Is Your Doctor Getting Cash Payouts from Big Pharma? (plus More Findings from the Drug Biz)

There’s been a lot of news from the Pharma realm these last few weeks. As you all know, I make a point of passing this kind of thing along…. Given the massive role pharmaceutical drugs play in our society’s conventional health care, I like to keep on top of the developments. Speaking of “massive,” first there’s news from the National Center for Health Statistics, which released a report measuring trends in prescription drug use and cost in the last decade. Between 1999 and 2008, prescription drug use rose in all age categories, as did the number of people taking multiple prescriptions. Approximately 88% of people over the age of 60 take one or more prescription medications on a regular basis. A whopping 66% use five or more prescriptions. Not surprisingly, cholesterol-lowering medications topped the list for this age group. In those 20-59, the most popular prescription was antidepressants. In children, 22% take a prescription drug, most commonly asthma medication. In the teenage category, the number jumps to 30%, with ADD/ADHD related meds first on the list. Not surprisingly, what we shelled out for Pharma products soared as well. Already taking inflation into account, Americans in 2008 spent more than twice ($234 billion) what they did in 1999 ($106.4 billion). Against this backdrop, we also learned that two popular prescription drugs were shown to actually cause the very problems they prescribed to prevent. Telling stories and statistics, I’d say. What’s more sobering, however, are a number of recent publications that illuminate the cultural and financial underbelly of the pharmaceutical industry as a whole. I think you’ll find it thought-provoking.

For those of you who have joined us recently, let me mention a few things first. I’m not against medication. In fact, I wholeheartedly support it when it genuinely and distinctively serves the critical health of an individual. I love living Primally, but I’m firmly planted in the modern age and appreciate its myriad of benefits. A number of us (and our loved ones), I know, wouldn’t be here without the help of medication at some point. When I refer to Big Pharma, I’m not referring to that worthy aim. I’m addressing instead the machinery that’s been built up around what should be a straightforward, transparent medical enterprise – a machinery that too often exploits and subverts the essential therapeutic purpose essential medication should serve. I’ve written before about underreported issues like manipulated statistics, off-label marketing, questionable research standards, and the FDA’s minimal reach. It’s not about mass conspiracy. These are simply the facts. I, for one, believe knowledge is power. You as a reader can choose what to do with it.

That’s why I appreciated a recent article in The Chronicle of Higher Education that a friend in the academe sent me a few weeks ago. Author Carl Elliott takes on “The Secret Lives of Big Pharma’s ‘Thought Leaders’” by revealing the staffing strategies pharmaceutical companies employ. The article focuses especially on the “key opinion leaders” (KOL’s), who Elliott describes as “a combination of celebrity spokesperson, neighborhood gossip and the popular kid in high school.” Within their academic circles, Elliott says, these big name researchers and practitioners have the professional clout to create inroads for the Pharma companies with their medical colleagues. Although the Pharma companies paint the KOLs role as “education,” their more strategic job is infiltration.

Reeling in these types of figureheads promises a unique and efficient means for reaching their medical field colleagues. All in all, pharmaceutical companies spend approximately one-third of their marketing budgets on this KOL program. The industry, Elliott explains, lures big name physicians with big money (sometimes much more than they earn from their medical practice or research) and with the enhanced sense of status that Pharma offers (complete with badges – no, seriously). The KOLs conduct industry sponsored studies, but their primary purpose is to create buzz within the medical field through their personal contacts and their mostly industry-written presentations. (Stray from the slides, dear doctor, and you’ll likely end up de-badged at the close of the conference.) KOLs also play a unique role in Pharma’s skirting of off-label marketing laws. Pharmaceutical companies manipulate the employment status of KOL physicians to allow KOL representatives the legal loophole of promoting off-label uses of the company’s drugs.

There has been public push back, however. As Elliott’s article notes, last year’s health care reform legislation included the “Physician Payments Sunshine Act,” a provision that legally compels pharmaceutical and medical device companies to regularly divulge to the Dept. of Health and Human Services all of their financial dealings with physicians and hospitals. It’s a start, but a more efficient means of controlling industry’s reach would be for universities and teaching hospitals to crack down on these Pharma ties. That move, Elliott explains, is unlikely given the number of academic physicians and administrators embroiled in corporate associations. Enlightening examples? As Elliott explains, University of Michigan’s president sits on the board of Johnson & Johnson. The president of Brown was a board member of Pfizer. So much for academic neutrality.

