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A study expected to provide scientific data showing Ritalin LA's advantages was not scheduled to start until the following day, he said, but the lack of research findings should not be an obstacle. "Obviously, we have to stick within data limits of what's published currently as well as what we know are factual about these products," he told the doctors. "But, of course, inferences can be made." One such "potential theoretical conclusion" of the article, Ms.

Zabusky added, was that a drug that worked for 9 hours might be better than a 12-hour drug. The doctors - John S. Markowitz and Kennerly S. Patrick of the Medical University of South Carolina - agreed to what Intramed and Novartis proposed. "I think we're quite clear on what you want the next manuscript to look like," Dr. Patrick said as the call concluded. To produce the new draft, Intramed turned to Linda Logdberg, who has a doctorate in anatomy and has made her living the last 12 years as a ghostwriter for Intramed and other medical marketing companies.

Starting with an outline approved by Intramed, Dr. Logdberg said that she produced a new manuscript in a few days. The assignment was one of her last ghostwriting tasks. Dr. Logdberg, who recently took a job teaching biology to high school students, said that she had become increasingly disenchanted with the process. Typically, she said, her manuscript would be sent to the drug company for approval before it was given to the doctors who were paid to be listed as the authors.

Some doctors fretted over each comma, Dr. Logdberg said, while others made no changes at all. The marketing companies, she added, "will drop a doctor if they don't think he will be particularly malleable." The result, Dr. Logdberg said, is marketing masquerading as science. "What I mind is advertising that calls itself education.