Is Medicine Making Us Sicker? (Part 3 of 4)

This blog post, written by guest author Al von der Linden, is part three of a four-part series. Click here to find parts one and two. Sign up for our newsletter to receive each installment by email as it is released. 

What Hippocratic Oath?

What happened to the Hippocratic Oath? Over the past 40 years, the pharmaceutical industry, along with some doctors and psychiatrists, have brushed aside the Hippocratic Oath. Instead of a commitment to prescribe only beneficial treatments and refrain from causing harm, an acceptance of a tolerable rate of injury and death from medicine to achieve a “greater good” is found. Unfortunately, this philosophy has left a needless trail of human suffering and death.

Since many medications carry the potential to harm people, why are American doctors prescribing more medications than they were in the past? There are several possible factors involved, but let’s begin with the place doctors commonly turn for guidance.

Medical Journal Influence

Doctors certainly don’t have time to do their own research, so they primarily rely on what they read in medical journals. They also understand there is less risk in prescribing treatment that is widely accepted by their peers. Medical journals clearly have a major influence over a doctor’s treatment plan.

Who determines what is published in medical journals? Here’s the rub. Drug companies have significant influence over medical journal content. Clinical practice guidelines, which doctors and other prescribers turn to for guidance in treatment decisions, are often written by experts with financial ties to industry.

When it comes to the drug approval process, drug companies heavily influence each step, and there is little transparency. The majority of trials on which the guidelines are based are paid for by drug companies, which often design the trials themselves. Some drug trials have been shortened to make the drug appear safe, even though it may prove harmful over the long run. Other drug trials have not reported a large portion of deaths that occurred.

Drug company employees analyze the data and hire medical writers to spin the results. They present the study to their academic experts who they pay to be their advisors and speakers. These experts, in essence, become the authors of the published paper. The paper is submitted to a medical journal editor, who has merely become a vehicle for story laundering.

It’s very difficult for doctors to find unbiased evidence about the potential dangers of the drugs they are prescribing because the drug industry has tremendous influence over what doctors learn and how they learn it.

Money Matters

Another reason American doctors are prescribing more medications is that drug companies pay them to prescribe their products. Each year, about half of all U.S. doctors accept money or gifts from drug and device companies, totaling more than $2 billion.

Does that money influence doctors? In many cases, yes. A 2016 ProPublica analysis of doctors receiving payments related to Linzess found that, on average, they wrote 45% more prescriptions for the drug than doctors who received no payments.

In addition, a research team at Memorial Sloan Kettering Cancer Center conducted 36 studies that recently confirmed receiving industry money increases prescribing. Industry money affects how doctors prescribe cholesterol medications, drugs for Alzheimer’s disease, multiple sclerosis, and blood thinners. It even affects which drugs are used to treat cancer and increases how many opioids doctors prescribe.

In addition to direct payments to doctors, the pharmaceutical industry spends about $80 billion per year on marketing and lobbying. This is far more than what is spent on research. The U.S. is one of only two countries that allow direct-to-consumer pharmaceutical advertising.

Why would drug companies need to spend so much money on advertising? To control the message in the media, of course.