Other reports out this week, however, add another more disturbing layer to this picture. A public interest group, ProPublica, in partnership with Consumer Reports and National Public Radio have compiled and released a series of reports assessing the pharmaceutical companies’ payouts to doctors and the public’s discomfort with their physicians’ industry ties.

Although the industry’s financial dealings are still private material, lawsuits aimed at Pharma’s marketing have required many of the larger companies to disclose much of their payout information. Although the details are scattered in public websites and documents, ProPublica compiled the information from these various resources. The result? A list of 17,000 doctors and $257 million dollars in payout. Additionally, the organization found that hundreds of physicians on the Pharma payroll lacked board certifications in their claimed fields or had been sanctioned by state medical boards for unprofessional (and in some cases heinous) behavior.

ProPublica’s site allows you to view top Pharma payouts and even check whether your doctor is on the payroll of one of the listed drug companies. The researchers acknowledge that their report represents only a partial tabulation. When the Sunshine Act goes into effect, we’ll get to see the full financial picture. In the words of a Coen brothers thought leader, “New s— has come to light.” Indeed.

Thoughts? What do you make of the emerging depictions and statistics? I’ll look forward to reading your comments. Thanks for reading, everybody. Have a great day.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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90 thoughts on “Is Your Doctor Getting Cash Payouts from Big Pharma? (plus More Findings from the Drug Biz)”

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  1. don’t get me started! We are constantly bombarded by ads which take longer to state their side-effects than their benefits. I intend to stay pharma-free indefinately.

      1. Or even better yet, a push to get rid of T.V.s!! I don’t miss my T.V. and I know I am not missing anything worth watching. I recommend!

      2. In addition to the horror of the blog post above, the whole idea of marketing drugs directly to would-be patients mortifies me. Nobody should be self-diagnosing (either with an illness, or deciding on a drug) and then instructed to “ask your doctor if Medication X is right for you!”

        I mean, this isn’t like deciding to take more Vitamin D…

        1. You’re absolutely right.

          Advertising medication makes people diagnose themselves and run off to their doctor to literally ask for that medication.
          All I can say is wow…those slick bastiches.

    1. I can honestly say there is way too much cash exchanged. Can we do anything, probably not. I recently QUIT a high paying pharma job to teach primal living and weightloss. Ethically, I could no longer be a part of something that treats everyone and everything with a pill. FDA regulates both food and drug companies, coincidence?? I think not. The fatter, more unhealthy they make us, the more drugs we go on, the more drugs the more drugs! CYCLE that needs to be broken!

      1. How did you go about doing this? I would love to be able to teach the Primal lifestyle for a living.

  2. Wish I could get my parents off pharm. drugs… they’d most likely be more healthy without them if their lifestyle choices were more primal.

  3. Big Pharma, while creating meds that can save lives, has a dark side too, as you illustrated. Another dark side to that industry is that they make no money off of healthy people. Their next goal is for otherwise healthy people to take one drug or another.

    1. Isuspect Big Pharma is in bed with the Junk Food producers to make people sick which causing them to take meds.

  4. my doctor is listed on the website as being payed off by pharm companies.
    People (including me) need to do more research on their doctors and the medical information they’re getting.

  5. This is one of the risky side-effects of a free market. People get conned into using certain medication by doctors on payroll. We just need to learn to do our homework before taking advice from any seemingly credible professional.

    1. Don’t be so hasty to blame “free markets”.

      Politicians are every bit as corruptible as anyone in the private sector. Greed and corruption are omnipresent, even where there are no markets at all!

      But you are right: We do need to learn to do our homework before blindly following someone else’s advice.

      1. Free markets are what have allowed the knowledge of the PB to spread and propagate as much as it has. If you’re anti-free market you’ve got more than one screw loose. Greed is good; it is AVARICE that is bad.

        Perhaps you think Mark somehow does not deserve the wealth he generates for himself from his knowledge and production. Perhaps you think jackasses like Emperor Dumbo can do better by everyone, spreading Mark’s knowledge in a more efficient, more efficacious way.

        Perhaps you are an idiot, too.

        1. Puh-lease — get off of Eduard’s back and lose the “free-market good, government bad” oversimplification.

          Both government and business are corruptible, as are science and religion. All human institutions are. It’s when we fail to be critical of our institutions that they become corrupted.

          —- Gos

        2. Wow, that was dramatic. Charles is just making a point that there’s more to it than market forces, and somehow it turns into “anti-free market” and “perhaps you think Mark” and “perhaps you are an idiot”?

  6. Why do you think most Dr’s have no idea how interrelated diet is to health? Big Pharma starts indoctrinating IN med school. Very sad but true. Drugs do have their place, but not to the extent that the human population is drugged up now. I wish my parents understood this too—as they are on ALL the pills that people their age are on—cholesterol lowering, blood pressure, blood thinners, antibiotics, thyroid—yikes!

  7. I remember seeing an interview with a gerontologist who said when he gets a new patient, invariably he has to unwind all the drugs they are taking that are causing all sorts of side effects.

    The elderly patient in the piece was feeling much better just taking the essential drugs for his condition. Lucky patient that found a doc that knew what he was doing.

  8. The is a big trifecta out there working against us. The processed food industry, pharma and the government lobbyists.

    Poor nutrition makes you reliant on medication and the politicians are lining their pockets with lobbyist $$$$.

    It just goes to show you have to take care of yourself.

    My biggest fear is that the lobby gets strong enough to start affecting our ability to truly practice a minimalist\natural\holistic lifestyle.

    1. I’m with you. I try to treat health issues for myself and family holistically and it seems big pharma and FDA are trying their best to prevent it.

    2. You are correct. I just had a friend’s older brother become diagnosed with melanoma. He went to a holistic doctor who diagnosed and cured him. The powers that be have been actively trying to supress and destroy holistic practicing physicians. All over the country. Your biggest fear is in full swing my friend!

  9. I checked all of my doctors and none appeared on the site. I would’ve been surprised if they were, as I’ve nearly always been recommended generics as a first line of attack.

  10. And don’t even talk about the money big pharma gives to politicians. They want to keep the FDA in check to do their bidding.

  11. I don’t have a doctor to check because I haven’t seen one in over a decade. This issue is just another in a long list of reasons why I will continue to avoid doctors and pharmaceuticals as long as possible. I too, am glad they exist, but I just don’t turn to either one of them until I try other reasonable options, and I count my blessings that, so far that has worked for me. I know it isn’t an option for many other people with serious conditions.

  12. I’m not defending the physicians or the pharmaceutical companies at all, but as patients we are not blameless. Have a common cold, run to the doctors office and demand antibiotics, feeling blue, demand antidepressants, sore back, we want muscle relaxers. Your kid acts up in class, his teacher demands Ritalin.
    Popping a pill is easier and faster than letting nature take it’s course.

    And FYI a doctor doesn’t have to be board certified in a specialty to practice as a specialist….

    1. Right on the money with that.

      Not many people realize that most medication are nothing more than symptom relievers.

      There is usually no treatment or investigation to underlying causes.

      No continuing profits in a cure.

    2. this is true. i am doctor. patients ask and expect an rx……. i counsel all day long when antibiotics are appropriate and not. the list goes on.

      your last statement is not entirely true. a general practitioner may be able to practice without being board certified, but specialists ARE board certified…… otherwise we can’t get malpractice insurance. now, it can take years to become board certified. after school, then residency, it might still take up to 5-6 years before you are board certified and not just “board eligible”. just f.y.i…….

      1. I work in the physician credentialing field, you’d be surprised at what some docs will try to get by with.

  13. Conventional doctors are taught to trust modern medicine in med school. I don’t think they have much exposure to a holistic approach.

    It’s sad but that may be a function of pharma contributions to the education sector.

  14. In light of full disclosure, I am a health care provider.

    I make no money from any drug company.

    It is important that you check to see if your provider is being paid by a drug company to promote a drug, but that may not have anything to do with what they are prescribing for your illness. If you have a strep throat and your get a prescription for penicillin, it doesn’t really matter if your physician gets paid to lecture on high blood pressure medication.

    Off-label use of medication is widespread and is often beneficial to the patient. There are a number of medications that we use in the Emergency Room to treat a migraine, for example. Many of these are off-label, taking advantage of knowledge of the pharmacology of the medication and the pathophysiology of vascular headaches such as migraines.

    Many of the discussions I have with patients center more on their desires for the latest medication they have seen promoted on television, and my impression of their application for the person’s illness.

    I like the idea of a Primal lifestyle and am a devote’ of Mark. I also assume that he is making money from the book sales and products he offers. Does this mean his products are not reliable or trustworthy? Not necessarily, it is just information I keep in mind.

    It is important that we all do research of how we take care of ourselves and establish an open communication with our providers.

