“All I Know I Learned Way Back in Medical School” Part Four: The Financial Ties That Bind

I know it’s been a good long while since I wrote anything in the “way back in med school” series, but a pertinent issue seems to have made it under my nose for inclusion.

That pertinent issue is financial in nature—specifically, doctors who sit on corporate boards of research firms and drug companies, collecting big bucks for selling out their integrity.

Since it’s been a good long while, I’ll bring you up to speed with links to part 1, part 2, and part 3. Other than the “celebrities spinning their wheels” series, this is the only other one in which I’ve breached the 3-issue trilogy rule of paper decoration.

Back to the finances: over a third of the many doctors who oversee clinical drug trials are tied to either the trial drug manufacturer, or one of its competitors. Patients ought to be alarmed at this number, because it may have a lot to do with trial results being skewed in favor of the drug and speedy FDA approval, only to later be removed from the market, like the recent Vioxx event.

Over 90% of patients enrolled in clinical trials aren’t concerned about this potential conflict of interest—especially cancer patients. In fact, patients are grateful for the drug company-to-drug-trial cooperation with doctors.

I suppose when you’re dying, the last thing you worry about is who’s profiting from keeping you alive a few more weeks.

For researchers, it’s money for nothing and results for free. People sign onto trials voluntarily, receive free treatment, and hope they’re getting the new miracle drug that will save them instead of the placebo. Drug companies send allotted miracle drugs free in hopes of getting good results, even if the drug harms the liver or kidneys (which most drugs do in the end). The more positive the results, the more positive and reassuring the ad campaign that will follow.

We call this “progress.”

Drug companies call this “filling the pipeline” and “shoring up the bottom line” for the investors of their companies—the people they REALLY answer to. The more drugs they invent and get into clinical trials, the more money they stand to make, and the more ads we stand to see in magazines and on TV. And the wheels go round and round…

Medicine is a big money game, and has little to do with actual health. Doctors have become glorified pill salesmen—drug reps in white coats. Sell so many pills, get so many kickbacks from drug companies. And the wheel goes round and round…

Have you ever wondered why fewer and fewer doctors are taking Medicare, Medicaid, and HMO insurance these days? More work for fewer dollars in reimbursement. Drug trials, on the other hand, are merely monitoring of side effects from the drug being tried. Not doctors, but nurses do most of the work—doctors just report the findings. This means more computer time and less people time, and for a lot more money. Sometimes the money’s so good, clinical trial doctors take unnecessary risks with trial drugs and give them to patients who clearly fall outside study parameters, such as people with failing kidneys or pre-existing liver problems, heart problems, or even allergies to similar drugs. Even though the patient will most likely fail the trial and have to be removed, or will leave the study voluntarily due to intolerable side effects, the doctor still gets paid for results, good or bad.

Some doctors are unethical enough to cover up bad trial results, putting the drug company and the money train in jeopardy, or worse, skew results by culling patients who have bad experiences with the drug, keeping only the ones who progress well—all the while getting paid handsomely.

Now who benefits? The personal injury lawyers, that’s who.