Why does your doctor prescribe particular drugs?
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Doctors have to get their training somewhere. So they go to medical
school. But that's far from the end of the line. Much of what I now know
about how to make people well, I learned after medical school not in
it. And medicine keeps changing. New discoveries are made all the time.
So how do doctors keep up with it? An amazing new report in the Journal of the American Medical Association details that for the most part doctors just keep eating what they have been fed. Here are the details.
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The authors of the report note that Big Pharma routinely pays physicians
and provides them with free continuing educational units to learn about
a particular drug they are peddling. This is a good deal for doctors
because they need these continuing educational units to maintain their
license. But here's the thing that makes this practice controversial.
Previous studies have shown that when doctors receive the payment and
the free educational units to learn about the drug, they start
prescribing that drug more. Just recently Big Pharma payment data and
Medicare prescribing records became publicly available. So to learn more
about how this system works the researchers looked at these newly
available records. Here's what they discovered.
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It turns out that a full 80% of these "industry payments" to doctors was
for meals. I've been to several of these dinner lectures. They are
great fun. You get to be with an entire group of nerdy docs just like
yourself, you get a great meal, you learn all about some new product Big
Pharma has developed, and you get free continuing educational units.
The researchers wanted to know how effective these freebies were at
getting the doctors attending to prescribe the drug being hyped. You can
probably guess the results.
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The report looked specifically at four different drugs. The first drug
was the statin drug, rosuvastatin. The second was a cardiac drug,
nebivolol. The third drug was the blood pressure drug, olmesartan. And
the last one was the anti-depression drug, desvenlafaxine.
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They were looking to see if the doctors prescribed the drugs more often after they had attended a dinner promoting them.
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A total of 279,669 physicians received 63,524 dinners associated with
the four target drugs. The docs eating the rosuvastatin dinner ended up
prescribing rosuvastatin 18% more after hearing the pitch. The docs at
the nebivolol dinner ended up prescribing that drug 70% more often. The
docs toasting at the olmesartan meal ended up prescribing olmesartan 52%
more often. And the docs digesting the desvenlafaxine dinner ended up
prescribing the drug a whopping 218% more often.
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That must have been an incredible meal! Why do I say that? It's because
the report also details how the more expensive the meal is, the higher
the final prescribing rate.
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So when you go to the doctor and he/she prescribes a drug for your
symptoms, understand that many times that decision is based mostly on
marketing. The authors of the study were quick to point out that, "The
findings represent an association, not a cause-and-effect relationship."
And I can believe that. I don't think there are going to be too many
doctors who are so naïve that they will prescribe a drug simply because
they had a good meal. The point is that this is where most doctors get
the majority of their information on how to help their patients — from
Big Pharma sponsored events.
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So if you want to get a good opinion on what kind of drug you could be
taking for your condition, then make sure you see a doctor that has a
strictly conventional focus. That is what his training is focused on. As
this study shows, they hunger for it. But if you want to learn about
some natural, alternative ways to heal your condition, see a doctor who
in addition to his conventional training has gone out of his/her way to
learn about these kinds of treatments. You can find docs like that at:
www.aaot.us, www.acam.org, www.naturopathic.org, www.abihm.org,
www.faim.org, www.ahha.org, www.amfoundation.org, www.aihm.org,
www.aaimedicine.com, www.icimed.com, and www.imholistichealth.org.
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Yours for better health,
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Frank Shallenberger, MD
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