The Dark Side of Medicine

Thursday, December 02, 2010

Carl Elliott, professor at the Center for Bioethics at the University of Minnesota, discusses the problems with medicine’s growing commercialism. In White Coat, Black Hat: Adventures on the Dark Side of Medicine, he looks at the social and legislative changes that have blurred the line between consumer capitalism and medicine.


Carl Elliott

Comments [18]

Drug rep from NY

Many of the practices that guest discusses have not happened in years. No pens, pads, mugs, and certainly no trips etc. The only thing we can do are educational dinners. If you read comments from Brian Lehrer show couple weeks ago you will see that docs use these programs to get more in depth info on drugs and to bounce ideas and thoughts off their colleagues in attendance.
Off label promotion is wrong an should not happen but ultimately doctors can write for whatever they want and find that is efficacious.
Feds pay for only a tiny percentage of R&D. Private industry through our revenue pays close to $50 billion each yr in R&D. Those Lipitor profits go to subsidize the cost of a rare cancer drug that may only afflict a thousand patients per year. When your family member gets rare cancer yu will want pharma researching the disease with the profits from other blockbuster drugs.
Most cardiologists I know think statins on the whole are so effective in preventing cardiac events with minimal side effects that one once told me only half jokingly that they should be in the water system.
Think about this : if big pharma didn't save or improve lives, we would be out of business. Our goals align with the public in this respect- help societal health or go broke. If you are looking for someone to hate, look to the insurance companies whose stated goal as a for profit industry is diametrically opposed to the interest of their customers- every dollar they deny in coverage is a dollar profit. The NP commenter should know this.

Dec. 02 2010 02:50 PM
ST from CT

Start asking your healthcare provider about their relationship to pharmaceutical companies. Do they allow drug reps in their office? Do they accept free samples? Do they listen to the pitch?

I am a nurse practitioner, and drug reps often show up to my office to push free samples and their load of marketing crap on me to influence how I prescribe. Our office has a closed door policy. No drug reps in our office, ever. If I want to learn about new treatments, I attend academic conferences where many view points are presented.

It's also rare for me to prescribe a new drug until it's been on the market for a while anyway. Too many deadly side effects come to light the first few years on the market.

Dec. 02 2010 01:01 PM
marjorie from Long Island

how about the very lucrative business of cholesterol drugs which it seems that everyone over fifty is encouraged to take. These drugs have no benefit for people who have not had a previous heart attack. See Bloomberg business week article from Jan 2008," do statin drugs do any good?." They come with very bad side effects for millions of people. Why are they still prescribed? Perhaps because they bring in 25 million dollars year for big pharma. It is a huge problem that the FDA and the drug companies are intertwined. In fact, it is a front page scandal which has not gotten enough media attention.

Dec. 02 2010 12:58 PM
Amy from Manhattan

anonyme, if antibiotics are used correctly, there's much less chance of resistance. The problem is that dr's. prescribe them too much, patients take them wrong (stopping before they've taken the full course), & huge agribusinesses routinely put them in the feed of healthy cattle.

Dec. 02 2010 12:51 PM

That's called a VNR - video news release - and it's old old old.

If these corps didn't have so many people who will blindly accept that they need the drugs, they wouldn't be making any money at all. Miracle drugs? Antibiotics have wreaked an awful lot of havoc on the ecosystem and on us as viri and bacteria mutate

Dec. 02 2010 12:41 PM
Amy from Manhattan

And Prof. Elliott's description of what happened w/Neurontin reminds me that The Onion was on top of this back in 2003! (,297/)

Dec. 02 2010 12:39 PM

doesn't the federal government pay for a lot of drug R&D costs

Dec. 02 2010 12:38 PM

The drug reps, I notice, seem to get younger and prettier with hot bodies tightly and sexily clad. Looks like the drug companies offer sexual enticement to the doctors as well

Dec. 02 2010 12:38 PM
Elizabeth from Manhattan

Why don't the AMA, the licensing boards, and universities/research institutions declare it unethical for a doctor or researcher to put his or her name on an article he/she hasn't written, when the doctor/researcher has not done or supervised the research?

Dec. 02 2010 12:37 PM
Amy from Manhattan

Another example of Rx creep is how FenPhen, approved by the FDA for morbid obesity, ended up being prescribed to people who wanted/needed to lose only a few pounds, so that many more people were exposed to the risk of serious heart problems.

Dec. 02 2010 12:35 PM

Many doctors can't earn like they used to (insurance cos and medicare have to take their pound of flesh) - nor can they take care of you as before (time) - it truly is the corporate takeover of the body

Dec. 02 2010 12:31 PM

those gimmicky things (magnets etc) were all they used to have - that and trade mags -

Dec. 02 2010 12:25 PM
Carl Ian Schwartz from Paterson, New Jersey

When scientific journals have become subverted to corporate profits--by ghost-written articles without possible peer review--the ostensible authors are debasing science into a form of prostitution. It's ironic--this has become a nation of prostitutes: it is legal to sell out your integrity and good name, but it remains illegal to rent out your private parts.
And then the powers that be paper this all over with "religion"!

Dec. 02 2010 12:24 PM

There was a piece in the Times not too long ago about med students at Harvard standing up to being pitched in class.

I am really all done with pharmaceutical companies - I am amazed they have any credibility at all.

I remember even in the 70s drug salespeople were scorned even while they made more money than their young peers - the sleaziness of drug companies is nothing new.

Dec. 02 2010 12:21 PM
Marie from New Jersey

In the world of immigrants, you can visit "bodegas" and find prescription medicine being sold secretly. Even if health officials are aware, and always wonder why?

Dec. 02 2010 12:07 PM

Much as I miss Bill Clinton and his talents I remember he opened the doors to and for Monsanto.

I just heard a stat on deaths from people taking their meds correctly, and correctly prescribed: 100,000+ a year in the USA.

We are not 100% sold out - we still have options.

We really do need to use our shopping carts to vote, and we need to be informed about what to put in them.

Dec. 02 2010 12:05 PM
Fred Sander

Might you ask Dr.Elliott if he is
documenting the simple fact that money
has taken over ethics at so many levels of
our society, from the top levels of government, to education, medicine, to the media, law. In effect, we have moved from an awareness of the veneer of civilization to a culture of corruption. With mendacity
the coin of the realm.

Dec. 02 2010 11:47 AM
Meredith from NYC

Leonard, please ask the guest to contrast other advanced countries with U.S. as to whether that line is blurred as much, or do they keep medicine and commercialism more apart, due to laws or cultural attitudes. Thanks.

Dec. 02 2010 11:08 AM

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