A new study published in the British Medical Journal – Protecting early career physicians from commercial influence – finds a disturbing trend of young doctors being wined and dined and used as pawns to promote new drugs. This influence is pervasive, especially in the field of pain management and cardiology – two medical fields where underlying health issues are not properly diagnosed or treated.
Study warns that drug companies are dictating healthcare through bribery
The study finds that drug companies and medical device manufacturers target doctors early on in their careers. The doctors are enticed by lump sum payments, sponsored education, lavish meals and other career opportunities. In this corrupt environment, drug company representatives hope to “cultivate long term, reciprocal relationships.”
“Ultimately, these relationships threaten the sustainability of healthcare and expose patients to unnecessary risk or harm,” says study authors Alice Fabbri, Ph.D., and Quinn Grundy, Ph.D.
A study published in JAMA Internal Medicine tracked 5,533 new American cardiologists. A majority of them (73%) accepted “industry marketing payments” before they even graduated. A total of 88% of these went on to take checks from drug companies in the first few years after graduation. Only around 12% of new cardiologists remained independent of pharmaceutical industry influence.
The drug industry influence expanded in medical fields that are “procedure intensive” and use more technology. The study found that 80% of doctors in these fields took money from Big Pharma before graduating, and up to 96% were taking money from drug companies in the first few years after graduation.
More drug money payments are given to cardiologists than to any other type of specialist. In one of the studies, 184 of the 195 directors of cardiac catheterization and electrophysiology laboratories routinely took drug industry payments. Only 11 of these directors turned down Big Pharma money that calendar year. According to a 2018 analysis, industry payments received by cardiologists fall into 12 known categories, including:
- Food and beverage
- Entertainment
- Travel and lodging
- Consulting fee
- Gift
- Charitable contribution
- Compensation for serving as faculty or as a speaker for a nonaccredited and noncertified continuing education program
- Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program
- Education
- Grant
- Honoraria
- Royalty or license
Drug company money severely influences diagnostic and prescription practices of new doctors
These payouts from Big Pharma ultimately influence a doctor’s decisions making, manipulating how they think, how they diagnose, and what they prescribe. “Even the receipt of low value industry-sponsored meals is associated with increased prescribing of the promoted brand name medication,” Fabbri and Grundy reported.
A 2016 JAMA Internal Medicine study followed the prescription practices of 2,444 doctors and the influence of drug company propaganda on their prescription practices. The study found that as industry payments increased, doctors are more willing to blindly prescribe brand name statins. This hasty prescription practice can miss underlying factors and pathologies that are causing the cardiovascular issues in each patient. Blindly prescribing statins for every patient misses important cellular, hormonal and inflammatory indications, causing further health issues. Today, statins are being recommended to teenagers at age 15 if they show any sign of high cholesterol.
The same trend can be observed with doctors increasing prescriptions of opioids for pain relief. Studies show that increasing drug industry payments encourages more doctors to prescribe opioids, ignoring the underlying issues for the pain and causing serious outcomes for patients. The same issues are going on in the cancer industry, the vaccine industry, etc.
Medical schools complicit
By design, medical schools fail to address this systemic issue, ignoring how this sleazy relationship harms the future of medical practices across the United States. By accepting drug company money, new doctors denigrate their own integrity, engaging in conflicts of interest that dumb down their potential, while threatening the future of patient care, as well as trust in the industry.
“Educational interventions should challenge the common belief among health professionals that they are immune to commercial influence, teach them how to critically assess information received from industry … and point them to independent sources of prescribing information,” Fabbri and Grundy commented. Instead of accepting the collusion as normal, medical students must be trained to discern when relationships with the industry are hindering their ability to objectively address health issues in their patients.
Sources include:
IfMSA.org [PDF]
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