6: Meta-Analyses and Systematic Reviews: Biases and Short-Cuts to Knowledge Chapter 7: Replication and Reproducibility of Research Results: A Crisis? Chapter 8: Distorted Outcomes and Retractions: Prevalence and Types Chapter 9: Journalology, Predatory Journals, Peer Review, Pre-Prints, and Guidelines Chapter 10: Can Misconduct and Fraud be Fixed? Chapter 11: An Entrepreneurial Health Care System: Risks and Benefits to Rational Prescribing