Posted by: Harold Knight | 07/03/2011

Your doctor’s probably not a quack, but she may a crook

Rod of Asclepius

Rod of Asclepius

crook. Early 13c., “hook-shaped instrument or weapon,” from O.N.  krokr  “hook, corner” . . . Meaning “swindler” is Amer. Eng., 1879, from  crooked  in figurative sense of “dishonest” (1708) (1).
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On June 25 I wrote about aging and facing death. I began that posting by quoting the TV ad from Abbott Labs about LowT that tries to persuade men over 45 their slowing down (mainly sexually) is due to “low testosterone.” The implication is that Abbott Labs can solve the problem. Never mind that slowing down is a natural function of being over 45 years old.

But we don’t want to hear directly about men’s health issues—especially issues that could affect sexual prowess. The most interesting thing about that ad is it never names a product. The ad says only that a “slowing-down man” should talk to his doctor, and by implication, tell her that Abbott Labs suggested the conversation.

Once the feeling of inadequacy and metaphysical lack is established in the psyche . . . then products we don’t need can be sold to us on the basis of the implication that the reason we feel empty and unfulfilled is because we don’t yet have them (2).

The doctor will know what to do about the problem that “men 45 and older just don’t feel like they used to.” You can bet your bottom dollar she will. She will have received a visit from a marketing representative of Abbott Labs who has given her advertising materials in the guise of slickly printed “information” pamphlets, a supply of free samples to give to patients, and, perhaps, a handsome personal gift from Abbott Labs.

Pharmaceutical manufacturers . . .  engage in the hard sell, stopping at nothing to reach their goals. If that means providing false or misleading data to physicians and consumers, then so be it. Pharmaceutical sales teams are . . .  equipped with powerful tools . . . Through distribution of free drug samples, skewed marketing materials. . .  the industry engages in deception hidden by a veil of flattery and free gifts (3).

Abbott Labs knows perfectly well how vulnerable men are when their virility is questioned. Abbott has staked their profits on their knowledge that “as far as romance is concerned, the idea and feeling that each of us needs something ‘other’ in order to complete ourselves represents a failure to accept our intimate selves” (3).  Americans are unable to accept realities about our intimate selves, our bodies, especially negative realities.

A month ago, my doctor discovered I have an imbalance of cholesterol .  He prescribed Crestor—of which I had never heard. Since then I’ve seen the commercial of a family frolicking in the surf without a care because Mom takes Crestor.  I was intrigued that my doctor had samples (enough for six weeks) at hand so I could get started and not wait until my prescription arrived from my mail order prescription plan.

I was also fascinated because this was the second time he prescribed Crestor, the first a year ago. The blood tests revealed exactly the same level of cholesterol as before—fascinating because I had lost the prescription and never taken the medication.

A little research revealed  A) taking Crestor has risks—one law suit is pending claiming a patient died from it, and B) at least two heart surgeons say taking such meds for cholesterol is pointless because that’s not what’s causing heart attacks (4). I’ll continue taking the meds after my samples run out, but if I die, I hope my sister will sue AstraZeneca.

Making light of my own situation is easy. However, it’s downright depressing to read about the stranglehold the pharmaceutical companies have on our health system—because they wield such influence over doctors,  and more importantly, over the medical journals that, in theory, disseminate the latest scientific information to the medical community—to our doctors.

That pharmaceutical companies influence the reporting of medical information to doctors is obvious. “Scientific” medical journals are

. . . utterly dependent upon pharmaceutical advertising, which can provide between 97 and 99 percent of their advertising revenue. By 2005, some major journals, including Consultant, Geriatrics, and American Family Physician, carried more advertising than editorial pages and glossy, full-color inserts that were longer than the journal’s longest article (5).

In order to insure the flow of advertising revenue from “Big Pharma,” the “scientific” medical journals advertise in the pharmaceutical industry marketing journals to remind the companies that advertising in the “scientific” medical journals,

. . .  flooding the pages of pharmaceutical-industry publications such as Medical Marketing and Media to vie for the attentions of Big Pharma. The Journal of the American Medical Association (JAMA) bills itself in advertising as “a priceless audience at a price you can afford,” while the Annals of Internal Medicine boasts: ‘With an audience of more than 90,000 internists. . .  Annals has always been a smart buy’ (6).

This posting began as a piece based on the Bardi quotation at the top. It turned into this diatribe because I can’t help myself. You would do well (or perhaps be disgusted) to read Washington’s article, online at the current edition of The American Scholar.

So does the horrendous state of our health care system mean Big Pharm and our doctors are in collusion as crooks to fleece all of us? I don’t think so. I think, if we were not all complicit in the morass of deception, we could easily (and would) do something about it. Since my writing was triggered by John Bardi’s article, and since I have gotten so far off track, I will quote a chunk of his writing and not try to make an argument about it (please don’t tell my students of argumentative writing). He says

. . .  there is the inescapable fact that, on every level, American culture is saturated with deception. Whether it’s on the large stage where products and politicians are presented to us, or on the small stage where we present ourselves to the world, some version of the age-old attempt to make what is seem like what is not is likely to be operating. . . The same gift of language that enables us to seek truth beyond our senses also gives us the means to deceive. But now there’s a difference. From government, business, and Wall Street all the way down to individual resumes and Facebook pages, the age-old capacity to deceive is now practiced with full cultural validation (indicated by the fact that we now refer to open, calculated attempts to mislead as mere “marketing”). Under these conditions honest self-inquiry becomes even more difficult (7).

Well, wait. Maybe I can make my point. If we are so guided by our frenzy to “fit in,” to “have stuff” (including sexual vitality after age 45), if we have become so spineless as to let  AstraZeneca and Abbott Labs make our decisions for us, if we are so afraid of honest self-inquiry that we simply accept deception in the form of “marketing,” we deserve far worse than doctors who are on the take.
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(1) “crook.” Online Etymology Dictionary. Douglas Harper, ed. 2010. Web. 3 Jul. 2011.
(2) Bardi, John. “Plato, Romance, & Self-Inquiry.” Humanist 71.1 (2011): 32-36.
(3) Connors, Amanda L. “Big Bad Pharma: An Ethical Analysis of Physician-Directed and Consumer-Directed Marketing Tactics.” Albany Law Review 73.1 (2010): 243-282.
(4) Lundell , Dwight and Todd Nordstrom. The Cure for Heart Disease: Truth Will Save a Nation. Heart Surgeons Health Plan, 2007.
(5) Washington, Harriet A. “Flacking for Big Pharma.” American Scholar 80.3 (2011): 22-34.
(6) Washington op.cit.
(7) Bardi op.cit.

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