To the Editor: By Sharon Kramer

[Guest guest]

From Medscape General Medicine™

Letters

Readers' Response to " So What Is a Sham Peer Review? "

Posted 03/27/2006

http://www.medscape.com/pages/homepages/ejournal/mgm

To the Editor,

Through an advocacy capacity, I assist those who have been made ill

from environmental exposures. The concerns raised by Dr. Chalifoux

[1] and other physicians in regard to improper medical peer review

practices are valid concerns. The problem is pervasive. Several, who

adhere to their oaths, have been harassed and persecuted for

speaking out on the subject.

Sham peer review has caused a situation in which many people who

have been made ill from exposures and injuries within occupational

settings are not able to receive workers' compensation or treatment

from their physicians.[2] Understanding how and why this is

happening is an easy trail to follow. The simplest way to explain

the situation is through an extended metaphor: To follow the trail,

one simply needs to follow the Guide that blazed it -- Money.[3] It

is a well-marked, loop trail that begins high up in the inner circle

of medical associations that write treatment protocols for injured

workers.[4] Money traverses its way down through the twisted path of

sham peer-reviewed medical journals.[5] It then crosses the bridge

into teaching hospitals and creeps along the shady, well-planned

route of administrative incentives for insurance denials.[6,7] It

trods heavily into the ravine of litigation, attempting to stomp on

those who dare to challenge its direction.[8] Money then shimmies

its way back up the cliffs to the trailhead of the protocol-writing

medical associations.

For those honorable physicians who refuse to follow the intimidated

pack -- as the pack follows the Money -- it can be an isolated and

treacherous trail.[9,10]

Sharon Noonan Kramer

Health Advocate

San Diego, California

snk1955@...

References

Roland C Jr. So what is a sham peer review? MedGenMed. 2005;7:47.

Available at: http://medgenmed.medscape.com/viewarticle/515862

Accessed November 15, 2005.

Injured Workers' House of Horrors. Denials of care & compensation

cuts lead to injured worker desperation & death, huge carrier

profits. December 16, 2004. Available at:

http://www.caaa.org/research/Release%20Sinclair.pdf Accessed March

16, 2006.

SourceWatch. Tobacco industry. Available at:

http://www.sourcewatch.org/index.php?title=Tobacco_industry Accessed

March 16, 2006.

California Medical Association (CMA). Hostile to physicians, harmful

to patients: the Workers' Compensation...reform? July 2005.

Available at:

http://www.cmanet.org/upload/cma_workers_comp_report_102705.pdf

Accessed March 16, 2006.

Study tied pollutant to cancer; then consultants got hold of it. The

Wall Street Journal. December 23, 2005 " ChemRisk submitted the new

study of the villages to the Journal of Occupational and

Environmental Medicine " (ACOEM Journal)

http://www.axcessnews.com/modules/wfsection/article.php?

articleid=7300

On campus, industry sets up a perchlorate confab. The Wall Street

Journal. December 29, 2005. http://list.mc.duke.edu/cgi-bin/wa?

A2=ind0512 & L=occ-env-med-l & D=0 & P=20967

Cates JR, Young DN, Bowerman DS, Porter RC. An independent AGREE

evaluation of the Occupational Medicine Practice Guidelines. Spine

J. 2006;6:72-77.

Mason E. Dealing with SAIF -- sick and feeling like a criminal.

KATU.com. December 15, 2004. Available at:

http://www.katu.com/team2/story.asp?ID=73443 March 16, 2006.

Some California doctors leaving Workers' Comp system. Insurance

Journal. February 21, 2005. Available at:

http://www.insurancejournal.com/magazines/we/2005/02/21/features/5236

2.htm March 16, 2006.

Feingold E-Mail Newsletter Archive: April 2005. Dr. Sinaiko on cover

of Medical Economics, a medical doctor's magazine. Available at:

http://www.feingold.org/enews/04-2005.html March 16, 2006.