    1. It would have been impossible to write a small article that would satisfy every faction of the medical establishment. Mark’s references to “off label” prescribing has more to do with pharmaceutical companies working to find more uses and more customers, than with doctors and emergency room staff looking for solutions to important medical problems. Our child’s doctor prescribed a drug for an “off-label” use until we drew line because the drug was causing tachycardia and GERD. The only reason she agreed to withdraw the prescription was because it was in “off-label” use. The problems with pharmaceuticals and prescriptions are made more complicated when there is obvious corruption and collusion by docs and salespeople.

  15. Since Big Pharma and all the corruption associated with it was created by the FDA, why would you want to give it more power?

    1. Right, because there was totally nothing wrong with all the medications that were created and sold and poisoning people _before_ the FDA was created to at least try to address that… yup.

  16. when I had my herniated disc…my back doctor walked around with his prescription pad ready to give as many pain killer as I needed. When I managed to close the hernia with yoga back bending poses ( a long and sometimes painful therapy) he was quite amazed…and asked me if In needed any more pain killers..!!

    1. Could you elaborate on how you were able to reverse your herniate disk, Richard? Are there particular yoga poses or a particular style of yoga that worked for you? How often did you do it? Any details would be appreciated. Thank you!

      1. Just Google yoga poses for back pain. Thats what I did. When I started, and was in tender state, I did it once a day, in the morning, As I improved I did it twice a day. I have been practicing for a long time. I do not know if you practice, but simple back bends done gently on the floor (locust pose) and knee to waist leg raise were the primary poses.

  17. A few words about generics: I work in the chemistry industry, specifically chromatography. Generics are not to be trusted. Most are produced out of the country in China and India. The factories are not using GMP’s and during the rare inspection by the FDA (a domestic agency), they receive a monetary fine for violations, they are not forced to stop production. That is why a lifestyle like the Primal Blueprint is so important! I’ve heard Robb Wolf talk about how much he thinks Boomers love medication and how hard it is to get them to try revising their nutrition. He’s right! That’s my parents. And the abuse of prescription meds like Xanax and Vicodin among my age set (late 30’s) is incredibly alarming.

    1. agreed………sometimes, i think generics are fine and are equivalent “enough.” and, i certainly understand $$ being an issue, but there are instances where generics are not necessarily the same. there can be as much as 25% leeway in drug concentration and impurities between some name brands and generics.

  18. Well, like what everyone else has said, ditto. I haven’t seen a doctor since getting diagnosed with this strange Metabolic Syndrome X, No explanation why, how, how to fix or how to anything. simply take this fiber pill for the rest of my life and all will be better. never took it and never went back.

  19. It seems to me that we in the UK are headed the same way although we are not exposed to nearly as much direct advertising of drugs as you are in the US.

    It seems to be the norm to treat raised blood pressure and abnormal cholesterol readings with drugs as the first line of attack.

    Only today I was talking to a hair products rep who stopped by the salon whilst I was having my hair cut … he was no more than 45 and had already had a heart attack and was overweight, one glance at his reflection in the mirror I was facing and my head said ‘carb head’ … I had the chance to talk about Primal and this website, he was really interested, seemed like no one had suggested his diet and lifestyle might be at issue.

    Very sad.

    1. I recently moved back to the U.S. after 4 years in the UK and one of my first (of many) culture shock moments was the number of pharmaceuticals advertised on TV. I was probably desensitized to it having grown up with it. Bill Bryson made a similar observation when he returned to the U.S. after 20 years in the UK (he has since returned to Yorkshire).

      I was prescribed blood pressure meds by my Scottish GP and took them with little noticeable impact. Two years ago I discovered Mark’s site, among others, and after only a month of pure primal my blood pressure was way down and within the conventional normal range.

      Sadly, I have found in both America and Britain people are deeply skeptical of my dietary approach and success, and simply have an expectation of drug treatments as they age.

      1. Yes! I came back in 2005 after living in the UK, too – and I’ve been talking about this for the past five years, in which time it’s gotten worse.

        I remember getting an ear infection while living in England (a recurring problem for me every years), and my shock when the GP suggested I use olive oil drips at night in lieu of writing me a prescription. The NHS certainly has its problems, but it was still far, far better than any treatment I have gotten in the US, nevermind the cost difference! I pay the same income tax rate here as I was paying over there. I would trade my public university state government health insurance for the NHS *IN A HEARTBEAT*.

