Doctors under the influence
Why didn't my doctor know?
You trusted your doctor when s/he told you that the COVID-19 vaccine was safe and effective and that you should take it without question, just like you trusted your doctor and took the annual flu shot, and all the other drugs you've been prescribed. He must know since he went to medical school and did a grueling residency and perhaps even a fellowship or two.
But now, after seeing that the COVID-19 vaccine isn't really safe and effective as claimed and, perhaps having caught COVID anyway, or even being vaccine injured, you are wondering how this all happened. Why didn't your doctor know?
Your doctor couldn't know because s/he's under the influence of Big Pharma. It turns out that most of the information doctors get (or don't get) about medication comes straight from the pharmaceutical companies, that are often “less than honest” about the medications they manufacture and sell. That started when your doctor was a medical school student and continues till today.
1. Pharmaceutical companies hook students in medical school
Pharmaceutical companies know how valuable doctors are to their bottom line. After all, doctors are the ones who “sell” their drugs to patients. Therefore, the companies work hard to become part of med students' lives, so that they see them as an ally and a natural part of their profession.
In an opinion piece titled, “The Pharmaceutical Industry’s Role in U.S. Medical Education” by Rijul Kshirsagar and Priscilla Vu at University of California, Irvine School of Medicine, they explain how this is done and the effect it has on their future abilities to practice medicine properly:
Medical students' exposure to pharmaceutical marketing begins early, growing in frequency throughout their training. Students receive gifts such as free meals, textbooks, pocket texts, small trinkets and even drug samples. Forty to 100 percent of medical students report exposure to the pharmaceutical industry…
As medical students are increasingly subjected to pharmaceutical marketing throughout their education, their skepticism towards the practices of the pharmaceutical industry gradually diminishes. Multiple studies report a relationship between exposure to the pharmaceutical industry and positive attitudes about industry interactions. As students' exposure to the pharmaceutical industry increases, their ability to determine industry bias decreases. In losing their ability to detect bias and analyze pharmaceutical marketing statements objectively, medical students hinder their future ability to practice evidence-based medicine. (Emphasis added.)
In fact, pharma's “takeover” of medical school education is so pervasive and insidious that Dr. Elia Abi-Jaoude, a psychiatrist at the Hospital for Sick Children in Toronto, who fought against pharma providing his medical textbooks, still wonders today about some of the things he was taught:
“The truth is, it’s hard to disentangle medical education from whatever the prevailing culture is in medicine, including ways of thinking or beliefs of the day about diagnosis or treatment,” he says.
“And currently, the pharmaceutical and medical device industries continue to have much influence over the shaping of such beliefs.” (Emphasis added.)
2. Doctors manipulated and used to increase drug sales
Once out of medical school and having been duly primed, doctors become middlemen between the drug companies and their patients. Here's what happens then:
a. Drug reps purposely manipulate doctors
Drug reps visit doctors in their offices to “educate” them about their company’s products, emphasizing the benefits but speak very little or not at all about the negative effects. This study shows that doctors know very little about the adverse effects of the drugs they prescribe. This is all the more disturbing since doctors are more likely to prescribe the drugs that drug reps promote.
Watch as this former drug rep explains how she was taught to manipulate doctors to sell them on her company’s drugs.
b. Doctors are more likely to prescribe a drug if they get paid from the pharmaceutical company tied to it. This can be in the form of payment for delivering promotional talks, consulting, or receiving company sponsored meals and travel.
c. Drug companies pay doctors to promote some of their most unremarkable drugs.
Doctors need to wonder about the veracity of drug reps and patients need to wonder about how their doctors are making prescribing decisions.
3. Negative effects of drugs trials not disclosed
Most negative drug trials are never published, so your doctor many never know if a problem exists. Dr. Ben Goldacre explains how publishing bias assures that most negative drug trials are withheld from doctors and the public, to the patients’ detriment.
4. Drug company exec - most drugs don’t work for most people
Surprising and troubling is this admission made by a pharma executive. In an article “Glaxo chief: Our drugs do not work on most patients”, Steve Connor, Science Editor for the Independent, quoted worldwide vice-president of genetics at GlaxoSmithKline (GSK), Allen Roses, as saying:
… fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them.
Connor further wrote that:
[i]t is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public.
Roses, an academic geneticist, ascribed the lack of benefit experienced by many patients to be a result of their genetic makeup. He believed that simple genetic testing could mitigate the problem.
The idea is to identify "responders" - people who benefit from the drug - with a simple and cheap genetic test that can be used to eliminate those non-responders who might benefit from another drug.
Does your doctor realize that much of what he's prescribing for his patients may be of no value to them?
