Physicians and bribery: a closer look at this common medical industry practice

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Physicians and bribery: a closer look at this common medical industry

practice

 

 

In 2001, 2.8 billion prescriptions were filled in the United States

for an average of 9.9 prescriptions per person. This statistic taken

from Ultraprevention, by Drs. Mark Hyman and Mark Liponis, certainly

supports their point that " drug industry prescriptions have gotten far

out of hand. " The overabundance of prescriptions isn't because of a

rise in illnesses or the availability of new drugs that effectively

and safely treat chronic diseases; rather, it is because of the

corruption of mainstream medicine. The philanthropy that was once

present in modern medicine has been replaced by a love of money, which

gave rise to an elaborate system of bribery, conflict of interest and

deception.

 

How does your doctor decide which medications to prescribe? Is the

decision based on the first-hand testimonies of other patients? Is the

decision made after a careful and thorough research of medical

journals? Usually not. As Michael T. Murray explains in Natural

Alternatives to Drugs, your doctor's decision has nothing to do with

medicine: " Most physicians do not make decisions about which drug to

use on the basis of scientific research or cost. They base their

decision almost entirely on which drug is the most popular choice of

their colleagues.

 

What determines popularity? The effectiveness of the drug company's

marketing and advertising efforts. In essence, doctors are often

bribed or lied to so that they will prescribe certain medications. "

Bribery is a danger in any business sector. In medicine, bribes can

prove downright deadly; nevertheless, they are shockingly common.

 

How would you like a bonus of $100,000 per year on top of your already

outrageously high salary? Wow, that sounds like a dream, doesn't it?

Well, for many doctors, obtaining a bonus of that amount is a reality.

These days, the majority of doctors have dived right into the " deep

waters of entrepreneurship, where there is always the danger of

conflict of interest between patient care and making a buck, " as

Martin. L. Gross phrases it in The Medical Racket. Entrepreneurship

has turned the medical industry into a giant game, where patients

serve as the chips, their lives the bets, and jackpots are won by

doctors, hospitals and pharmaceutical companies.

 

At times, the bribes are obvious, such as when pharmaceutical

companies send physicians on exotic vacations in exchange for

listening to lectures about the companies' drugs for a few hours of

the day, while the rest of the day is quite literally a day at the

beach (or the golf course). The ways in which some hospitals bribe

physicians are especially sickening, according to Professor Ann Blake

Tracy in Prozac: Panacea or Pandora: " Did you know that some hospitals

offer special incentive deals that give doctors valuable gifts like

fax machines and car phones, if they schedule surgeries when the

hospitals are hurting for business? " Incentives belong in car

dealerships, not in doctors' offices.

 

Sometimes the corruption is not as conspicuous; it could be a matter

concerning conflicts of interest. " Conflicts of interest are

institutional weeds. They take root below the surface and become

pervasive problems often long before they show their ugliness, " Dr.

Jerome P. Kassirer quotes an " observer " as having stated in his book,

On the Take. Now, what are these conflicts of interest, and are

doctors really so susceptible? Dr. Kassirer asks a few questions in

order to determine the severity of this subtle corruption: " Have the

fees that physicians charge given them an incentive to bring patients

back to their offices too often, or to order too many tests that

aren't needed? Or have they skimped on tests if ordering too many

shrinks their paycheck? Are they more inclined to order certain

expensive drugs or promote certain products because of personal

financial relations with some of the drug companies, contrary to

patients' best interests? " The answer to all these questions is,

unfortunately, yes, which signals the existence of a pervasive level

of corruption.

 

Now you know why doctors' prescriptions follow trends and why the

whole world seems to be on the same drug at the same time. Now you

know why so few doctors prescribe alternative medicines for their

patients: Nature doesn't offer bribes.

 

One big question, however, remains unanswered: How can doctors accept

these bribes and look in the mirror afterward? According to Dr.

