Wag the Dog, Healthcare Style

It’s not jaw dropping news hear that industry has an undo influence on medicine today.  The routes by which industry infiltrates medicine, however, is just short of legendary.

I have always wondered how we got to where we are in medicine.  Doctors are there to help their patients get better and stay better, right?  But at what point did industry (and when I say industry, I am generally referring to the pharmaceutical companies and device manufacturers like artificial hips, pacemakers and stents for cardiac procedures) start to influence the relationship between the doctor and patient?

Make no mistake.  These companies are very successful at what they do and they do it because it works.  Every single one of us can be influenced by gifts and wooing, so don’t hold your doctor to blame.

But when the medical profession is no longer questioning the validity of the research and recommendations coming from industry, we’ve got a problem.  How can a class of drugs like the statins, that lower the absolute risk of a heart attack by 1%, rise to be the most successful class of drugs ever developed?  Why are beta blockers still being used for high blood pressure despite a decade of information that this class increases the risk of stroke and diabetes?  The list is quite long.

Maybe it’s become so pervasive that medicine can no longer tell the difference.  In which case, we are lost.

In this particular study, researchers evaluated different aspects of potential influence:

  1. Evidence base production–producing their own clinical trials that support the product.
  2. Evidence synthesis–compiling data that they produce into compelling packets.
  3. Understanding of safety and harms issues–the downplaying of risks, like what we saw with Merck and Vioxx.
  4. Cost-effectiveness evaluation–manipulation of data to make it look like the product is worth the cost.
  5. Clinical practice guidelines formation–guidelines produced by the national organizations (like the American HeartAssociation) are created by members who have financial ties to industry.
  6. Healthcare professional education–infiltration of the medical schools and sponsoring of continuing education lectures.
  7. Healthcare practice–drugs reps guiding doctors’ behaviors through direct contact. Healthcare consumer’s decisions–direct to you advertising, increasing the likelihood that (a) you’ll think you have something wrong with you like “shift work disorder” and (b) you ask your doctor to prescribed THAT medication.

Researchers were able to find that industry plays a significant role in ALL of these aspects of healthcare.  Pretty much every aspects of what we consider “health care” is played out and driven by industry.

Sure, in some cases there is an actual desire to help the patient on the side of industry, but this is far overshadowed by the desire to earn a profit.  And you and your doctor are at the end of the chain that has been manipulated long before it ever got to you.

Think about THAT the next time your doctor wants you to try that “free” sample.


James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.