What does that do to the practice of medicine? How does that make you feel?
5. Profits put before patients
The genetic testing and targeting of drugs that Roses was excited about, flies in the face of the drug company’s purpose - to provide the most value possible for its shareholders. This means that profit, not the patient, is their first priority. As Connor explained:
This [identifying non-responders] goes against a marketing culture within the industry that has relied on selling as many drugs as possible to the widest number of patients - a culture that has made GSK one of the most profitable pharmaceuticals companies, but which has also meant that most of its drugs are at best useless, and even possibly dangerous, for many patients.
6. Pharmaceutical companies market drugs they know are dangerous
When the company's bottom line is more important than people, safety doesn't matter and fines are merely a cost of doing business. Here are some examples:
- Merck, the manufacturer of Vioxx, knew the drug caused heart attacks and death, yet hid this information from doctors and the public for many years. Merck agreed to pay $950 million to settle the criminal charges to which the company had pled guilty.
Email records also showed that
Merck made a "hit list" of doctors who criticized Vioxx, according to testimony in a Vioxx class action case in Australia. The list, emailed between Merck employees, contained doctors' names with the labels "neutralise," "neutralised" or "discredit" next to them.
- Johnson & Johnson, makers of Johnson’s baby powder, knew for decades that their baby powder was carcinogenic and did nothing.
… internal documents examined by Reuters show that the company's powder was sometimes tainted with carcinogenic asbestos and that J&J kept that information from regulators and the public.
- in 2009, Pfizer was ordered to pay $2.3 billion, which was, at the time, the largest health care fraud settlement in the history of the US Justice Department,
Pfizer promoted the sale of Bextra for several uses and dosages that the FDA specifically declined to approve due to safety concerns.
… the company illegally promoted four drugs – Bextra; Geodon, an anti-psychotic drug; Zyvox, an antibiotic; and Lyrica, an anti-epileptic drug – and caused false claims to be submitted to government health care programs for uses that were not medically accepted indications and therefore not covered by those programs.
Our responsibility
The insinuation of Big Pharma into medical school education and then into doctors' practice of medicine is an international cause of great concern.
“Medicine and the Involvement of the Pharmaceutical Industry”, is a 2019 policy document by the Belgian Medical Students' Association. In the introduction to their Policy Statement, section 1.1, they state:
There are three main concerns that can be distinguished from each other. Firstly, there is a risk that drug promotion influences the health actors’ decisions. And indeed, no less than 60% of the worldwide marketing budget is invested in drug advertisements. Even though most healthcare professionals are convinced that they are not influenced by drug promotion, results of review studies prove the opposite. Secondly, due to the difference in focus, there is a possibility that the interaction between the pharmaceutical firms and healthcare professionals gives prominence to the commercial part, while the quality of care to the patient and research is lost. The last main concern is that investing money by the pharmaceutical industry into research can lead to distortions in scientific evidence. About 70% of a research budget comes from pharmacy, which means that favorable results are important to them. [1]
They want to tackle, as stated in section 1.2 of the policy statement, “the potential unhealthy relationship between the medical field and the pharmaceutical firms.”
In a 2020 opinion piece in the British Medical Journal (BMJ) titled, “Conflict of interest in medicine: how medical students can become catalysts for change,” Danish public health physician Alice Fabbri, speaks of her own experience as a medical student when she discovered that the drug companies were influencing her profession.
I was a fifth year medical student when I attended an elective seminar at my university in Italy about “Conflict of interest in the medical profession.” The speaker described several examples of the strategies the pharmaceutical industry uses to influence policies, research, and professional practice. It was just a two hour event, but for me it was a turning point. During my clinical rotations in the following days, I started to notice the presence of pharmaceutical companies in the everyday life of health professionals—from the contact with sales representatives, to the sponsored education materials, to the pens, notebooks, and other gifts that find their way into the doctors’ office. Until that moment, these practices were completely normal to me. During my medical training no one had ever told me to question them, or told me about the effect of industry influence on healthcare.
Doctors are the products of these medical schools and the pharma influence which follows them throughout their medical careers. To get the best possible care, patients must actively voice disapproval and discourage doctors from receiving drug reps to their offices, from receiving any gifts or forms of remuneration from drug companies, and even from accepting their samples.
There is no reason for doctors to rely on drug reps for information about any drugs and/or for instructions on prescribing. The information is out there, both the good and the bad. If their patients can find it, so can they.
Don't be afraid to question your doctors to make sure that they are not diagnosing and prescribing while “under the influence." That's your right and your responsibility - your and your family's health and lives depend upon it.
Here's how to know if your doctor is prescribing properly:
