Rather than to clearly examine the medical practices which are being foisted upon the people, and to make cogent, intelligent recommendations, our medical society is instead being strongly influenced by the corporate entities that are poised not to improve the health of the country, but to improve the financial health of its stockholders. Too much influence, money and legislative power has been put into the hands of these corporations, and now we are paying the price. The fox is in charge of the proverbial henhouse.
So what are the factors and the forces that have wrested the power from our control? To coin a phrase, one need to simply “follow the money”. Sadly the specter of profit, at the expense of our nation’s health, is driving the bus. It is my belief that too often the perspective of, and approach to health is not developed by the patient or their provider, but by the corporations. The relative ease by which a physician can diagnose a condition and recommend a treatment, neatly pigeonholing health interventions into a drug class or treatment protocol is startling. Similarly decision making by physicians in not driven by the best and most prudent information on how to influence and modify an patient’s health, but by the newest and most convenient drug.
Case in point. Let’s look at the diagnosis of “depression”. The extent of the conventional medical thought process has already ended by time that you read this sentence. “The individual is depressed. S/he needs an antidepressant.” Now grab the prescription pad! Done thinking, let’s get treating!
But what if one were to take a moment to recall that multiple other forces are in play that could be contributory to a clinical presentation of depression? Strong medical data exists that relates a sense of depression to personal and social issues, life changes such as a loss of a family member or a divorce, drug use and stress. Additional data strongly correlates depression with more tangible things, such as inflammation, infection, or metabolic disorders. Elevated insulin, a state easily modified through dietary changes, has been strongly associated with depression, as have nutritional deficiencies of substances such as vitamin D, SAM-e, alpha lipoic acid, B vitamins and tryptophan. Maybe your depression could be modified with fish oils, anti-inflammatories or herbs? These have all been well studied. So when in the course of modern medicine did we begin to turn off our brains and to simply cow to the newest, most cleverly promoted drug?
The average American is probably oblivious to the unending barrage of marketing from the big Pharm companies comes across their physician’s desk over the course of the year. Most large medical offices are seeing weekly if not daily introductions to a new drug or therapy- delivered by the advertising department of the drug company. Unfortunately this information is not being delivered in an unbiased way. The physicians, within the extent of the law, are effectively being bribed to prescribe. Unlike the halcyon days of the past, when we physicians were literally taken on junkets sponsored by the drug companies, the dissemination of information- with the perks- has become much more subtle and insidious.
One way to influence physicians is to sponsor “training” seminars. This is generally a lavish meal at the finest place in town, accompanied by a brief “informational” talk on the merits of the sponsor’s product. This is pretty tempting, I know. More than once I too have been swayed by an invitation to dine on Big Pharm’s dime. Marshall Mc Luhan once said that the “medium is in the message”, but it is hard to shrug off the message when it is accompanied with expensive wine, a wild truffle terrine and the Atlantic salmon en croute.
Similar temptations occur in the office place, where some offices routinely schedule lunches with the sales force of the newest, greatest drug. Drug “reps” are uniformly attractive, well dressed, well coiffed, and arrive not only with lunch for the staff, but a variety of sundries, tokens and tchotchkes all cleverly designed to sway the prescriber’s attention to the recommendation of the sponsor’s drug. I have seen lunch spaces strewn with logo hats, pens, note pads, rulers, key chains, books, penlights, and mugs following a presentation. These trinkets are for the staff. The new textbook, event tickets, and pre-printed prescription pads all reside securely in the office of the physician.
The medical marketing of today is now cloaked in the guise of medical information, and the prizes are not as obvious as a golf trip to the Caribbean. All physicians are responsible for maintaining a certain number of Continuing Medical Education credits by the respective medical boards of their states. Typically these are fairly costly to attend; airfare to the city, hotel lodging and meals. But it is well within the law for a drug company to sponsor a physician’s medical education, and many take advantage of this opportunity. Now of course the lectures are unbiased. It just happens that the best product for the treatment of the condition to be discussed is made by the entity that sponsored the conference! Is it coercion or coincidence? Sometimes the areas begin to grey, and sadly so too do the motives for recommending a certain medication or treatment.
So what then can we, the public do to remedy this? Generally we as a whole lack the training, insight and status of a prescribing doctor. What we can do is to perform an act which is sadly evading the collective conscious of the contemporary physician. This is to THINK. We can all take a moment to reflect upon what seems to be the best, and safest course of action for our health, and whether the newest, greatest thing will really live up to its hype and hyperbole. We can QUESTION our providers as to why a certain (often new and expensive) treatment is being recommended to us. We can EDUCATE ourselves (and believe it or not our doctors) by reading, studying and utilizing the multiple resources that are available through the internet, seminars, webinars, medical publications, and our friends. And finally, we can be
REMINDED that true health is not simply found in a pill or tincture, whether pharmacological or from the health food store, but from a commitment to a path of wellness found in our family, our community, our lifestyle choices, and our mind.
Dr. Scott Resnick
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