Healthy Skepticism International News

November 2000

Changes

November / December 2000 Vol 18 No 11/12

Mansfield PR. Changes. HS Int News 2000;1:1

Your input is welcome as always
New Management Group
New Methods
New name: Healthy Skepticism
Our aims have not changed
We are moving from paper to the Internet
Free subscriptions
Paid subscriptions
Calendar year paid subscriptions
Subscriber participation

Your input is welcome as always

We welcome all comments, questions and suggestions from subscribers in response to the changes described below:

New Management Group

We have a management group consisting of Director Peter Mansfield (GP), Treasurer Jon Jureidini (child psychiatry), Secretary Melissa Raven (public health), Agnés Vitry (drug information) and Katrina Allen (GP educator) who have been meeting once a month in Adelaide since mid 2000. We include Joel Lexchin (emergency medicine) in Toronto as a corresponding member of the management group. If you are interested in accepting responsibilities as a member of the management group then please let us know. The ways in which members of the management group have been working with many others on a variety of tasks are described below.

New Methods

MaLAM commenced in 1983 with a specific focus on writing open letters to drug companies with subscriber participation about harmful marketing in “developing” countries. This was very cost effective in the 1980s but during the 1990s we became concerned that continuing with that approach would not be cost effective for the more subtle problems that were coming increasingly to our attention. Consequently we have been exploring new methods for achieving the same objectives. (For more about our objectives see below.) Most of that exploration has been done with issues in Australia and New Zealand. The focus on Australia and New Zealand has occurred despite our ongoing concern with issues in all countries especially “developing” countries. One of the reasons for the new geographical focus is that we are stronger in Australia and have had funding from PHARMAC New Zealand. Another reason is that the differences in drug promotion between countries are less than they were 20 years ago. Also, we have moved towards believing that some problems need to be solved in “developed” countries before they can be solved elsewhere. However we expect that during the next few years we will move towards covering a wide range of countries including many editions about problems in “developing” countries. If any subscriber would like to see more editions of any type that are likely to advance our aims and is willing to write them then we would be very pleased to publish them.
Below is a list of most of our activities over the past 2 years. They are classified according to their main focus into three areas: advocacy, research and education. However most activities involve more than one area or assist other work in more than one area.

Advocacy

Joel and Peter have represented us in Geneva at meetings of the World Health Organization - Non-Government Organisation Roundtable.
Inspired by a call at a Roundtable meeting from Charles Medawar of Social Audit to give direct to consumer advertising (DTCA) priority as a major emergency, Peter, Joel, Charles, Barbara Mintzes (epidemiology), Margaret Ewen (consumer advocacy), Anne Rochon Ford (consumer advocacy) and many others have collaborated on writing submissions to government inquiries and visiting politicians and key stakeholders in Australia, New Zealand, Canada and Europe.
Peter has been working on possible “win-win” responses to the systems problems that lead drug companies to have little choice but to oversell drugs. Consuming Interests, the policy journal of the Australian Consumers Association, published an early draft of this work. We will publish a more developed version later this year.
Journalists are increasingly contacting Peter. This has led to many reports including three national television appearances in Australia in the first half of 2001. The Australian Financial Review commissioned an article giving the case for prohibiting research by drug companies in favour of more research at universities.
Joel, Peter and Melissa have participated in the e-drug and nofreelunch e-mail discussion groups.
Production of MaLAM International News has continued but is running behind schedule. The next three editions have been finalised and will be mailed out soon.

Research

Joel has been developing a database of published work on pharmaceutical promotion for the WHO Essential Drugs and other Medicines policy department (EDM).
Vasiliy Vlassov (general medicine), Joel and Peter have had a paper about drug advertising in Russia accepted for publication in the Western Journal of Medicine.
Melissa and Peter have been working with academic psychologists to supervise honours students’ research on the psychology of drug company influence on prescribing.

Education.

Peter has produced Healthy Scepticism New Zealand for PHARMAC and Melissa and Peter have written a paper on feedback from readers. From this they compiled a poster presented for an Australian Quality Use of Medicines symposium.
Peter has been developing teaching materials for critical appraisal of pharmaceutical promotion for WHO EDM. Peter has trialled drafts of this material with medical and pharmacy students, general practitioners and senior hospital pharmacists around Australia and New Zealand. Katrina and Peter are developing randomised trials of such teaching of general practice trainees.
Peter and Joel have written a case study and feedback about “new drugs” for the Australian National Prescribing Service (NPS). The next edition is the first of three presenting the feedback for our subscribers.
Peter and Paul Glasziou (evidence based medicine) have written a case study and feedback about hormone replacement therapy for NPS and Peter has provided training on this topic for NPS staff.
Jon and Peter have written articles for Health Matters (UK) and for Australasian Psychiatry.

