Topic: Research Fraud

For someone who has been a part of many clinical trials, I will be the first to admit that I have very little training in research design or statistics. Oh, the hours I’ve spent surreptitiously curled up on the sofa of a doctors’ lounge or my own apartment, thinking that somebody paid somebody a lot of money to write “science” so I could figure out how and why I would know things. It pretty much worked. There were a few mentions of statistics at my delightfully thorough prep school, but there was not so much as a word at medical school. The research types were always hanging around medical school settings — their brains rented and services bought by the medical side of things — as they did not make much money. We did receive some wonderful instruction from clinicians as to how to evaluate research literature and decide how to apply it to our practices.

I have a vivid memory of an endearing shy and spindly instructor during a course required for incipient biologists at Boston University. He had Jewish afro hair, coke bottle bottom glasses, and a more than passing resemblance to a young Woody Allen. Oh, how he despaired that we were mostly going to be money-chain doctors as opposed to truth-chasing scientists. I remember that once, and only once, did he reach fiery intensity in that class. “Nothing will be published unless the probability that it actually shows what it is supposed to show is greater than 19 out of 20, that means p>.05. But nobody wants to admit what that really means.” Oh, how silent we were, on the edge of our chairs.

“That means one out of every 20 research papers in your favorite medical journals is all wrong, and nobody knows which one of the 20!” He lifted his finger into the air, like Leonardo da Vinci’s enigmatic portrait of St. John the Baptist. And believe me, this man was no Baptist. “At least, that would be true if everybody was doing their research correctly and honestly and all that, but they are not. No, most of them don’t know, or have forgotten, or maybe lie, but nobody really knows how much scientific research could be fake or could be rubbish…” I knew then that I was in for things I did not yet know much about. I also knew that I was going to have a bit of a hard time somewhere in this, as I had assimilated absolutely all of the private readings in the front and back of a highly traditional Jewish prayer book, and other people — mostly men – were probably not playing by the rules. Oh, a few girls had called me crying with guilt after “accidentally” copying someone else’s homework or even examination, always citing some extraordinary parental expectations they did not want to ruin. Personally, I never got into male style game playing. Although, I have certainly learned to recognize such game playing and have seen how competition accelerates, confuses, or forgets “ethics” or “rules.” I have actually heard male professors, in a large Midwestern university setting, joking about how many infringements of university rules could be practiced without seeing a flag lowered in penalty. I’ve heard enlisted men on their way to a mess discuss how often and for how long they could have a woman visit the barracks unattended.

I do not say that women do no wrong; only that the notion, the ethos, of competition and “cheating” has a male edge to it. Their absence on these lists of fraudulent scientists is all the more noteworthy because more women seem to be entering academics than ever before. I have not found a good way to trace if they are also leaving faster, or getting less grants and publications. The sheer volume of folks that seem to be doing this is increasing astronomically. I cannot find a single female name on any list of those guilty of this sort of infraction, anywhere.

So leaving sex and all its roles and values aside, it seems reasonable to look at why there is more of this and why it is happening in ways that seem impossible to check or police in any manner. From fraud in bio-informatics, near my old homestead at the University of Kansas to an outlandish report on the “cult” of fraud, the field seems to have run rather amok.

We do have people who are supposed to police this sort of thing, although it may not technically be criminal. But as in the Kansas case cited above, or any other, the wrongdoing has to be known before anything can be done about it. So, for once, we have a government entity about which I am not going to yell or scream about bribery and corruption. Although, I have no reason to expect there is less in this agency than anywhere else. Honestly, there are not enough people in the world to check all the facts asserted in “original” research, which is very hard and very expensive to reproduce.

Could this actually be more of a problem here in the states than elsewhere? Oh, the wonderful capitalistic and competitive and greed driven culture that we have in the United States of America. Look, there are pressures on people to get publications and grants and all sorts of prestige in the academic world. I left this game a long time ago. Some have never quite forgiven me for leaving the game of academic prestige.

Leave it to the fair-play and ultra-civilized Brits to ask us to slosh empathy for those who commit research fraud. It is superficial to me, with disproportionately small awards, but empathy is as precious as it is rare.

Author's Bio: 

Estelle Toby Goldstein, MD is a board-certified psychiatrist in private practice in San Diego, CA.

Practicing Medicine Since 1981

In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology).

Experienced In Many Situations

She has worked in a variety of positions, including:
■Fireman/EMT
■Medical school professor
■General and Orthopedic surgeon
■Brain surgeon
■Army Medical Corps psychiatrist
■Prison psychiatrist
■Community Mental Health Center staff
■Consultant to a major transplant hospital
■Drug researcher

“Whatever It Takes!”

She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine — or Integrative Medicine. Her practice is cash-only, doesn’t accept insurance or government payments, and she operates on the concierge, or “private doctor” practice model to give her patients the absolute best quality of care and the highest level of confidentiality.

Dr. Goldstein’s philosophy is “Whatever It Takes!” Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible — not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available — most of which are unknown to standard, mainstream doctors.

Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy.