Strange times we live in.
What used to only happen in less-than-honorably governed countries – those with dictators and overt fraud and corruption – election tampering, suppression of human rights, the media and freedom of speech – now happens even in the U.S., once a bastion of democracy, free speech and freedom of the press.
With leaders declaring ‘fake news’, and the proliferation of online access and its carefully crafted campaigns to disseminate misinformation online now an industry unto itself, who or what can you trust?
And importantly, what about the information regarding your family’s health? The ‘science’ behind your doctor’s recommendations – can it be trusted? Where do doctors get their information? Can those sources be trusted?
When we look at the statistic that the U.S. has 5% of the world’s population, yet takes 56% of the world’s drugs, and when compared with other developed nations, is rated near the bottom for health care with, it begs the question ‘What’s a person to do?’
The Take Away:
- There is enormous corruption and bias that affects the scientific process at all levels – from research to the FDA to your doctor.
- Much of medical/health information available to both doctors and lay people, due to entrenched financial motives, is biased, inaccurate, and not ‘scientifically’ valid.
- As a consumer, as a patient, as a parent, you must be ever-vigilant regarding what you’re told about your health.
- Your personal lifestyle habits are a path to health and wellness, and serve as protective barrier to getting drawn into the abyss of misguided and corrupt efforts that make up much of today’s ‘health care’ system (really a ‘sick care’ system).
Patients rely directly on their doctors; in turn doctors rely on:
1. Their education
2. The FDA oversight of drug and procedure approval
3. Pharmaceutical drug companies (who fund research, lobby government, sponsor conferences, and provide sales representatives to ‘teach’ doctors on the efficacy and use of medications)
4. Reading medical journals
So what do these ‘portals’ of information yield?
‘When doctors are being lavished with meals and speaking fees by the likes of Pfizer and Merck, can you really trust them when they later write prescriptions for those companies’ drugs? Medical schools were long considered above such vulgar stuff. Now, however, it turns out that many professors and instructors are, legally, on the dole as well, and students are beginning to worry that what they’re being taught is just as one-sided as what patients are being prescribed.’ [article link]
FDA – the fox guarding the hen house
It would seem hopeful that the FDA, with its assigned (assumed?) role as a ‘watch dog’ agency would be a successful frontline defense against corruption and fraud which would ultimately trickle down to doctors and their patients. The reality is not so altruistic: according to Forbes, 75% of the FDA’s drug review budget is provided by pharmaceutical companies ‘This is an astounding number. Is any other federal agency supported to this extent by the industry it regulates?’ [article]
Here’s another article describing this unhealthy relationship: FDA Repays Industry by Rushing Risky Drugs to Market
The groundwork: Pharmaceutical companies – big pharma – are enormously profitable and spend enormous amounts of money not only researching and developing their products, but also on the marketing of them to both doctors and the public (and the lobbying of governments and politicians). A lot is at stake – billions and billions of dollars. And whenever billions are involved, the opportunity for corruption and fraud is proportional. To give you some idea of the scale of this, one drug company, GlaxoSmithKline (GSK), pleaded guilty in 2013 to criminal charges and agreed to pay $3 billion for promoting its best-selling antidepressants for unapproved uses and failing to report safety data about a top diabetes drug; the fines included civil penalties for improper marketing of a half-dozen other drugs.
In 2014: China fined the same company, GSK $489 million for bribes (this totaled 4 percent of GSK’s 2013 operating profits)
And those fines don’t include lawsuits with verdicts for individuals – read here for the GSK’s history of legal judgments.
You get the drift – huge financial hits are simply factored into the cost of ‘doing business’; as such, drug companies’ scruples are questionable at best, outright fraudulent at worse.
In days past, doctors, medical schools, hospitals, and researchers ‘hung their hats’ on scientific studies published in peer-reviewed journals. Are journals and their peer-reviewed articles still as trust worthy? (Peer review is the system used to check papers before they appear in journals. It is a way of validating the research work through the scrutiny by other experts for the methodology that was used.)
The question: Is peer review still the ‘gold standard’ it’s purported to be?
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine” [from Dr. Marcia Angell, former editor of NEJM, in her book The Truth About the Drug Companies: How They Deceive Us and What To Do About It; Random House, 2005]
Okay that was in 2005; what about more recently?
In a 2015 article titled Let’s stop pretending that peer review works, Richard Horton, editor of the prestigious British journal The Lancet is quoted saying the peer review process is ‘…unjust, unaccountable … often insulting, usually ignorant, occasionally foolish, and frequently wrong.’ [article link]
Horton goes on to say ‘The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, ‘poor methods get results’.” [article link]
CONFLICT OF INTEREST
This is where the rubber meets the road. As this article accurately states ‘COI is nuanced and complex. It is far more than the individual interactions, it is woven into the fabric of how our profession interacts in economic environments that prioritize profits over people.’
A similar article, referring to teaching hospitals in particular goes on to say ‘A large majority of the hospitals studied had policies in place for internal disclosure of potential conflicts of interest, but lacked policies for disclosure to the public.’; and ‘… there has been very little public accountability surrounding pharmaceutical and medical device manufacturers’ influence on purchasing decisions and even on the therapies available to patients.’
Conflict of interest, Level 1: ‘The holy grail of medical research are randomized controlled trials (RCTs) – studies in which large numbers of patients are randomly allocated to different treatments without the patient or the clinician knowing the allocation and the efficacy of the various treatments compared. RCTs are best way of determining whether a new drug is effective and have to be completed before a drug can be marketed. Because RCTs are very expensive, they are often supported by drug companies. ‘… drug companies provide grants or drugs for the trial or assist with data analysis and/or article preparation.’ Whenever an article is submitted for consideration, the authors must declare any conflicts of interest – i.e. financial ties or gain – in theory this is supposed to function as a shield against bias and unwarranted influence. [article]
However, there is another level where bad science can be published, accepted as truthful, and then influence your doctor and his/her recommendations:
Conflict of interest, Level 2: ‘But what about the journal editors who ultimately decide which papers get published? … the researchers suggest, journals [themselves] should live up to the same principles related to conflicts of interest as those that they require from their authors and should routinely disclose information on the source and amount of income that they receive.’ [article]
See also this article regarding what’s termed ‘journal impact’ and its financial influence on whether a study gets published or not.
What’s a person to do?
Google it. That’s a standard practice for all of us today, right? We look up (a) the symptoms we’re experiencing, (b) the condition/disease we’ve been diagnosed with; (c) the ‘side effects’ of the drug we’ve been prescribed; and/or (d) alternative options for treatment, healing, recovery, etc. But what about Google and their business relationships – are they ‘partners in crime’ as well?
We’ll often end up on Wikipedia; but Wikipedia itself cautions against relying on what you find as anybody can edit the content. And now recent research and analysis shows Wikipedia, due to its success, is becoming biased, influenced, corrupt and fraudulent itself (Google donates regularly to Wikipedia).
So again, what’s a person to do?
1. Eat well – the link between nutrition and health is well established
2. Exercise daily
3. Follow the money – look to see who’s to gain from a recommendation given to you. For example – daily exercise, eating organic vegetables, good protein and healthy fats, along with getting sufficient sleep, and adopting gratitude as your default perspective on life – as recommendations for attaining and maintaining health have no ulterior motive or profit-driven agenda; yes, your local farmers market and neighborhood CrossFit will benefit from you patronizing their businesses, but that’s a win-win-win situation, right?
4. When dealing with a health challenge, or even a crisis, proceed with:
- common sense
5. Keep your ‘master system’ – the nervous system – free from interference: regular chiropractic care is a proven method to keep your body and your health functioning better.
And last, keep in mind when dealing with a crisis – for example, pneumonia needing antibiotics – the ‘crisis’ is a separate entity and strategy from the recovery/follow-up phase of rebuilding your health in general and immune system in particular with actions such as sleep, healthy diet and in the specific case of a follow-up to have had to take antibiotics, probiotics.
- Horton R, Offline: What is medicine’s 5 sigma? The Lancet April 2015: 385(99760) [article link]
- Kanchan T Pharmaceutical companies as the funding sources for continuing medical education. Indian J Crit Care Med. 2015 Mar; 19(3): 186–187. [article link]
- “In clinical research, conclusions are not based on facts alone, but are also affected by the choice and interpretation of statistical analyses.” Mosca L, Sex, statins, and statistics. The Lancet April 2015; 385(9976) p1368-1369 [article link]
- Lundh A, et al. Conflicts of Interest at Medical Journals: The Influence of Industry-Supported Randomised Trials on Journal Impact Factors and Revenue – Cohort Study. PLoS Med. 2010 Oct; 7(10): e1000354 [article link]
- Ioannidis JPA. Why Most Published Research Findings Are False. PLoS Med. 2005 Aug 2(8): e124. [article link]
- Marcovitch H. Editors, Publishers, Impact Factors, and Reprint Income PLoS Med. 2010 Oct; 7(10): e1000355 [article link]
- “Increased body weight was associated with increased death rates for all cancers combined and for cancers at multiple specific sites.” Calle EE, et al. Overweight, Obesity, and Mortality from Cancers in a Prospectively Studied Cohort of U.S. Adults. New England J Med 2003; 348:1625-1638. [This is an epidemiological study, not a pharmaceutical-influenced-funded research study – big difference]