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October 22, 2010

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1) From my personal experience as a practicing adult and child and adolescent psychiatrist, I attest that Dr. Satel's view of the benefit of pharm reps meeting with MD as beneficial is flawed. Up until 2004 I met with Drug reps and always used name brand psych drugs. For the last 6 years I have not seen any reps, and I predominantly used generics, especially lithium with as good or better results
2) Dr. Satel misses the point of the book : that the beneficence and fiduciary issues between health care provider and patient will always be under threat from countervailing demands on providers and researchers. For this reason every patient must ask and assess these issues before deciding to approve or reject a physician's recommendations. Carl Elliott did us a service - both provider and patient- in illustrating the myriad of ways these conflicts can occur
3) Dr. Satel should have indicated how her employment in the American Enterprise Institute might have influenced her review. For example, are Big Pharm Companies donors to the Institute?

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