Profile of a medical ghostwriter

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Dr. Carl Elliott writes about ghostwriting in the December issue of Atlantic magazine, “Playing Doctor: How to spin pharmaceutical research.” He profiles a young scientist (“David”) who became a ghostwriter about 10 years ago. Excerpts:

“Ghostwritten articles surface again and again in litigation (in cases concerning Vioxx, Fen-Phen, Zyprexa, Premarin, Neurontin, and Zoloft, to mention just a few). Years before the Avandia scandal, GlaxoSmithKline paid $2.5 million to the State of New York to settle a lawsuit alleging that it had concealed studies suggesting an increased risk of suicidal behavior in children and teenagers taking Paxil, most notoriously in an article “authored” by Dr. Martin Keller of Brown University. One 2003 study in The British Journal of Psychiatry found that ghostwriters working for a single medical-communications agency had produced more than half of all medical-journal articles published on Zoloft over a three-year period.

To many critics, the moral outrage of ghostwriting is like that of plagiarism: academic physicians are getting credit for articles they didn’t actually write. To David, letting someone else take the credit for his work is a minor humiliation. The real problem, of course, is much worse: spinning data perverts science. It also downplays risks that can lead to serious injuries, and deaths. As David puts it, “The moral crime I was being asked to commit was to do with truthfulness.”

A few years ago, David went to a cardiology congress in Barcelona, where he had dinner one evening with a group of fellow medical writers. They were a friendly bunch, but he found them terribly sad. Medical writing has little glamour, and whatever moral purpose it might once have carried has been rubbed away by the constant friction with commerce. If you are a true believer in the glory of the market, the work might be invigorating, and the long hours a mark of pride. But if you are a lapsed biologist, raised in the church of science but compelled to leave, it is apparently a source of nagging resentment. Says David, who for all his protests has yet to give up his job, “What a wretched epitaph to a life this would be.”

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Bruce Wilson

November 19, 2010 at 5:20 pm

I am disappointed in you for citing this article without a word of criticism. You, of all people! Where is the balance in this article? Where is the voice of professional associations like AMWA and EMWA, each of which have been fighting ghostwriting and other unethical practices for years? Guidelines for professional medical writers are posted on those organizations’ websites and state clearly that ghostwriting is to be avoided. Where are the comments from medical writers like myself who hammer away trying to raise the ethical standards in our industry? Nowhere. Elliot chose sensationalism over truth.
His polemic against ghostwriting is valid, but he makes the same stupid error of equating “ghostwriter” with “medical writer,” as does the uninformed lay press. As a bioethicist, he should know better. “David” is no representative of our profession. A real professional would shun ghostwriting projects and demand full acknowledgment on papers he’s worked on, including the details of his assistance and the source of funding. He would demand full access to the authors, from beginning to end. If this is not provided, he would walk away from the project. He would also refuse to play along with attempts to plant marketing messages in the paper, no matter how subtle.
Yes, we all feel the “constant friction of commerce” as Elliot writes. But we are not merely “well paid technicians who perform a specialized service for our clients.” Nor are we an unhappy bunch, trapped in our “unglamorous” work. Comparing us to lobbyists, public-relations consultants, and hit men is more than insulting! Hit men!
Where are your standards, Gary? Please don’t let this terrible piece of writing be posted on your site without criticism. Look at the comments under Elliot’s article on the Atlantic site and you’ll see I’m not alone.
Bruce Wilson
Medical Writer
AMWA member
Montreal, Quebec

Gary Schwitzer

November 19, 2010 at 6:06 pm

Thanks for your comment.
Let’s not lose sight of the big picture. As you point out, “His polemic against ghostwriting is valid.”
So Elliott mixed in the term “medical writer” with ghostwriter where he could have chosen his words more carefully. His focus on the practice of ghostwriting came through clearly to me.
Where are my standards? They reside in support of the marketplace of ideas. I posted Elliott’s article. I posted your comment.
Ghostwriting is still a big problem, which is probably why “AMWA and EMWA…have been fighting ghostwriting and other unethical practices for years.”
Elliott knows, works with, and supports good medical journalists. He rails against ghostwriting.

Bruce Wilson

November 20, 2010 at 9:03 am

All ethical medical writers rail against ghostwriting. I posted my comment to make it clear that “medical writer” does not imply “ghostwriter.” Elliott conflates the two, especially in his last paragraph. Poor reporting like that hurts honest professionals. We have some educating to do.
Thanks for responding.