ADHD Experts Have a Bad Case of Gatekeeper Syndrome

Gatekeeper syndrome afflicts many many healthcare professionals. People with gatekeeper syndrome dismiss or ignore any solution that does not involve them (or someone like them) being a gatekeeper and charging “toll”, i.e., making money. When I was a teenager, I had acne. None of the dermatologists I saw showed any interest in what caused it or even seemed to understand it was possible to learn the cause. All of them prescribed drugs (antibiotics) so powerful I had to see them again and again to get the prescription refilled. That’s garden-variety gatekeeper syndrome.

A recent New York Times article about Attention Deficit Hyperactivity Disorder (ADHD) illustrates gatekeeper syndrome among professionals from whom you might expect better. The article describes ADHD experts at various universities wringing their hands: Did we overemphasize drugs at the expense of “skills training”?

Some authors of the [1999] study — widely considered the most influential study ever on A.D.H.D. — worry that the results oversold the benefits of drugs, discouraging important home- and school-focused therapy and ultimately distorting the debate over the most effective (and cost-effective) treatments.

What about finding the cause(s) of ADHD? And getting rid of it/them? Maybe that would be a good idea? None of the experts quoted in the article even seems aware this is possible.

When an ordinary psychotherapist or doctor has gatekeeper syndrome, I think they’re just a foot soldier. The experts in the Times article are not foot soldiers. They’re generals. They are professors at world-famous universities, such as UC Berkeley and McGill, with enormous influence.  (One is a former colleague of mine, Stephen Hinshaw.) They don’t need to see patients and dispense treatments to make a living. They have assured income (tenure) and prestige. They enjoy freedom of thought.

Too bad they don’t use their freedom and prestige to better help the children they study and the tens of millions of children who will be diagnosed with ADHD until someone (not them, apparently) figures out what causes it. Instead, they study who should get the revenue stream that each new diagnosis provides.

Thanks to Alex Chernavsky.