Overdosed America

The points brought up throughout our reading this week pointed again and again to the repeated abuse of physicians' and patients' trust by pharmaceutical companies marketing seemingly useless drugs via schmoozing, bribes, and false advertising. More disturbing to me, though, was our final selection on the effective treatment of America's most common serious illness - diseases such as stroke, cancer, heart disease, and obesity. Not only did the authors show that many of the new - and quite expensive - drugs are minimally effective in treating these conditions, but straightforward lifestyle changes proved astounding success. As the research repeatedly showed, not smoking, exercise, and a healthy diet are the keys to reducing these diseases, but our healthcare system has no means of promoting such measures.

Could a universal healthcare system address these issues? Dr. Murphy posited that this would be the most logical way to motivate all parties involved in healthcare to work to the benefit of the patient. He envisioned a system in which the less medical care a patient required, the more profit all parties received in providing care. If pharmaceutical companies are to be a part of this equation, they must be motivated to seek the best for patients not out of high morals, but because it will benefit their company to do so. As it stands now, these businesses will only increase their profit by making patients sicker, so long as their patient is alive to continue to require their drug. This is why, as Marcia Angell suggested in her speech, pharmaceutical companies target ubiquitous chronic illness rather than diseases with relatively quick and simple cures.

What does this mean for physicians today? The author of Overdosed America, John Abramson, points to an end in physician bribery and pharmaceutical "gifting." But he goes further than asking physicians to simply "say no to drug companies" - Abramson highlights the crucial role of the physician, especially those in primary care, in advising patients in the making proven lifestyle changes before prescribing exorbitant medications.