Kassirer, it's all a matter of self-deception: " Physicians know that

pharmaceutical companies don't provide these services simply out of

altruistic motives, yet they are eager to believe that they can

preserve their integrity in the face of such bribes. How then, do they

cope with the gross discrepancies between the knowledge that they are

being bought and their need to believe that they cannot be bought?

Disavowal probably explains much of the mechanism of self-deception.

Whereas avowal is a capacity to identify one's true thoughts and

motives, disavowal aids self-deception by evading these motives. " In

other words, corrupt doctors actively try not to question themselves

about it, thereby perpetuating their state of self-deception.

 

Physicians may not overly concern themselves about the bribery they

allow to take place, but we as consumers must. Gross asks, " What could

be better than stopping the waste of $100 billion (at the very least)

in medical, dental and pharmaceutical fraud, and using the money for

any good purpose, including lower federal taxes for all? And in the

process, cleansing the stain that dishonest doctors have cast on the

profession and, by extension, on their honest colleagues? "

 

Ask yourself that same question. There is no downside to stopping

medical corruption right here, right now.

 

The experts speak on physicians and medical corruption:

" Physicians: Dishonesty "

 

The competition was fierce, and the hardest-fought battles took place

in India's largest cities, where physicians practicing all traditions

of health care went after the hearts, minds, and rupees of the growing

middle class. By 1994 it was glamorous to be an antigovernment

physician who decried the stupidities and corruption of state and

federal authorities. It was fashionable to declare as lies most

government public health declarations. And intra-physician competition

often echoed this antiestablishment theme, making the most outrageous

of " physicians " chic among the middle and upper castes.

Betrayal Of Trust By Laurie Garrett, page 32

 

Analyzing why there is so much medical error Leape acknowledged the

lack of reporting. Unlike a jumbo-jet crash, which gets instant media

coverage, hospital errors are spread out over the country in thousands

of different locations. They are also perceived as isolated and

unusual events. However, the most important reason that medical error

is unrecognized and growing, according to Leape, was, and still is,

that doctors and nurses are unequipped to deal with human error, due

to the culture of medical training and practice. doctors are taught

that mistakes are unacceptable. Medical mistakes are therefore viewed

as a failure of character and any error equals negligence. We can see

how a great deal of sweeping under the rug takes place since nobody is

taught what to do when medical error does occur. Leape cited Mclntyre

and Popper who said the " infallibility model " of medicine leads to

intellectual dishonesty with a need to cover up mistakes rather than

admit them. There are no Grand Rounds on medical errors, no sharing of

failures among doctors and no one to support them emotionally when

their error harms a patient.

Death By Medicine by Gary Null PhD, page 10

 

Despite what many doctors think, vitamins and minerals are not

something invented by the health food industry; they are part of our

biological system. Without them all life stops and you die. Vitamin

and mineral deficiencies can often lead to disease, and you do not

have to be embarrassed about taking vitamin and mineral supplements.

The medical and scientific literature supporting nutritional

supplements is extensive and goes back over a hundred years. I know

many doctors who religiously take supplements themselves but will not

recommend them to their patients because of fear of being ridiculed by

their colleagues. This is intellectually and morally dishonest.

Health And Nutrition (see related ebook on nutrition) Secrets by

Russell L Blaylock MD, page 36

 

I am not implying that those who review manuscripts are corrupt or

even conscious of their bias. Nevertheless, doctors and scientists who

are interested in nutritional medicine almost invariably complain

about how difficult it is to have their work published in

" peer-reviewed " medical journals.

Preventing And Reversing Osteoporosis By Alan R Gaby MD, page 250

 

Despite the obvious corruption of the drug company/doctor marketing

connection, I don't blame the drug companies, the detail men, the

government agencies which are supposed to police these activities, or

the patients who badger their doctors for drugs. doctors have enough

facts in their possession to know what's going on. Even where the drug

is fully tested and the side

The Aids War by John Lauritsen, page 272

 

" Physicians: Corruption "

 

After all, I am not talking about overt corruption such as fraud,

bribes, office-buying, or kickbacks. Yet what we are concerned about

is equally problematic, far subtler, and largely hidden from sight.

