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Your health is for sale

Medical specialty societies are on the take, as any doctor has long known. Why should that concern consumers?

Because big money is influencing nearly every treatment you get.

From the drug maker’s free stethoscopes doled out in medical school, and the helpful online algorithms of medical signs and symptoms that insidiously direct doctors to prescribe a sponsor’s brand name drug, all the way to the endowment from the device manufacturer received by a hospital that is implanting their pacemakers, billions are spent on impelling doctors to embrace some treatments and shun others.

Grossly unethical outrages have continued to turn up during a decades-long series of investigations into the unholy relationships between drug and device makers and their customers (the prescribing doctors and operating surgeons) led by longtime Sen. Chuck Grassley.

The ultimate payer is the health and even the very lives of unwitting patients.

The latest evidence, turned up by Freedom of Information requests and Grassley’s committee investigations, concerns the obvious conflicts of interest when the nation’s lofty, authoritative medical specialty societies accept millions from drug and device makers.

These ‘societies’ are the inside clubs that devise the criteria to make a diagnosis, such as what constitutes high cholesterol, or what level of blood pressure is officially labeled hypertension, and then create medical decision-making guidelines which direct specific treatments.

Wouldn’t it be nice to trust one’s doctors to wade through the influences, and just make decisions based on hard scientific facts for the greatest good for their patients?

Dream on.

If cardiologists did that, then there would not have been a recent study finding more than one in five patients who received cardiac defibrillators did not meet science-based criteria for getting them. Is it any coincidence that the guidelines to implant pacers are formulated by the Heart Rhythm Society, which collects millions of dollars per year from makers of drugs, catheters and defibrillators used to control abnormal heart rhythms?

Even general practitioners are subject to the weight of authority imposed by specialty society guidelines. Nearly 100% of US doctors adhere to the recommendations issued by American Heart Association’s cholesterol panel, resulting in 40 million Americans being prescribed statin drugs. Does your doctor disclose that your prescription is influenced by the one of panel’s highest-ranking members’ six-figure research relationship with a billion-dollar drug giant?

Although any given doctor - let’s say your doctor - might never have received a gift or payment from drug makers, their decisions are yet directed by specialty societies who craft the definitive guidelines.

In other words, it is almost never a case of your doctor thoughtfully evaluating the medical literature, data, and experiential evidence to make an independent decision on what’s best in your case.

What is the health care consumer to do?

It is prudent to adopt a healthy skepticism. It is not necessary to go to medical school to challenge a doctor. Ask questions.

Beyond the basics of informed consent, ask your doctors what they know about the statistics of safety and effectiveness of the treatments they are proposing, and where they got that information second hand through a specialty society, or their own review of the medical literature?

You may have to do some doctor-shopping!

Find out more about the long history of the questionable characters who have crafted modern medicine in the new book Heroes & Scoundrels, detailing the good, the bad and the ugly of the winners of the Nobel Prize in medicine.



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