I appreciate all the attention my recent Skeptical Sleuth blog post received at Psychology Today (PT). The blog expressed concern about Pfizer financing the development of quality indicators for monitoring oncologists’ attention to patients’ psychological distress. But it also raised troubling issues whether well-meant efforts to improve cancer patients’ adjustment and quality of life really worked or merely disrupted what was already being done for these patients. Namely, oncologists could behave consistent with quality indicators by simply passing out antidepressants without proper evaluation and followup of patients, rather than providing patients with the opportunity for a discussion of their unmet needs and concerns.
I had fun writing the blog and continue to see blogging as a writing laboratory and a place to experiment with alternative means of effective communication beyond the conventional journal article. I had deliberately crafted the blog with hopes of achieving a broad appeal with the title of “$10 Million from Pfizer: Generous Philanthropy or Buying Influence?” and subtitle, “Is Pharma Hijacking Screening Cancer Patients for Distress?” But that is not what you will see if you now go to the PT blog.
Shortly after posting the blog, I was notified that PT staff took it down. Mysteriously, my profile photo was also removed. An email from PT announced that the blog had been removed for editorial review. I was told in a telephone call to PT was that concerns had been raised that the blog’s provocative title and subtitle might offend the pharmaceutical companies that regularly advertise in the side panels accompanying blogs. When the blog went back up, it had an unappealing title that would not have been my choice,“Cancer Treatment and the Pursuit of Quality Indicators.” [zzzz]
The earlier posting and its title had been automatically approved. I had immediately begun publicizing it with links placed on Twitter and Facebook. It was annoying that all links to it were broken and then an edited post with a different title appeared.
PT editorial staff now say that any of my future blog posts will be subject to pre-approval, solving one problem but substituting another one. I cannot immediately provide a working link to a new blog post or publicity on Twitter or elsewhere. Furthermore, I wonder why only my blog posts are singled out. Certainly one can go to PT and readily find examples of blog posts where authors should have been saved from themselves and the embarrassment of their hype, inaccuracies, and simple foolishness. If the editors are going to implement pre-review, why limit themselves to potential offenses to advertisers?
The blog is now back up but re-titled “Screening for Cancer Distress.” Spokespersons for PT said that they would repost my profile photo but can offer no explanation why it was taken down in the first place. They had also eliminated all previous “Likes” to my earlier posting and title, setting them to zero, apparently because it was now a new post.
It is ironic that I would run afoul of the PT censors because of a blog title that contained criticism of the pharmaceutical industry. I previously posted a series of blogs that challenged Irving Kirsch’s calims that antidepressants were no more effective than placebo and therefore worthless. Kirsch is a hero of the radical anti-antidepressant tribe, many of whom are are hostile to the pharmaceutical industry more generally and have never encountered a drug that they would take, at least one from pharmaceutical companies.
I argued that Kirsch’s position did not come from the evidence. Furthermore, if he were to stick to such a position consistently, he would have to concede that psychotherapy was no more effective than placebo because of similar effect sizes. These blog posts were promptly spammed by anonymous posters. One poster revealed his identity so that I could recognize him as a University of Nevada psychologist associated with Scientology.
As I have commented before, there are areas of tribal warfare in science and biomedicine in which anyone attempting to contribute to the conversation is immediately filtered as being for or against a particular position. They are then praised or trashed on that basis, not on the basis of any consideration of their message. So, I guess the posts about Kirsch typecast me as pro-Pharma and now my post about Pfizer hijacking screening cancer patients for distress makes me has anti-Pharma. I hope that for some people that this casting and recasting doesn’t get in the way of their reading my message
I remain annoyed about the taking down of my post and the altering of its title, but upon reflection, what else could I expect? Let’s restrain our righteous indignation for more appropriate contexts. PT is a for-profit company that provides free opportunities to blog in order to collect the substantial advertising fees from companies wishing to place the advertisements accompanying the blogs. PT is not in the business to promote bloggers nor to ensure the integrity of blog posts, but to make money.
Having a blog at PT is a Faustian bargain. PT gets nearly free content that attracts advertisers. No one should blog for the money, but PT makes miniscule payments from a share of advertising revenues that even in a good month won’t pay for the cheap wine to celebrate getting paid to write. The real payoff is that bloggers are assured a certain publicity and a potential reach into a pretty large audience, without having to attract one themselves. But what an audience it is, and there is a temptation to pander to it with catchy taglines. A recent post: “You’re 10 Post-It Notes Away From the Life You Want.” Who would want to compete with that? I got over 10,000 hits with an early post “Did a Study Really Show that Abstinence Before Marriage Makes for Better Sex Afterwards?” but only 681 shortly thereafter for “How Much Do Behavioral Interventions Change Cardiovascular Risk Factors?” Hopefully I can resist being shaped by the contrast.
And then there is the risk being lumped with others also along for the ride who can prove embarrassing at times. Even before the censorship, I had qualms about having a blog on PT. It’s unpredictable whether my blog would be posted along with advertisements for dubious herbal products or with links to many of the other bloggers who engage in psychobabble and hype. I took great offense when Mark Lane posted about botanical remedies for cancer and embedded links in his blog to sellers of these dubious products on the Internet. These are not just silly, they’re dangerous and I don’t understand why I should get censored for criticizing pharmaceutical industry and Mark Lane can get away with praising exploitative and fraudulent products to fight cancer.
I had started with fantasies about my blog arming a lay audience with the tools to decide for themselves about the credibility of scientific articles and media coverage of them. Maybe like dropping weapons to insurgents. But in the end, I felt like the parachutes carrying the weapons were floating down into a jungle and I had no idea about who the insurgents were or even whether they were there. Certainl,y many of the replies I got suggested there was not a lot of intelligent life, even if occasionally there were flashes, perhaps lost stragglers trying to signal with mirrors.
PT usually doesn’t interfere with bloggers. But once censoring has occurred, and particularly when it is motivated by fear of offending pharmaceutical companies, censoring taints all PT blogs with an unanswered question: is the blog that I am seeing censored or, more likely, did the blog avoid censorship by its author tailoring what is said to avoid censorship? Bloggers who wish to avoid this kind of suspicion should be going elsewhere. I am working on that, but will make a slow departure, not just throw a hissy fit and disappear. I’m concerned too that my previous posts will remain accessible.
So I think it is now time to move on from PT. I have had almost 60,000 hits to my mostly monthly posts, but I think to accept such censorship indefinitely would be a mistake.I am negotiating a suitable new home for my blog. I seek a more science oriented intelligent lay and professional audience. For now, there will a few more posts of Skeptical Sleuth, but but that’s it.
Postscript: I now blog at PLOS Mind the Brain and Science-Based Medicine, as well as this secondary blog. But my old blog at Psychology Today is still accessible. Although I have not blogged there in over a year, my posts still get regular visits, with over 113,000 visits by September 5, 2013.