  20. very worrying indeed. what can u do? well first off do your research to see if your doc is on one of these lists, though as u say these lists are very incomplete.

    next, if your doc suggests u go on meds, ask him straight up whether he has any links to any drug companies, espcially any companies associated with the drug he recommends (including parent companies, suibsidiaries, etc, and not just the sort of links mentioned in this article, but does he own shares, has he done any paid ‘consulting’ work for them etc).

    dont let him fob u off, ask him for a straight yes or no. if he is evasive it will be obvious he has something to hide. so unless he gives u a straight “no” i would be very skeptical of his suggestion and get a second opinion (and if he does say no then u have to hope he isnt telling u a bare-faced lie).

    dont be afraid of this seeming rude, or being none of your business. it absolutely IS your business – this is your health we’re talking about.

    of course this wont solve the problem kb mentioned about doctors being indoctrinated by pharma in med school, but at least its a start.

    i cant think of any other walk of life where u can go to what is supposedly an independent expert for advice, and yet not have any means of knowing whether he was effectively a paid employee of one of the companies whose products such an expert might recommend u to buy. absolutely outrageous!

  21. Yah…. then we have the big name people like Dr. Oz hustlin the swine flu vaccination on us, and he is invested in the makers of the swine flu…

  22. Funny, I brought up this topic with my wife, who is not as..”fanatic” about these issues as I am. She simply responded “when did you ever think a big corporation has your best interest in mind”! Simply put.

  23. I’ve known this for a long time. I always assumed that if a medical provider was pushing a name-brand med there was something in it for him/her. I’m over 65 and still take no meds whatsoever. Heck, it’s even hard for me to remember to take my vitamins!

  24. Is this just the U.S. or do other countries with where they have more centralize medicine have this problem too. I would think not as much as medication cost are shared by the public. Just a thought.

  25. Thanks for the great post Mark. It is an important topic. The power of Big Pharma, Big Agra and the junk food companies is really scaring.

    Maybe in the USA things are extreme but in Germany we are heading in the same direction.

    I will print out this post for my family doctor who has conventional training but is very interested in what she learns from me. I will give her Robb Wolf’s book as a christmas gift. 🙂

    I mean there are a lot of honest, hard working MDs who just have no clue what is going on outside the Pharma-dominated conventional healthcare industry (actually sick-care-industry).

  26. I work in a pharmacy as a technician and have seen the disparity between the whole sale price of medication and the retail price. For example, the pharmacy pays around $0.01 for a bottle of 1,000 aspirin. The retail price is $11.99 no matter if you are prescribed 1 pill or 90 pills. That is just the tip of the iceberg. Big Pharma is definietly a problem, but don’t forget the retail pharmacies who bilk the money out of their customers. That is the main reason why pharmacists make $115,000 per year at the major chains.

    Also, don’t believe the hype about Big Pharma using their profits for additional research. They only apply about 1/6th of their earnings to research.

    1. You need to do some research…this is untrue. They use a great deal of their money on research. I agree with you on retail pharmacies.

      Why is no one mentioning insurance companies in all this mess. If you want to see who controls the drugs in the world today it is them. It is scary.

      1. I do agree a lot of $$ is spent on research. Perhaps if reps weren’t paid 100,000/yr and provide offices with elaborate lunches and KOLs expensive dinners there would be even more $$ for research. I see about 14 overweight pts a day on rx’s that could have been avoided if the diet and lifestyle had been under control. However, yes, insurance would rather pay for 3 drugs than for 100/mth for prevention which is hopefully temporary. I spent 12 years telling docs additional drugs to use to basically TREAT side effects of other drugs. really??? 150 bill $$/yr spend on obesity related diseases. Lets address the uderlying problem. Fortunately, I teach primal living to my weightloss pts and they love it. Not a diet, a lifestyle!

  27. Full disclosure – I work in health insurance, and have 2 relatives who work for big pharma. It’s amazing that we are spending twice as much as in 1999 for drugs. Around that time I read an analysis of why US healthcare costs are twice as high as any other country. About 1/3 was attributed to doctors doing more procedures, 1/3 to health insurance overhead, and 1/3 to drug companies. My employer is non-profit, and I know for a fact that we don’t make any profit, and have been cutting administrative expenses every year. Doctors complain to me about how little they are getting paid by my employer. But when Bush passed the medicare drug act – drug companies raised prices to get most of the additional money in the bill (though my relative who is in marketing denied this). The drug companies are not taking any hits with healthcare reform, so we are all paying.

