Carlat's contrarian take on psychiatrist inquiry

Newburyport psychiatrist Dr. Daniel Carlat has staked out some substantial turf on conflicts of interest.

On his blog and elsewhere, he has detailed his decision to stop speaking at medical-education conferences sponsored by drug companies, linking such activities to "biased education, corrupt physicians, and, ultimately, harm to our patients."

So it's something of a surprise to read that he is giving Dr. Joseph Biederman, Dr. Timothy E. Wilens, and Dr. Thomas Spencer of Harvard Medical School the benefit of the doubt after reading records released by US Senator Charles E. Grassley. Biederman, widely regarded as influential in the rise in bipolar diagnoses among children, and his colleagues did not disclose all the payments they received from companies that made the medications they researched and recommended.

The discrepancy is important when it comes to federal funding from the National Institutes of Health, Grassley's hearings make clear. But Carlat, who knew all three doctors during his training at Massachusetts General Hospital, thinks the lack of reporting, while perhaps "a little sleazy," falls short of malevolent.

"I don’t think they hid these payments out of greed, sneakiness, or the thrill of getting away with something. They probably simply didn’t believe these earnings were relevant to the NIH funding they received," he writes. "The big lesson here is that Congress must pass the Physician Payment Sunshine Act, because we will never be able to grasp the extent of the complex financial relationships between companies and thought leaders without this legislation."