Manipulation of drug trials is possible only if there is a not insubstantial number of doctors who volunteer to act as authors, representatives, or opinion leaders generally. This raises the question of why such opinion leaders are obviously easy to find. The main reason for this easy availability is the habilitation procedures at universities. A habilitation procedure to gain a university professorship is hardly possible today without third-party funding. Further, medical faculties nowadays often use the amount of third-party funding they have received as a means of advertising themselves. However, it is not difficult to understand that such funding does come at a price, particularly in the non-surgical disciplines. Many colleagues have such third-party funding to thank for their subsequent careers. In this way, the foundations are laid for lifelong closeness to the pharmaceutical industry, which knows full well how to cultivate and exploit this closeness.
This is not primarily an oversight or mistake committed by doctors; rather, it is a systematic error inherent in an understanding of medical excellence that is based on publications and third-party funding. In the case of manipulated drug studies, universities’ habilitation and research procedures have just as much to answer for as statutory initiatives to achieve excellence that provide counterproductive stimuli.
Dr. med. Stefan Sachtleben
66955 Pirmasens, Germany
Conflict of Interest Statement
The author declares that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
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