    1. They are not taking hits? They are being wiped out! Yes we are spending more on drugs, but the days are coming short when products are going to be gone and new drug innovation is all but extinct. If you look at the big drug manufactures they have all laid off well over 50-60% of their workforces in the last year. They are being crushed by healthcare reform. The problem is not with one group…it is a total failure of the system. Every aspect of it is broken. Insurance companies manage to the dollar, not patient outcomes…thus no preventative medicine in play (no exercise nudging, no diet discussions, etc). Big pharma has the pressure of making products and gets about 7 years to make money on that product before it goes generic. So the 600-800 million it can cost to develop the product has to be made back in a very short period of time. Healthcare providers by in large do very little self educating after they leave school, so it is up to the companies that provide therapies (drugs, devices, etc) to try and educate them. I can assure you all as much as a conspiracy theory as you want to make it does not exist.

      I am glad people are mentioning big agra, food processing, etc in all this too. Everyone has their little piece of blame in this…but in my opinion the most blame falls on us…the consumers. We allow this to happen to us. We take medicines without research, we eat food without thinking it through, we accept decisions from insurance companies without fighting for what we know is right. It is time for Americans to get up off the couch and stand up for themselves. For the last 30+ years we have trusted everything and everyone a bit much.

  28. Both of my parents are in their early sixties and currently take statins: mom because of hereditary high cholesterol, Dad because of a blocked artery and a medicated stent that was addressed last year. On top of that, he takes aspirin and a host of other things that are supposed to keep his arteries clear, and Mom takes Fosamax and stuff for “negligeable” glaucoma…and probably a bunch of other stuff I don’t know about.

    She’s been experiencing muscle pain and weird symptoms that her doctor is dismissive of. It’s taken two years of harassing her, and she has finally agreed to see another doctor and let them review everything she is taking. I hate the fact that they’re taking so much medication, and am trying to do my best to be a good example. They’re finally starting to ask questions about PB, and I hope I can get through to them, because I can only see the pharmaceuticals increasing with time, otherwise.

  29. I worked in the pharma industry for several years and there were two specific issues that led to overprescription, only one of which was directly to blame on the pharma companies.

    1. Pharma companies do indeed pay to have their drugs prescribed. It’s not quite as straightforward as that since the regulation covering this is quite arcane. However, they can for example, give rebates to the hospital and your insurance provider in return for prescribing their drug or putting it higher on the formulary. In other words, the whole medical industry is incented to put drugs in your hands. By the way, this usually has nothing to do with individual doctors and more to do with hospital and insurance company administrators.

    2. Patients want pills. Sorry, that’s the truth. We want to be sent home with something simple to do, not some vague instructions on “lose weight and live healthy.” Sorry, I actually shouldn’t say WE since I assume most of us on this site aren’t like that, but most Americans are. They want the easy way out “take a pill and feel better” and if they don’t get it they complain. The pharma companies are more than happy to feed this habit but I actually don’t think they’re to blame for it.

    1. You are right. As long as people believe the myth that a pill solves their problems, they want it. They don’t want to change their diet or their lifestyle. They prefer eating crap and take drugs to manage the consequences. Weird. The difference between alcohol or tobacco industry and Big Pharma is that most people know that booze and tobacco are dangerous for their health and won’t solve their problems. But how many MDs really educate their patients about the dangers of masking symptoms with drugs instead of looking for the causes? Some MDs actually do this but it is not the norm.

    2. Sigh. I agree that people want the easy way out…

      …but, who fed them that mentality? I suspect big pharma noticed this characteristic and capitalized on it which reinforces it. I blame both.

    3. Amen! People want the quick one seems willing to work for anything anymore!

  30. Several years ago when my cholestoral started to tick up into the 190’s (runs in family) my family doctor asked if I wanted to participate in a drug study for a new drug. It was for a new drug targeted to people who have some kind of “inflamation” that causes high cholestoral. He gave me the paperwork and the study would last 3 years and you may or may not be getting the real drug. Since it is a major accomplishment for me to remember to take a vitamin every day I didn’t think I’d be a good participant plus I didn’t want to be taking a drug for a condition I may not have. A while later there was an announcement that Pfizer was suspending a drug study because too may participants were dying from heart attacks. I’m pretty sure it was the same drug. I did ask my Doc if he was being paid to solicit participants and he aknowledged he was.

