by Dr. Ben Lerner

The pharmaceutical industry is raking in unheard of profits--more than three times the average of the other Forbes Fortune 500 industries, and that's even after all of the costs of research and development! Much of this is done under the guise that it is for the "greater good". However, the facts are that the system has become replete with research bias and conflicts of interest.

In an article entitled "Selling Sickness; the Pharmaceutical Industry and Disease Mongering," the British Medical Journal traveled to the depths of the health care system crisis created by what they called the "medicalisation" of society. Medicalisation is the medical industry's practice of turning commonly found symptoms into a "disease" so its members can prescribe a medication for it. In addition, the medical industry works to increase the awareness of its drugs and treatment to get more customers. Take, for instance, the copious amount of television commercials, billboard ads, and bowl sponsorships that focus on a medication!

There is what's been described as an "unholy alliance" between pharmaceutical manufacturers and doctors who are informing the population that they are, in fact, ill. Medical doctors are intelligent, good people. They go through an extended educational process to learn how to help. Nonetheless, due to the speed at which information is coming across a doctor's desk, and given how busy doctors are with their medical practices, they couldn't possibly keep up. As a result, for prescribing advice, they're forced to rely on the very skewed opinions of drug reps and the biased research paid for by pharmaceutical companies. I've heard it said that so much new information on medical treatment comes out each year that within four years a medical doctors training is obsolete!

Picture a dozen police officers trying to contain a stadium full of college kids, trying to keep them from rushing the football field after their teams big win. This picture will give you a slight idea of what a medical doctor is being asked to handle during the course of their career. Doctors have been taught, since the time they were medical school students, to rely on the pharmaceutical and medical device manufacturers and their reps for reinforcements (help, support, education, and advice on practicing medicine).

In 2001, all of the major medical journals--The New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine, and The Lancet--put out an all points bulletin which served as a red flag warning that clinical research had really become little more than commercial activity. Then, in a 2003 publication, the British Medical Journal said, "twisted together like the snake and the staff, doctors and drug companies have become entangled in a web of interactions as controversial as they are ubiquitous." 1

John Abramson, M.D. points out in his book, Overdosed America, that a 2002 article in the Journal of the American Medical Association showed that "59 percent of the experts who write the clinical guidelines that define good medical care (the standards to which doctors are often held in malpractice) have direct financial ties to the companies whose products are being evaluated." If doctors choose to ignore guidelines, they risk their reputations, their standing in the medical community, and being charged with malpractice.

"The exaggeration and distortion of the 2001 cholesterol guidelines that are responsible for the millions of Americans being treated with cholesterol lowering statin drugs (lipitor, zocor, prevachol, lescol, mevacor, crestor) despite of lack of scientific evidence of benefit of such widespread use is presented as a case in point." Dr. Abramson further explains that if these new guidelines are followed, the number of people taking statin drugs will go from 13 million to 36 million with the only likely upside being drug company stockholder profits and not healthier people.

A key strategy of the alliances is to target the news media with stories designed to create fears about the condition or disease and to draw attention to the latest treatment.

This has led to problems on several key levels:

• People with benign, normal symptoms taking dangerous drugs. As we are convinced that natural signs of aging and common conditions are diseases or treatable symptoms, we take drugs for such things as balding, anxiety, mild bone loss, restless leg syndrome, and indigestion, which put us at risk for issues that were not true illnesses or risks.

• People being tested regularly and undergoing unnecessary treatments with drugs and invasive surgery. Very few people after middle age can pass tests without being told that they have some sort of "risk." This risk is turned into a pseudo-disease leading to such things as dangerous breast and colon surgery and "preventative" medications. For example, a male patient over forty goes to the doctor for a sore throat and finds the doctor's finger up his rectum. The doctor informs him that he has a prostate issue and removes it, causing the man to be impotent for the rest of his now-miserable life.

• Fear and a loss of clarity in the important practice of medicine. As a result of "disease mongering," the more the medical industry influences a nation, the sicker that nation "considers itself to be." It eats away at our self-confidence and teaches us that we're weak and incapable of staying well--that all signs and symptoms are potentially dangerous conditions and diseases. Truly, this sort of marketing has blurred the lines of when we need drugs and surgery and when we don't.

Worst of all, rather than people focusing more time and attention on their health as they age or as they see degeneration setting in, they settle for a diagnosis and the latest medications. The only winners are the ones who profit.

Suggestions from the British Medical Journal on disease mongering include:

• A move away from corporate funded information of medical conditions and diseases

• Widened notions of informed consent to include information about controversy surrounding the definitions of conditions and disease

• Lead people to participate in their health and not just in their disease.16 [Inside out versus outside in]

What stands in the way of change? The answer is powerful pharmaceutical and medical technology companies, along with other powerful corporations with incredibly large vested interests in the medical business. This kind of money and influence can tip the scales of opinion from professional caution to uncritical acceptance. If you look at the people who make up governmental, FDA, hospital, and medical health advisory boards and their financial ties to pharmaceutical companies, you clearly see conflicts of interest. Sadly, the public is unaware of these interlocking interests and continue to believe in the sanctity of medicine and an industry that's forgotten that it's sole purpose was to serve the people, and not itself.

I truly don't believe that the people in the medical industry are bad people. I know that, for the most part, their chief aim in life has been to help. The problem lies in the fact that in the eyes of most citizens, they are gods. Without caution or investigation, they've been given total authority in the health care world. With seemingly nowhere else to turn, we have completely handed over to them the public trust--so much so that out of fear, no one dares doubt them, even in the face of a broken, desolate, and ever failing health care system.

Caring doctors enter this system, but the system simply has scientific, philosophical, and ethical flaws. It just doesn't work. As people and other health delivery systems begin to challenge and shake the foundation of the medical industry, the industry starts to fight fiercely to deny alternatives--a practice that certainly is more for self-preservation and not for the preservation of the public.

Instead, I believe in what were originally the true principles of medicine. Many of my own friends, patients, and family members have been saved by the power of emergency medical intervention. Unfortunately for all, what was once designed to save us from disaster or death in the case of extreme circumstances has now crept into our every day lifestyle. Symptoms of all kinds have been labeled "disease" causing us to now fear every sniffle, cough, ache, or pain. What's worse, we now seek passive medical retribution for both our physical and mental wellbeing rather than actively participating in it. When symptoms arrive as a result of how poorly we've neglected our bodies and minds, rather than taking personal responsibility for our own wellness and trusting in the recuperative powers of our body, we seek those who are now only too willing to take on this role for us.

The result of our unwillingness to actively participate in our health means handing over full authority of our lives to the industry of medicine, the pharmaceutical and medical establishments that have become so bloated and powerful with our hard earned dollar that we're now witnessing out of control profit.

While on one hand I personally owe much to the practice of medicine, experts are finding that the harm that the present health care system is causing now outweighs the good. It's time that balance was restored! While there is still good left in the system, it's time to replace the disease mongering and money mongering mentality with new ways of thinking, and more appropriate ways of taking care of our bodies.

I'm not angry at the system. It is what it is. Instead, I urge that you be aware of it, choosing your doctors and taking their advice with extreme care. And llook out for those drugs! Realize that you have the power to take back the authority over your life!

1 Moynihan,Ray. "Who Pays for the Pizza? Redefining the Relationships Between Doctors and Drug Companies". Education and Debate. 326.7400.1189 (2003). 31 May. http://www.bmj.com/cgi/content/full/326/7400/1189