Those who say watchdog journalism is dead and gone are just plain wrong. And there’s no better way to refute that notion than to explore the body of work Milwaukee Journal Sentinel reporter John Fauber has created over the past five years. Fauber, who came to the medical beat from the trenches of business news, set his sights on the underexplored, story-ripe intersection of medicine and business. For his work, Fauber merits a CJR laurel.
One early example: in January 2009, Fauber and then-colleague Susanne Rust, acting on a tip, looked into an online continuing medical education course at the University of Wisconsin-Madison School of Medicine and Public Health that was sponsored by Wyeth Pharmaceuticals. It’s common for drug companies to pay for such programs, but this one deserved special scrutiny. In 2002, a major clinical trial showed that hormone replacement therapy resulted in increased risk for breast cancer, heart disease, and blood clots. Researchers stopped the trial mid-stream. That same year, Fauber and Rust found, the university began a medical education program for doctors that “promoted the therapy, touted its benefits, and downplayed any risks.” Wyeth, a maker of the drugs used in the study, poured $12 million into the program, $1.5 million of which went to the university. When the reporters sniffed out the conflict and questioned the university, the course was removed from its website, although Fauber and Rust reported the course material remained on the Internet available to doctors and the public.
In 2009, Fauber, whose work has won several awards, reported other stories dealing with the nexus between the university and big pharmaceutical money. One revealed an orthopedic surgeon at the university received $19 million in royalty payments from device maker Medtronics, but he failed to disclose all of those payments to his employer because university rules were fuzzy about the amount that had to be reported. Another story detailed how the university received money from Solvay Pharmaceuticals to pay for a series of medical journal articles touting the benefits of testosterone therapy and downplaying the risks. The testosterone phenomenon, the Journal Sentinel found, was “based largely on iffy science, promotion, manipulation and conflicts of interest.”
And thus the paper launched in early 2009 its ongoing series, “Side Effects,” in collaboration with MedPage Today, an online medical news source for doctors that underwrites part of Fauber’s salary and runs the stories simultaneously on its website. The 40 or so stories in the series to date untangle the web of financial relationships tightly woven in America’s medical industrial complex, showing that universities, researchers, friendly family physicians, medical device makers, educators, even regulators are caught in its threads. All theses ties, of course, raise serious questions about the independence of American medicine, its stratospheric price tag, the honesty of information patients receive about medical interventions, and the quality of care they receive. It’s a sickness gone viral, spread by big money―which is the theme of most “Side Effects” stories.
In the past few years, Fauber, who covers this beat full time, has branched out beyond conflicts of interest near the banks of Lake Mendota. Last year, he showed how the American Academy of Pediatrics endorsed guidelines that recommended drugs to treat childhood acne, but didn’t tell doctors that 13 of the 15 experts who drafted the guidelines were paid consultants or speakers for companies that make the drugs. The paper reported the organization that developed the guidelines, the American Acne and Rosacea Society, had received nearly all of its revenue in 2011 from companies that make acne drugs.
Some of Fauber’s pieces have shown how regulators charged with protecting the public are also ensnared in the medical industrial complex. In 2013, the Journal Sentinel and MedPage Today obtained, through public record requests, emails between FDA officials and drug industry representatives showing that they had held private meetings at expensive hotels at least once a year since 2002 sponsored by IMMPACT, an organization funded by drug makers. At the meetings, they discussed clinical testing procedures and other matters that affect the public. The public, though, was absent.