One observer commented: " Conflicts of interest are institutional

weeds. They take root below the surface and become pervasive problems

often long before they show their ugliness. " The weeds in this case

expose physicians to powerful temptations to make money at the expense

of their patients' welfare. Aside from harm to patients, conflicts of

interest may be subconscious and as such can undermine judgment and

integrity and lead to self-deception.

On The Take by Jerome P Kassirer M.D., page 52

 

....he and his colleagues receive funds that allow them to spread their

educational message to thousands of physicians. Dr. Libby believes

that despite the drug-company support of these efforts, strict

adherence to published guidelines in creating the content of the

sites, multiple layers of peer review by experts, and assessment by

his audiences preserves the objectivity of these programs. By

disclosing all his financial conflicts of interest and by being

involved with so many companies, Dr. Libby believes he can maintain

his independence, objectivity, and reputation as an opinion leader in

his field.45 The involvement of these high-level academics in such

ventures is open to various interpretations. Dr. Libby asserts that

they simply exploit a corrupt system in a way that benefits patients.

Nonetheless, to me these relationships between the academics and the

companies (which may include providing advice about drug marketing)

are too close, too collaborative, and too cozy. They generate income

for some of the participants and thus induce some obligation to

advocate for the company in unseen ways.

On The Take by Jerome P Kassirer M.D., page 104

 

If Dr. Horowitz is correct, then allopathic physicians in this century

knowingly participated in an unarguably evil enterprise of medicalized

killing that is not much different from the corrupt heart-rendering

Mexican Mysteries of an older, equally sinister America.

Physician by Richard Leviton, page 524

 

Many doctors are paid by Eli Lilly and other drug companies to do drug

studies for them or they are affiliated with a university or hospital

which do these studies. The " don't bite the hand that feeds you "

philosophy plays a major role in their defending the safety of Prozac.

Are the incentives being offered to them by Lilly to prescribe this

drug so great that they feel it is worth " selling out " their own

patients? What is it? Have they become totally irrational themselves

from their own personal use of Prozac? We are aware that doctors in

general have on of the highest rates of prescription drug abuse. Just

how serious is the abuse of these mind-altering drugs among the

individuals we are trusting with our lives? Psychiatric nurse, Joyce

Strom-Paikin, puts her license and credentials on the line to fight

the " conspiracy of silence " that exists in the medical profession with

the use of drugs by doctors and nurses in her book, MEDICAL TREASON.

She feels this is a practice which " threatens to corrupt the

profession and cost lives of many patients. " In defence of physicians

it should be stated again that they receive very little training in

medical school on the use of drugs. Our entire system is in desperate

need of revamping.

PROZAC Panacea or Pandora by Ann Blake Tracy PhD, page 176

 

Sometimes physician chicanery is the result of doctors entering the

deep waters of entrepreneurship, where there is always the danger of

conflict of interest between patient care and making a buck—too often

a quick, dishonest buck.

The Medical Racket by Martin L Gross, page 112

 

Unscrupulous pharmaceutical companies, corrupt government officials,

venal physicians, stupid and cowardly media people, incompetent and

dishonest researchers — none of these things are new. They are

business as usual. Where, then, does the buck stop? Who is responsible

for pharmacogenocide?

The Aids War by John Lauritsen, page 272

 

But we couldn't disagree more. Good news? That more and more people

are spending more and more of their money on drugs they don't need? In

2001,2.8 billion prescriptions were filled in the United States, or an

average of 9.9 per person. We think that drug industry prescriptions

have gotten far out of hand. Doctors have been bribed and brainwashed

by pharmaceutical companies to prescribe new, expensive medications

for every ailment—even when a

Ultraprevention by Mark Hyman MD and Mark Liponis MD, page 76

 

Of course, other professions don't police themselves so well either.

How many unethical lawyers are disbarred? How many corrupt judges are

removed from office? How many check-kiting legislators are impeached?

