I'm a doctor, so I can say this with a straight face: Don't trust your doctor. There's no question in my mind that today most doctors are businessmen first and doctors second.
And you shouldn't trust your doctor anymore than you trust your stockbroker, (if you are foolish enough to have one). Neither one looks out for you, they primarily care about themselves. That's the reason the individual retail investor on Wall Street is the last one to buy a high-flying stock before it is about to tank, and the individual patient is the last one to swallow a deadly pill, when everyone else in the know has already stopped taking it.
Take the painkiller Vioxx, for example. I have a friend in the drug industry who used Vioxx, but then heard about the heart problems and stopped taking the drug. That was more than five years ago. My friends isn't a doctor, but he heard about the damaging heart data years before any patient became aware of this. Meanwhile regular patients kept popping those Vioxx pills like candy. And now some of the patients who suffered heart attacks after taking Vioxx line up in court. My friend had information any doctor could get if they cared enough, just like Wall Street firms have bad information about stocks they try to sell to us, but keep to themselves.
Stockbrokers make money if they can convince you the market is going up, then you buy and they make a commission. They don't make money if investors pull out their money. So they always try to convince the investors that the market is going up and up. Doctors make money when you come to their office and they get to prescribe an expensive drug, even though you might have been able to get a much cheaper and equally effective over the counter remedy without ever seeing a doctor. So they often don't tell you about those cheap options.
Yesterday, the New York Times writes, a jury in New Jersey found that Merck had "misled the Food and Drug Administration about the dangers of Vioxx and acted with wanton disregard for patients taking the drug." That's pretty strong words. And the jury awarded $9 million in punitive damages, in addition to the $4.5 million in compensatory damages already awarded last week.
And of course, lying and cheating drug companies should be punished. But doctors shouldn't pretend like they knew nothing. They shouldn't hide behind drug company data and the pretty sales reps in their offices, but they do.
The fact is that already in medical school doctors are taught about all the ways to manipulate scientific data and not to trust drug company information. But sometime after they leave medical school, start meeting pretty sales reps, get little gifts, are taken to dinner or become speakers for various drug companies, all those warnings seem to simply vanish form their little minds. And the patient becomes someone they can use to test the most recent, least tested, and most expensive medicine on, without any cost to them.
My point is that if my non-doctor marketing friend knew better than to use Vioxx five years ago, then many doctors should have known too. They just didn't care.
In fact, a study published in the Journal of the American Medical Association, found that requests from patients for medications have a "profound effect" on physicians prescribing. These findings indicated that direct-to-consumer (DTC) marketing of prescription medications also exerted significant influence on treatment decisions.
The actors in the study who asked for a brand-name drug were two to four times as likely to walk out with a prescription, compared to when they didn't ask for the drug and showed the exact same symptoms; so much for doctors' long education and scientific judgment.
In a way, much of the medicine has turned into a racket; a monopoly for doctors to make money off prescribing drugs that could just as well have been bought by educated patients without his interference. The JAMA study proves that the doc is often just a bobbing head anyway.
So do I have any advice? Know your doctor and use a doctor who practices medicine, not business. (I know, not an easy task to find someone like that.) And if you see a long line of sales reps outside his office; run, even if you know him really well.
Truth is; if I wasn't a doctor, I'd be really scared about going to another doctor. He's not thinking of you; he's thinking of that long-legged blonde, in a tight skirt, waiting outside your examining room.
But don't take my word for it; this is what my friend and former sales rep and author Jamie Reidy wrote in his book "Hard Sell," about his life as a drug sales man: "I witnessed men undergo complete personality makeovers in the presence of female salespeople. The women had the most basic human response on their side; regardless how behind schedule or how crazy the day, a male doctor would snap to attention at a mere whiff of perfume or a glance at a pretty girl, his instinctive desire to reproduce having kicked into gear."
So trust me on this. Don't trust your doctor.
IMPORTANT LEGAL DISCLAIMER HERE