A TALE OF TWO ANTHROPOLOGISTS-A new paper is being released in the Annals of Family Medicine on just how much the Pharmaceutical companies have infiltrated the overall practice of medicine, and how much it is affecting our health. The study was conducted by a pair of anthropologists from Michigan State University.
According to the researchers, Pharmaceutical companies now have a direct effect on how doctors practice medicine, and therefore on the health of patients. There are three ways Pharmaceutical Companies are doing this:
1. Lowering Diagnostic Thresholds- This means that more people are diagnosed with a disease they didn’t previously have. For example, in 1993, the definition for high blood pressure was 160/95 or higher. It was subsequently lowered to 140/90 , and in 1998 was lowered again- to 130/80. These changes resulted in an estimated 22 million additional high blood pressure diagnosis (in people previously considered normal) and a subsequent 22 million more prescriptions written. Now, the criteria has been lowered again, to 120/80 as a condition of pre-high blood pressure.
Similar tactics have been used in diabetes and cholesterol, according to the authors. In fact, diabetes, cholesterol and high blood pressure seem to be the main targets of the pharmaceutical companies right now.
2. Clinician Rewards Systems- Medical doctors are now monitored and rewarded for keeping their patients readings below the new standard guidelines. Of course, these guidelines are being created or influenced by the Pharmaceutical companies themselves.
The researchers found that many insurance companies with strong Pharmaceutical ties rate and reward medical doctors by whether they are keeping their patients on medications that are keeping them below the new guidelines, and are often paying “substantial” bonuses that encourage the doctors to respond to mild test results with very “aggressive” use of medications- else they get no bonus and lowered ratings.
When you do not agree to the situation, your doctor may get very angry with you, as you are affecting his/her standing with the insurance and pharmaceutical industry, and you are also affecting his/her bonuses.
3. The Prescription Drug Cascade- This means that by putting more and more people on more and more medications, people are starting to have more and more symptoms being caused by the medications themself. Instead of taking you off medications that are causing adverse affects, or finding medical alternatives to the medication that is bothering you, the new symptoms are being seen by the pharmaceutical industry as yet another chance to put you on yet more medications. When these new medications cause new problems, more medications are added yet again.
This turns into a cascade affect, what some people call the “medical funnel”, where you start off on nothing, end up on one or two medications, another couple are added due to lowered diagnostic thresholds, then you start having side effects, get medications for them, get more side effects, get more medications for them, and so on, until you are on an unbelievable slew of medications.
Of course, this is sheer profit for the pharmaceutical industry and hospitals across America.
THE BOTTOM LINE– According to the researchers, the bottom line is that spending on prescription drugs in the United States has risen by 600% since 1990. The majority of that money has come from prescription medication for three disorders- high blood pressure, cholesterol and diabetes. And each of these disorders are regularly having their diagnostic criteria lowered.
And the patients- they are suffering. The authors gave many, many examples of how the new practice of medicine is taking relatively healthy people and sucking the life and money out of them until they have no life or money left. If the person has good insurance, it is other policy holders that suffer the financial consequences, as the insurance companies raise the deductibles and co-pays and lower the payouts to make up for the money being sucked out so that they do not lose profits.
The study also highlighted frustrations by physicians who say they are now putting people on 3 and 4 and 5 medications for each condition, like cholesterol, high blood pressure and diabetes, when before they only had to prescribe one. Additionally, much to their confusion, the medics are claiming that even on such a plethora of medications, it is hard to get their patients readings below the new artificially set normals being created by the pharmaceutical industry. And even more puzzling to the doctors is that even if they are able to get the readings that low, the patient is often absolutely miserable and no longer functional. As one medical doctor put it- “I’m not sure why”.
CLOSING REMARKS– The authors obviously concluded that a lot of change needed to happen. Research companies without Pharmaceutical ties need to do be the ones doing the research, Pharmaceutical companies should only make the medications, and doctors should be doctors, and should treat their patients without input or pressure from any other entity. The authors even agreed that medical doctors needed to stop seeing Pharmaceutical representatives and stop going to “conferences” funded by Pharmaceutical companies.
In the meantime however, you are going to have to watch out for yourself.
Reference: Hunt LM, Kreiner M, Brody H. The changing face of chronic illness managment in primary care: a qualitative study of underlying influences and unintended outcomes. Ann Fam Med, September/October 2012;10(5):452-460
Hope this helps, Dr Matt and Dr Robin
This week’s bit of Useless Information: Bulletproof vests, fire escapes windshield wipers and laser printers were all invented by women.
This email is courtesy of Matthew Barnes, D.C. and Robin Barnes, D.C. Neither this nor any of our emails are intended to be medical advice and should not be taken as such. They are opinion and are for informational purposes only. None of the nutrients discussed here are meant to diagnose, treat, or cure any disease.