We got the drug industry we deserve

A biting commentary on just who is writing treatment guidelines for diabetes and cardiovascular disease was published in the British Medical Journal, summarized in theHeart.org's HeartWire here.

"About half the experts serving on the committees that wrote national clinical guidelines for diabetes and hyperlipidemia over the past decade had potential financial conflicts of interest (COI), and about 4% had conflicts that were not disclosed.

"Five of the guidelines did not include a declaration of the panel members' conflicts of interest, but 138 of the 288 panel members (48%) reported conflicts of interest at the time of the publication of the guideline. Eight reported more than one conflict. Of those who declared conflicts, 93% reported receiving honoraria, speaker's fees, and/or other kinds of payments or stock ownership from drug manufacturers with an interest in diabetes or hyperlipidemia, and 7% reported receiving only research funding. Six panelists who declared conflicts were chairs of their committee.

"Of the 73 panelists who had a chance to declare a conflict of interest but declared none, eight had undeclared COI that the researchers identified by searching other sources. Among the 77 panel members who did not have an opportunity to publicly declare COI in the guidelines documents, four were found to have COI.

The closing quote by Dr. Edwin Gale of the UK is priceless:
"Legislation will not change the situation, for the smart money is always one step ahead. What is needed is a change of culture in which serving two masters becomes as socially unacceptable as smoking a cigarette. Until then, the drug industry will continue to model its behavior on that of its consumers, and we will continue to get the drug industry we deserve."

It's like having Kellogg's tell us what to each for breakfast, or Toyota telling us what car to drive. The sway of the drug industry is huge. Even to this day, I observe colleagues kowtow to the sexy sales rep hawking her wares. But that's the least of it. Far worse, even the "experts" who we had trusted to have objectively reviewed the evidence to help the practitioner on Main Street appears to be little more than a hired lackey for Big Pharma, hoping for that extra few hundred thousand dollars.

Comments (6) -

  • Jim Purdy

    10/14/2011 1:36:03 AM |

    I am not a fan of any drugs, and as a result, I change primary care physician regularly, usually after two visits.
    ON THE FIRST VISIT, I explain to the new doctor that I do not, and will not, take prescription medications. I explain that the only reason I am in their office is to get orders for lab work, so that I can review the results and make my own decisions about lifestyle changes, especially diet. The doctor then calls me" non-compliant" and prints numerous computer-generated prescriptions anyway. Obviously, it is the doctor who is non-compliant, since I have already said I do not want drugs.
    ON THE SECOND VISIT, the doctor asks, "Have you been taking your medications as ordered?" When I tell the doctor again, as I did at the first visit, that I do not take medications, the doctor says, "You're crazy and suicidal." I then find the next doctor, and the cycle starts over.
    As I see things, I have two choices when I feel ill:
    1. I could attack my body with some bizarre BigPharma chemicals that our ancestors' bodies have never dealt with in millions of years of evolution (Oxycodone, hydrocodone? Really? Are doctors nuts?).
    2. Or I could get out of the way and let my body heal itself as has been done over many millions of years of evolution. All I want to do is support that process by making sure to give my body the proper nutrition in the form of the appropriate whole foods.

  • Dr. William Davis

    10/14/2011 3:40:23 AM |

    Wow, Jim. Creepy.

    Don't despair: I'm confident that you will eventually find a healthcare practitioner who will act as your advocate, not a provider of drugs. It may take, unfortunately, going through quite a few practitioners before you come on such a person.

  • Suze

    10/19/2011 1:44:46 AM |

    Great post. I am starting to think there are two kinds of people - those who seek drugs and those who run from them. LOL.
    Among other occupations, I am an OR nurse. I have been wined and dined by the best reps ever, to buy their wares for surgery. It's all about the money.The drug companies have a lot to lose if we all quit taking their meds. Which is exactly what I want to do. I do not want to be a slave to a diagnosis and accompanying pill bottle. I want to be freeeeee.
    This is not to say there is a time and place for medicine. There IS. But not for every sniffle.

  • Jeanne

    10/20/2011 11:44:20 AM |

    Boy Suze, I can relate!  I'm a nurse as well and spent lots of years in NICU, but a change to chemical dependancy/psych was eye opening and downright disgusting in the amount of meds handed out.

    I used to ask patients if they were hungry when dispensing a 6oz. Cup FULL of various pills before breakfast!
    Couldn't take it and quit. Couldn't be a party to pharm management over real therapy.  I also take as few pills as possible, especially antibiotics.

  • N

    11/30/2011 6:36:01 PM |

    Hi Doc,

    I just visited my parents, and my mom shared her recent blood work with me.
    Her cholesterol was a mere 210, and her doc (general practitioner), put her on a statin !!!
    I told her about your blog a bit and particle size, but of course she's hesitant since her doctor obviously has more credibility than me.

    Outside of eating better, what next steps should I advise her to take?  She agreed to request a cholesterol particle size test (is there an official name for this?).

  • Dr. William Davis

    12/1/2011 4:22:01 AM |

    Yes, N: Lipoprotein testing, such as NMR Lipoprofile or Atherotech VAP.

    It really shouldn't be that tough, but we are battling the incredible ignorance in the primary care community who is spread too thin to master any one area.