And how many incompetent public school teachers are fired? There is a

lot of room for more policing of the professions. Maybe methods used

against doctors will be tried in your profession next.

Your doctor is Not In by Jane M Orient MD, page 193

 

The politically feasible course is to subject physicians, clinics,

nursing homes, suppliers of medical equipment, and other providers to

the same law that is used to wage war on drug dealers or

Racketeer-Influenced Corrupt Organizations (RICO). The RICO law

provides for civil forfeiture of property.

Your doctor is Not In by Jane M Orient MD, page 200

 

" Physicians: Bribery "

 

Most physicians do not make decisions about which drug to use on the

basis of scientific research or cost. They base their decision almost

entirely on which drug is the most popular choice of their colleagues.

What determines popularity? The effectiveness of the drug company's

marketing and advertising efforts. In essence, doctors are often

bribed or lied to so that they will prescribe certain medications.

Natural Alternatives To Drugs by Michael T Murray ND, page 25

 

If the drug company didn't expect the gift to influence the doctor's

decision, why would it give the gift? According to a 1992 article

published in The New England Journal of Medicine written by Douglas

Waud, M.D., the term gift should read bribe. A gift implies that no

strings are attached. Dr. Waud criticized the American College of

physicians' and AMA's guidelines because they seem to recommend that

Natural Alternatives To Drugs by Michael T Murray ND, page 25

 

When I was editor of the New England Journal of Medicine, I published

an opinion piece by Dr. Douglas Waud, a University of Massachusetts

professor of pharmacology entitled, " Pharmaceutical promotions.. a

free lunch? " Waud asked: " So where does one draw the line? I suggest

that we simply not be on the take, whatever the amount or context. I

do not like the idea of a monetary limit on bribes (unless it is

zero). Nor do I see the subsidization of education as appropriate. I

believe that physicians can buy books and attend meetings without fear

of landing in the poorhouse. I also don't buy the argument that asks,

Would you be willing to have these arrangements generally known? My

motivation comes from within, not from a fear that the Boston Globe

may be looking over my shoulder. "

On The Take by Jerome P Kassirer M.D., page 65

 

[The internist] noted that your .. presentation .. created an

emotional response among the physicians greater than any he has seen

in the past two decades. This doctor was insulted by the implication

that physicians can be corrupted with trivial gifts or free meals. In

fact, since the intent of the drug-sponsored dinner lecture is clear

at the outset (i.e. pharmaceutical marketing), sitting through an

obvious marketing lecture was considered by this physician as

appropriate " payment " in kind for the meal. I thought that the most

interesting of his remarks focused on the context of pharmaceutical

marketing to physicians in the greater world of business practice in

this country. This physician asks why we, as physicians, agonize so

much about the ethics of what are standard business practices in other

industries. Sky boxes at sports arenas, high-priced restaurants, and

luxury hotels all survive as means for providing business to business

perks. Even the IRS recognizes the validity of " business

entertainment " as a standard part of doing business by allowing travel

and entertainment as tax deductions. This physician asks whether

fast-food advertising in elementary schools (to an unsophisticated

audience) is any more ethical than giving medical students medical

instruments. Since we, as physicians, are not being treated by payers

as professionals but only as line " providers " of health care services,

why should we hold ourselves to values different than any other

businesses?

On The Take by Jerome P Kassirer M.D., page 66

 

The ultimate drug company " bribery " is sending an M.D. on an exotic

vacation and including CME courses along with it. The physician spends

a few hours a day listening to lectures on how to prescribe the

company's drugs and the rest of his time on the beach or golf course.

Prescription Alternatives by Earl Mindell RPh PhD and Virginia Hopkins

MA, page 13

 

Doctors Borison and Diamond pleaded guilty to the theft, bribery, and

racketeering charges brought against them by the Georgia Attorney

General. They were each fined $125,000 and were sentenced to prison.