  31. this is tricky….. big pharma, like big agra…. have some real issues. in fact, it’s all connected with the state we are in as a whole…… the same big cycle of bad nutrition, obesity, health problems, inactivity, and trying to cure all with pills.

    there is also a funny catch 22 in healthcare with doctors and pharma and research. we need more research. but, who pays for the research? big pharma (or agra or junk food industry). who does the research? the doctors.

    over the years the pharm companies can offer very little incentive to their doctors on a personal level…… no more trips to hawaii, no more golf clubs, no more dinners. now, even no more pens or sticky notes.

    a good doctor will listen to their patient, will educate their patient and will treat their patient, without bias, but with integrity and as their own patient advocate.

    i know i’m preaching to the choir about this…….. but, i often encourage nutrition changes, exercise, natural / herbal remedies for lots of common ailments my patients complain about. i often get the response, “so, you’re not gonna give me a prescription then?”

    1. Someone recently asked me: “Why can’t they just make a pill to supply all the nutrition we need?”

      He’d prefer to just take a pill for every meal, instead of having to go food shopping, then go through all the trouble to prepare, cook, eat the meal, then clean dishes.

      He didn’t understand why “science” can’t deliver this yet.

      On a related note, he’s still waiting for “science” to deliver a magic pill that can undo all the damage caused by junk food – allowing us to eat all the junk food we want without consequence.


  32. I have epilepsy, and was given a positive prognosis when I was diagnosed at thirteen. About three years ago, I suggested to my neurologist (not the original one who gave me the prognosis) that I taper off my two anti-epilepsy medications because I found through my own research that they both (Carbatrol and Lamictal) caused fatigue and depression, two things I was suffering from. I told my doctor that I wanted to experiment with ending the medications, as my case of epilepsy is quite mild. He told me I could NOT due to “liability issues.” I announced that I was going against Dr. John Towbin’s (of Little Rock, AR) orders and decided to decrease my doses on a weekly base anyway, since I had experimented with “tapering off” with a former neurologist and knew how, and because my simple partial seizures that last for ten seconds were far less burdensome than the side effects of those drugs. He sent me a letter dismissing me as a patient due to “complications in our doctor-patient relationship.” I’ve ever since suspected him of being a paid-out doctor. I just looked him up and, sure enough, he’s received $3,000 from a company called Pfizer… I suspect that if more companies released that info, more things would show up by his name.

    Most importantly, getting off the meds was the best decision I ever made for myself in the face of opposition. How dare another human being suggest that I cannot do something pertaining solely to my own body, which no one knows better than me? I’m healthier than ever since quitting that prescribed crap three years ago!

    1. Wow! What an amazing story! I am so impressed and think you are a fantastic role model. Way to go Lara!!

    2. Your issue is a real one…but the blame does not fall on pharma here…this is legal issue. This guy is afraid because of what has happened in the legal world over the last 20 years.

      Let’s play this out from his perspective – You quit taking that medication and he agrees to it, knowing you have a history of seizures.
      – You might have a seizure while driving a car and run over a few people and kill them.
      – You and all the family members file suits against this guy until he can’t see straight.

      He “can’t/won’t” take that level of risk.

      If you think 3,000.00 is a lot of money in the pharma world for using physicians as speakers you are a bit off too. Just to give some background on that…3,000 would be the equal to attending one meeting as a physician expert. The lead speakers/educators for major brands do 30 or more of these a year. I am not saying it’s right….just giving some facts. I know this will stir discussion so let me also say that this has become so regulated now that the use of these types of events is on the downturn in a big way. The discussions are heavily regulated and the frequency of them is headed to near 0 in the coming years. This would be one of those things that used to happen, but is no longer happening much.

      The funny part to me about the money thing going to docs who educate on disease states and therapies is interesting. I see industries all the time that do this and we don’t even blink. Is it any different than the guy named Jared who lost all that weight on Subway? Is it any different than some of the big company retreats that the folks at Bridgestone and other tire manufactures do with big customers? What about what the oil companies do with their customers? Michael Jordon hocking some shoes? etc?

      I just think we need to all take a step back and think about it all. The best thing we can do is educate ourselves and make the best decisions possible with the best possible information.

  33. I stayed pharmaceutical free for five years with diet and exercise. However another problem arose 95% blocked coronary artery. So what do you do then? I am only 54 yrs old. So then came the stent and now 2 script drugs. I intend to use the Linus Raulings therapy and Dr Sears Pace program to reverse the damage but in the mean time I will have to stay on commercial grade pharmaceutical. Use any pharmaceutical drugs with caution and if your Doctor is script happy find a new one. You know the one’s I am talking about, you go for this they give you that and now you have this so they give another to counter this and that. By the time there finished with you are on no less than ten meds. To your good health Russ

  34. Everyone should watch the documentary “Your Are What You Eat”. Mark’s article is a great supplement to the film’s message.

