I think I'd rather that these comments were aired in public, so that we know what is thought in private.
It allows us to challenge the mind-set.
Otherwise, the health services staff are having these thoughts and discussions behind our backs amongst themselves anyway, unchallenged.
At least this exposes them for what they are.
That's my view too. I'd rather have these views in a public place than have it so that patients only ever get to face them alone in a doctor's office.
But this particular response is written as if it was a paper. This is what makes it so pathetic - rather than submit it as a paper it has been sent to the comments page.
It does seem a bit odd. Also, it doesn't cite or refer to the decade old article they're supposedly commenting on. I'd have thought it was a late night (maybe slightly drunken) post that was instantly regretted were it not for the fact that two people put their name to it - presumably they must have discussed and proof read it together.
I suspect the real problem is that the service as a whole agrees with the views expressed in the letter - not necessarily be meme rubbish but the statements used to justify it. I think the thing about support groups is one of White's themes and he is associated with the service.
Notice also the authors have not apologized just been told to try to get the BMJ to remove the article as its embarrassing. Or more likely they are worried that patients will not want to be referred to their service as they see the attitude of the staff. Then their nice little cash cow disappears.
They've still not released the results on mediators from PACE, but it looks like they did not find that support group membership affected anything (or not much) there from the hints we've had, eg:
http://www.trialsjournal.com/content/12/S1/A144
They've still gone on promoting the idea that support group membership is harmful based on, I think, just one old piece of research which took no account for the possibility that joining a support group could be correlated with worse health, or longer illness.
Also, as they're results show that their interventionsead to almost no improvement in objective measures of capability, it wouldn't be that amazing if membership of a support group did mean that patients were less prone to response bias improving questionnaire scores in the way which they seem to have built their careers upon. That would not be a bad thing.
(I just read the discussion of when that was first released, and someone pointed to Sharpe's article for Unum as an example of their views on patients groups, and thought it might be of interest to others here too:
http://issuu.com/maxhead/docs/unum_cmo_report_2002 ). All three of the PACE PIs reported COIs involving the insurance industry.