At the time of their highly publicized indictment, Eli Lilly pulled

all studies still in progress with Borison and Diamond, reassigning

them to other centers. Regarding the many studies the pair had

completed over the years for Lilly, however, a spokesperson said the

company was confident that none of the data provided was compromised

in any way. But Dr. David Hess, chief of neurology at the hospital

where Borison was the chief of psychiatry, told investigators, " This

whole thing was very dirty. It was basically a numbers game. These

patients are purely used for the greed of the researchers.. [it] was

very apparent to me what was going on. " While some insist that the

repeated exposes are not representative of the testing of psychiatric

drugs, others note that many of the most disturbing practices

highlighted in the exposes—such as the exorbitant sums of money

involved, employing staff with little training or clinical experience

to evaluate patients, and advertising for subjects rather than using

real patients coming into doctors' offices seeking treatment—are not

uncommon in psychiatric drug testing.

Prozac Backlash by Joseph Glenmullen MD, page 211

 

....shocked to discover that their doctor's advice could be colored by

less than virtuous motives. You're supposed to believe that everyone

in the medical community is in it purely for humanitarian reasons. If

you believe that, just try to see a doctor or check into a hospital

without flashing your insurance card!.Did you know that some hospitals

offer special incentive deals that give doctors valuable gifts like

fax machines and car phones if they schedule surgeries when the

hospitals are hurting for business?.If your doctor is prescribing a

certain drug for you, wouldn't it bother you to know that the makers

of the drug may have offered him a free trip to New Orleans in return

for his patronage? Drug companies regularly bribe doctors with free

drugs, dinners, trips and even cash. "

PROZAC Panacea or Pandora by Ann Blake Tracy PhD, page 235

 

The Veterans Administration had been dispensing research money for

several years as a sort of bribe to attract doctors despite the low

pay in government service. The money from Washington was doled out by

the most influential doctors on the staff, not necessarily the best

researchers, but I still felt I had a good chance because the VA was

having an especially hard time recruiting orthopedists. …

The Body Electric by Robert O Becker MD and Gary Selden, page 70

 

Kickback scams are omnipresent in medicine. Dishonest and ingenious

doctors can take in sums much greater than $100,000 a year. In one

case involving Caremark International, a Minneapolis-based home care

company, a federal grand jury indicted them for paying astronomical

kickbacks to one physician. How much? Caremark pleaded guilty to mail

fraud and paid a fine of $161 million. Suprisingly, the doctor was

convicted but that conviction was overturned on appeal; the charges

against the executives were dismissed entirely.

The Medical Racket by Martin L Gross, page 115

 

" Physicians: Pressures on "

 

Increasingly, people are questioning the values and the presumptions

of medicine, asking whether our way of caring for people is the best

way. The administrative structure of medicine is being overhauled from

top to bottom by governments, by market managers, by physician

executives and health management consultants. At the same time, new

advances in medical science promise a new era of biologic innovation,

with everything from fetal surgery to gene therapy to treatments to

prevent aging. Each innovation comes with a promise and a price, and

the more we innovate, the more we are forced to question and compare

and prioritize among interventions, populations, problems, and

allocation schemes. The individualistic morality that sees virtue in

the unencumbered and unswervingly loyal commitment of each doctor to

each single patient seems to be crumbling under the assault. Medical

societies agonize over the compromises that doctors are being forced

to make. Journals are filled with soul-searching articles bemoaning

the changes and looking for villains. We blame the corrupt government

or the greedy managed care administrators or the heartless market.

Do We Still Need doctors by John D Lantos MD, page 98

 

How much suffering and death are the American people willing to take

before they stand up to the bureaucracy? How many physicians must be

put into prison before all physicians cry " enough! " to the increasing

government control over their profession? How many Watergates do we

need before we realize that mortal men are corrupted by power, and

that the solutions to one's problems lie not in increasing the power

of government but in decreasing it?

World Without Cancer by G Edward Griffin, page 330

 

Overview:

 

* Physicians and bribery: a closer look at this common medical

industry practice

 

Source: http://www.newstarget.com/009334.htm