    1. I couldn’t find this documentary. Do you have any additional info such as the producer or director? Thanks.

  35. Meghan after reading your message just watched the documentary you mentioned. Its pretty disturbing stuff.

  36. I guess the “just say no to drugs” thing never caught on, huh?

    I did have a couple of studies where the material used was funded by drug companies, and have gotten a few pens and writing pads, but that’s it. I guess I’m old school, but being a doctor has importance to me and I will not compromise that.

  37. Yes about 10 years ago I was on everything from muscle relaxants to antibiotics to anti-fungals, you name it. My Dr. would write me an RX every visit even when I said I don’t want to take any more pills for God’s sake! He would call in the prescript. himself to a little pharmacy across the street and he would never give you an choice to go to your pharmacy of choice. I finally stopped going there but the kickbacks he was getting he never tried to hide. It was pretty obvious.

  38. Isn’t it interesting that NPR did a piece on this on Friday (10/22/2010) and quoted info from Pharma. Mark, how timely.

  39. I agree totally. We don’t need all these drugs to keep our cholesterol down or get our blood pressure under control. I believe we can control most of our health problems through diet and exercise. Great book Mark, very inspirational. Check out my blog too, .

  40. I was shocked yet at the same time not shocked. I actually know some of the people on ProPublica’s list. Not as my doctors but professionally and from knowing them it is easy know why they get so much money, they are the best of the best. But at the same time from knowing them I also realize that there speaking efforts are in regards to research they have done on a particular medicine.

    I understand the perspective of people who pay for their own auditing because depending on where your funding comes from you have to provide payments to a third party to audit your program, etc.

    Very tricky.

  41. The last time I saw a Physician was when I wanted an answer or solution for my hard stools. That was 4 years ago at the age of 36. A colonoscopy was suggested which I refused. Nothing was done.

    I went to the doctor when I was 31 for ‘depression’…was put on Celexa and gained 30 lbs within a year.
    Come to find out all I had was vitamin D deficiency from living in WA state and working in doors for years.

    I also saw a doctor in my early 20’s for chronic sinus infections.

    I have gotten 0 help from physicians except my allergy shots, to build anti-bodies.
    Cured all my problems myself, doing years of research and adopting a primal diet.
    If only the internet and MDA and all this info would’ve been around 20 years ago…I could’ve solved many things myself sooner. But it’s never too late:)

  42. Another Paleo Doc here, sounding off with a couple of points:

    1) Big Pharma is no different from Big anything. They are all trying to get you to buy their crap and they are willing to spend a ton of money to make this happen. As a proximate example Big Fitness. No offense to Mark, but a lot of people make a lot of money pushing nutritional supplements that have no benefit at all. How about Big Agriculture? Are they really looking out for your best interest? As a consumer of anything, do your homework and you are less likely to get screwed. While you would like your doctor to be above commercialism, he probably isn’t.

    2) There are thousands of docs getting thousands of dollars to espouse the benefits of a drug they are being paid to represent. This only happens with branded drugs and usually only with those drugs that have competition. If it comes in a shiney free box, it isn’t going to be cheap. That said…

    3) A lot of branded drugs are very beneficial and represent a true improvement over the prior offerings. Some do not and Big Pharma is guilty of rushing products to market or slightly altering an existing drug to extend its patent. However, I use branded drugs in patients when it is the right choice and they tend to deliver as promised.

    4) Generics can be very bad for you. They only have to contain 80% actual drug which can really matter. They are produced over seas or by venture capitalists who are trying to squeeze every drop of profit out of their investment, so less drug for you means more money for them. BTW, pharmacists have a bonus formula that is partially determined by how many branded scripts they can convert to generic. That’s creepy.

    5) Direct to consumer marketing needs to go away. They are like beer ads: costly, high production endeavors designed to convince you that you need their product to fill a void.

    6) Yes some docs are on the take, but many are not and are trying in earnest to help people. But understand that I sometimes feel like a mechanic at a stock car event because by and large, people are constantly doing things that actively damage their bodies. This is what turns them into patients. If you want to say I practice reactive medicine, fine, but I am reacting to something. Also, while I try to be proactive and preventative, only a small % of patients are going to be receptive to the total reprogramming it takes to go primal (you all know what that is like). I emphasize getting off grains, but truth be told, I am a Urologist, so while important, it is off topic and I don’t have much free time to really dig into their nutrition and fitness regimens.

    Also, I am not on anybody’s money list. I have been offered, but it feels very wrong and I would rather spend the time with my wife and kids as opposed to shilling anything.