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How Scientific Is Modern Medicine, Really?

By Dana Ullman, MPH

the Hippocratic tradition of “First, do no harm.” Sadly, however, it seems that too few doctors understand or respect this Hippocratic dictum.

Pharmaceutical Overload

Today in America, every man, woman, and child is prescribed, on average, around 13 prescription drugs per year (not counting the many over-the-counter drugs that doctors prescribe, or which patients take on their own). Just 12 years earlier, Americans were prescribed, on average, fewer than eight drugs per person. That’s a 62 percent increase in little over a decade! This practice of “polypharmacy” is increasing substantially. Big Pharma is pushing it hard and benefiting from it in a big, big way.

According to a 2008 nationwide survey, 29 percent of Americans used at least five prescription medications concurrently. Three years prior, a different survey showed that only 17 percent took three or more prescription drugs at the same time. Problems arise when drugs are not tested for approval in conjunction with other drugs, and the safety and efficacy of the use of multiple drugs together remains totally unknown.

Even conservative publications such as Scientific American can no longer deny the increasingly serious problems caused by pharmaceuticals. A recent article highlighted the fact that in the past seven years there has been a 65 percent increase in drug overdoses leading to hospitalization or death.

Drugs for Young and Old

We all want drugs given to infants to be as safe as possible, but parents will be surprised to learn that very few drugs are ever tested on infants. A 2007 study of over 350,000 children found that an alarming 78.7 percent of children in hospitals are prescribed drugs the FDA hasn’t even approved for use in children. If this isn’t shocking enough, a survey in England found that 90 percent of infants there were prescribed drugs that were not tested for safety or efficacy in infants.

There is almost a 350 percent increase in adverse drug reactions in children prescribed off-label drugs than in children who were prescribed drugs that have been tested for safety and efficacy. Doctors are committing “medical child abuse” on a regular basis.

An even stronger case can be made for the epidemic of “elder medical abuse” due to the much larger number of drugs prescribed for our senior citizens. It is no wonder that so many of them have become mental zombies, while Big Pharma profits big-time, and insurance companies simply raise their rates.

If we were living a lot longer and the quality of our lives was improved by medical care, one could make a case that today’s medical care provides more benefits than problems. But this is simply not true.

We are often told that the average lifespan is longer than ever, but this is simply a clever, even tricky, use of statistics. The average lifespan has risen because there has been a considerable reduction in deaths during the first five years of life. This reduction in deaths has resulted not from the use of any specific conventional pharmaceutical agent, but primarily from a medicinal agent called “soap.” Because fewer of us are dying at an early age, our average lifespan rises. But an American who was 40 years old in 1900 had a similar chance of living to 80 as an American who was 40 in 1960.

The Guise of Science

Adherents of conventional medicine consistently assert that their methods are scientifically verified, and ridicule other methods suggested to have therapeutic or curative effects. In fact, conventional physicians have consistently worked to disallow competitors, viciously attacking those in their own profession who have questioned conventional treatments or provided alternative modalities. More recently, medical organizations simply work with insurance companies to help them determine what should and shouldn’t get reimbursed—a clever, bloodless way to kill competition.

Yet strangely enough, whatever conventional medicine was in vogue in one decade often is declared ineffective, dangerous and sometimes barbaric in the next. Despite this pattern, proponents and defenders of “scientific medicine” tend to have little or no humility, continually asserting that today’s cure is truly effective— and labeling any alternatives to this ever-changing treatment as quackery, sheer quackery, whether they know anything about these alternative treatment modalities or not.

One of the remarkable features of conventional medicine, for which it should be honored, is its history of consistently and repeatedly disproving its own treatments. The fact that only a handful of conventional drugs have survived 30 or more years is a strong testament that conventional medicine is honorable enough to acknowledge its mistakes. But because drug patents only last for a limited time, there are substantial benefits when drugs have a relatively short lifespan. Big Pharma can charge big money during this time frame, and then, when the drug goes off-patent, can develop a new, high-priced drug to replace it. Like the fashion industry, medical fashion changes rapidly, supporting a powerful economic arms race.

Big Pharma, Big Bucks

In 2002, the combined profits of the 10 largest drug companies in the Fortune 500 ($35.9 billion) amounted to more than the combined profits of the remaining 490 companies put together ($33.7 billion). The only reason these drug companies have not maintained this shocking financial advantage is that the oil companies’ profits have increased considerably since the Iraq War, raising the 490 non-drug companies’ profits slightly higher. Then again, one would assume that the profits of 490 of the largest companies in the world would be substantially more than those of just 10 companies in one commercial field.

This economic information is important—even essential— because learning how to separate the science of medicine from the business of medicine has never been more difficult. The drug companies and the medical profession, which together have been called the “medical-industrial complex,” are wonderfully effective in convincing consumers worldwide that modern medicine is the most scientific discipline that has ever existed.

Modern drug companies are rarely run by physicians. Instead, businessmen run them. Marcia Angell, M.D., a Harvard professor of medicine and former editor of the famed New England Journal of Medicine, explains this evolution:

Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the U.S. Congress, the FDA, academic medical centers, and the medical profession itself.

There is big, big money to be made in drug sales, and brilliant marketing has led too many of us to ignore or excuse this bully side of medicine.

The New York Times recently uncovered the fact that Pfizer admitted to paying $20 million in the last six months of 2009 alone to 4,500 doctors for “consultation” and to speak on its behalf. (This doesn’t include payments to doctors outside of the U.S.) It seems to be time to stop calling them “drug companies” and start calling them “drug pushers.”

The 800-Pound Gorilla

Yes, there is a gorilla in the house, but anyone who refers to it as a gorilla is usually called a quack or a crank. This gorilla was not born yesterday; it has been growing for generations. A part of its self-defense strategy is to eliminate competing forces, whether the other side seeks cooperation or not. Any competitive force is frequently and soundly attacked.

The history of homeopathy shows this dark side of medicine. From 1860 to the early years of the twentieth century, the AMA had a clause in its code of ethics preventing members from consulting with a medical doctor who practiced homeopathy; they weren’t even allowed to treat a homeopath’s patients. At a time in medical history when doctors bloodlet their patients to death and regularly prescribed mercury and various caustic agents to sick people, the deed that the AMA considered reprehensible and actionable was the “crime” of consulting with a homeopath.

In fact, the entire Medical Society of New York was kicked out of the AMA in 1881 simply because the state’s medical organization admitted medical doctors who utilized homeopathic medicines, no matter their academic credentials. The New York organization only rejoined the AMA 25 years later.

This big gorilla is not a monster to everyone, however. It’s wonderfully generous to executives, sales forces, supportive politicians and the media, from whom it buys substantial amounts of advertising (and from whom it receives an incredible amount of positive coverage). And this gorilla is wonderfully generous to stockholders. It might seem inappropriate to criticize profits, but it’s important and appropriate to do so when profits are unbelievably excessive, when long-term efficacy hasn’t stood the test of time, and when concurrent use of multiple drugs is rarely, if ever, scientifically tested.

Although these observations may seem harsh and offensive to some people, they are made with the acknowledgment that most of us know someone whose life was saved, or at least whose health was significantly restored, by conventional medicine. I, myself, am the son of a fabulous father who was a physician and insulin-dependent diabetic. I would not be alive today if it were not for some important conventional medical discoveries, such as insulin.

We should not throw the baby out with the bathwater, nor should we ignore the bathwater in which we place our babies. Most of us also know someone whose health has been seriously hurt, or whose life was cut short, by modern medical treatments.

Drug companies defend their large profits by asserting that they spend tremendous amounts of money on research and development, but they tend to hide the fact that they spend approximately three times as much on marketing and administration. And the obscenely high profits of the drug companies take into account all known expenses. Ultimately, drug companies are wonderfully creative in convincing us all that their drug treatments are “scientific”…and too many of us actually believe them.