
The APA Meeting: A Photo-Essay - alexatkeplar
https://slatestarcodex.com/2019/05/22/the-apa-meeting-a-photo-essay/
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tptacek
This is like the seeds of 3/4 of all the bad HN threads all in one blog post.
We can relitigate the concept of psychiatry, debate the implications of big
pharma, yell at each other about wokeness versus PC culture, pretend not to
understand how trade shows work or, I don't know, find some way to argue about
how they should be run... and who knows what else. And virtually none of the
comments will be from people who have studied in psychiatry, are seriously
engaged (pro- or con-) with pharma, or have ever run a trade show.

If it survives on the front page, we should make a bingo card for the thread;
for instance, I should score a point the first time an HN user psychoanalyzes
another user over the Internet on it.

I'm not saying the post is bad (I'm not a fan of this blog, but whatever; I'm
a fan of lots of things you probably hate, too). But there's a difference
between a bad blog post and _a bad HN submission_ and this, to me, seems like
an archetypical example of that.

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dkarl
I'm glad I read the piece. It's going to generate some pointless, awful
arguments here, but the comments aren't everything.

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tptacek
The mods can turn comments off on posts, but rarely do. I think, if we want to
broaden the kinds of stories that can survive without flagging, that should
happen more often.

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dkarl
I hope your comment stays at the top to at least inspire people to try to
exceed your expectations.

~~~
tptacek
That is indeed part of why I wrote it.

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everybodyknows
There's illumination here for those of us who've been prescribed shockingly
expensive drugs with generic near-equivalents going for 1/40th the price (as I
have):

>I asked the Lucemyra® representative why I might prescribe Lucemyra® instead
of clonidine for opiate withdrawal. She said it was because Lucemyra® is FDA-
approved for this indication, and clonidine isn’t. This is the same old story
as Rozerem® vs. melatonin, Lovaza® vs. fish oil, and Spravato® vs. ketamine.
...

~~~
mistermann
There's also illumination for people who are interested in the debate on
whether or not one should research medical issues on the internet yourself, or
"trust your doctor, they're a professional".

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atomical
There are externalities for experimentation which include bankrupting the
health system. Imagine if everyone only ate red meat. Bowel cancer would soar.

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tschwimmer
I think the thing that stands out to me about this whole thing is how nakedly
corrupt it comes off as. I'm sure the legions will rush to rebut me and say
"But Psychiatrists have ethical standards! They would never let ice cream
influence their decision to prescribe a substandard drug!" That may be true,
both philosophically and perhaps even in practice (though I doubt it...[0])
but even still, the bonanza of sleazy advertising is _so_ embarrassing to
psychiatry, drug companies and the FDA.

Drugs should be prescribed on a clinical basis, full stop. Attempting to
advertise your medication on any other basis should be a criminal offense. We
as a society need to draw a bright moral line to stop this type of behavior.
Though I laughed at Scott making light of it, this stuff isn't funny. This is
a life and death issue.

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bradleybuda
Food should be rationed on a nutritional basis, full stop. Attempting to
advertise your food on any other basis should be a criminal offense. We as a
society need to draw a bright moral line to stop this type of behavior.

I mean, everyone needs food. It's life and death. Clearly more important even
than psychiatric drugs.

~~~
tschwimmer
This is a false paralellism. There is no equivalent to 'taste' in terms of
medication. Sure, you may urge your doctor to switch from one medication to
another because it works better for you or has more acceptable side effects.
But that's very clearly a clinical decision.

In any case, shilling with free ice cream or a giant house of cards does not
communicate this information.

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cwkoss
It's kind of horrifying to consider that advertising has a statistically
significant chance of influencing a psychiatrist away from prescribing based
on what best suits the indication.

~~~
bookofjoe
Strong statistical significance. When I was in med school (UCLA 1970-74)
everybody took aspirin and/or Tylenol. Now, I'm the only person I know of who
still takes those two drugs rather than the zillions of newer, more expensive
pain relievers. Why? Because none of the drug company-sponsored studies
concluding that their new drug was better than my old standbys were convincing
to me. As an experienced scientist who co-authored a number of investigational
drug studies, I know whereof I speak.
References:[https://scholar.google.com/citations?user=5DdrMc8AAAAJ&hl=en](https://scholar.google.com/citations?user=5DdrMc8AAAAJ&hl=en)

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malandrew
Looks like psychiatrists have a word for every disorder except the disorder
they themselves are afflicted with.

It's either that or these preponderance of woke talks and problematizing
anything and everything is a prime example of the Shirky Principle in action.

[https://kk.org/thetechnium/the-shirky-prin/](https://kk.org/thetechnium/the-
shirky-prin/)

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cafard
Last I heard (three or four years ago), the APA was suffering from a fall-off
in pharma advertising. If that is the case, and it hasn't rebounded, just
think what the advertising must have been fifteen years ago.

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malandrew
this quote from the article was especially poignant:

> Second, psychiatry has always been the slave of the latest political fad. It
> is just scientific enough to be worth capturing, but not scientific enough
> to resist capture.