New name: Healthy Skepticism

We have decided to change the name of the organisation from MaLAM to Healthy Skepticism because our methods are changing and we need a new name that will be better for promoting our objectives. Our reasons for choosing the Greek spelling are a long story that we will save for later.
We plan to describe ourselves as:
Healthy Skepticism
Defending health care from misleading and harmful marketing. Advocacy, Research and Education.
Formerly Medical Lobby for Appropriate Marketing (MaLAM)

Full implementation of this change will take time. Meanwhile both the old and new names may be used.

Our aims have not changed

Our aims, as expressed in our constitution, are:
(a) to defend appropriate compassionate scientific medical care, health professionals and the public from marketing practices which may be detrimental to health.
(b) to engage in dialogue with bodies involved in health-related marketing.
(c) to provide a balance of information and practical opportunities for action, which assist health professionals to act for the benefit of the public.
(d) to encourage bodies involved in health-related marketing to provide reliable information to assist appropriate therapy.
(e) to support the development of marketing quality control systems and other methods which enable health-related marketing to become more trustworthy and helpful.
(f) to support appropriate compassionate scientific medical care.
(g) to provide a Medical Lobby for Appropriate Marketing where:
Appropriate Marketing refers to “health-related marketing with provision of appropriate information to assist health professionals to provide appropriate compassionate scientific medical care”
Medical Lobby refers to “an organisation which conveys the concerns of health professionals in ways that encourage Appropriate Marketing.”

Our aims have not changed. However we believe that it would be healthy for our organisation to discuss our aims at least once every 10 years to decide if any updating is appropriate.

We are moving from paper to the Internet

We have also decided to move from distributing our newsletters by post towards having them available only on our new upgraded website:
www.healthyskepticism.org.

Our previous URL: www.malam.asn.au will continue to link to the same website as www.healthyskepticism.org indefinitely.
We will discontinue our original website:
www.camtech.net.au/malam

We will notify subscribers via e-mail when new editions are posted on the website.
If you prefer to read MaLAM newsletters on paper then you can print them from the website.
If you are currently a paid up subscriber and do not have access to the Internet then we hope you will consider gaining access. If you are not able or do not want to do that then please fill out the enclosed form to continue to receive MaLAM editions in the mail until your subscription runs out.
We request all subscribers in all countries to visit www.healthyskepticism.org to register as a subscriber. If you do not want to use our online system to register then you can use the fax or post option on our website. You will have the choice of being a free or paid subscriber as described below.
Since 1986 we have had a network of MaLAM distributors around the world. We are very grateful to our distributors for reproducing MaLAM editions and posting them to subscribers in their country for all those years. Now distributors are no longer essential in those countries where subscribers can easily access the Internet. We are hoping that distributors in those countries will refocus their support for us towards promoting our website etc. In those countries where access to the Internet is less easy distributors remain very important for us. Consequently we are very pleased to announce that a new group of Sri Lankan medical students has recently agreed to distribute our newsletters in their country. We are happy for anyone in any country to copy and distribute any of our work to anyone as long as we are acknowledged as the source. However we do not give permission to be cited as the source of material we did not produce.

Free subscriptions

We will provide free Internet subscriptions for those who want them. We can afford to do this because the addition of extra recipients to our free subscriber e-mail list does not cost us any more. The advantage of this is the possibility of reaching larger numbers of people who are not already committed to our aims.

Paid subscriptions
For people who are willing to pay for a subscription we have set up a separate paid subscriber e-mail list. At this stage, paid subscribers will gain no advantage over free subscribers other than the satisfaction of supporting Healthy Skepticism. Subscribers are essential for our core funding so Healthy Skepticism can only succeed if we have your continuing support. In the future we hope to give paid subscribers ways to participate by voting on issues on our website etc. (see Subscriber Participation below.)

Calendar year paid subscriptions
In Australia we have been counting subscribers as paid up from the month that they first paid a subscription to the same month of the next year. This has caused a lot of confusion. Consequently, we have decided to move to calendar year subscription periods. From now on we will start requesting resubscriptions from all paid subscribers in November every year to cover the following year. This new arrangement will be more efficient and make financial planning easier for us.
Consequently we will not be requesting any more subscription payments until November 2001. If you feel that we are under-charging you then please feel welcome to make a donation via our website.

Subscriber participation
One of the strengths of our original focus on letters to drug companies about marketing was that it gave subscribers an opportunity for personal participation in the process. Consequently it is important for us to develop new ways for subscribers to be involved. At this stage the best ways to be involved in Healthy Skepticism are by promoting our work to others, by notifying us of material suitable to be posted on our website or linked to from our website and by writing original material for our website eg. about experiences at CME events sponsored by drug companies or particularly bad experiences with drug company representatives, etc.
As mentioned above, all subscribers are requested to visit www.healthyskepticism.org to register as a free subscriber or as a paid subscriber (No payment will be required until November 2001).

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