Few have been blind to the escalating number of drug advertisements appearing in magazines, newspapers and airing on the radio and television. Drug ads run during commercial breaks of the most watched television shows and most listened to radio programs throughout the nation.
Page after page of full-color print ads run in the most influential magazines in our country-- ads on the first page that show, for example, the relief, the freedom, the quality of life an individual can experience with, say, an allergy medication. The patient is shown running through a field of flowers, free of the symptoms of hay fever. On page two, a page few take time to read or even note its existence, is the bad news: the potential side effects and downside of legal drugs. No drug is without them.
Regardless within which media the ad takes shape, several elements are clear: the ad impresses readers and sells drugs. Unfortunately, this type of ad serves as the pied piper leading the uninformed patient to an unknown future in terms of health.
The pharmaceutical industry pushes the envelope when it comes to advertising and promotion, testing the parameters of acceptable drug promotion under the supposed guidance of FDA "rules." Certainly critics believe the FDA's guidelines are inadequate and often compromised by drug industry marketers. Certainly these same critics know the FDA often turns a blind eye to questionable marketing practices by the industry.
What we know without hesitation is that there is a political "leg up" the drug industry enjoys thanks to the golden triad: politics, propaganda and the press in concert, a triad which allows the drug industry and medicine itself a huge edge in the health care market.
Politics
The first arm of the triad, politics, comprises a number of players: the political action committees (PACs) and the FDA. These entities serve as a mutual admiration and nepotism society, forming a circle of palm greasers and policymakers that ensure a virtual anti-trust existence without legal repercussion. By denouncing all other forms of health care, and by claiming most nonmedical avenues have "unproved effectiveness," medicine, with the policymaking support of government, ensures itself the luxury of virtual noncompetition.
Medical industry PACs play a significant roll in maintaining medicine's supremacy by dollars allocated to politicians to glean support for their causes. According to the organization Campaign Study Group in their 1996 database, the American Medical Association's PAC ranked as the sixth highest contributing group in 1996, following such contributors as the International Brotherhood of Teamsters; National Education Association; the UAW (United Auto Workers); and the Association of Trial Lawyers.
In the category of health care, health care providers and drugs/medical equipment, the AMA ranked #1 and #2 in PAC dollar contributions. The PAC contributions of health care providers and drugs/medical equipment rival all other category leaders, including both Republican and Democratic PACs; defense/aerospace; electric power; financial services; and insurance PACs.
Even with the unmitigated influence of PACs on their side, medicine's best ally is the FDA. The FDA's efforts are so biased toward medicine that their approval process all but guarantees nonalternative products and techniques do not clear the approval process hurdle. Simultaneously, the FDA's approval process is designed not only to expedite the approval of medical products and equipment, but to provide invaluable assurance that the medical products and equipment are successful once in the marketplace and without nonmedical competition.
Two of the FDA's activities exemplify this: the FDA's hesitancy to act when serious and even deadly side effects of drugs are reported. Once a drug is approved and in the marketplace, the FDA's modus operandi appears to be one of extreme hesitancy to ac ton a drug's safety even when widespread reports of side effects surface.
On the other side, if there are even anecdotal stories or rumors of a food supplement causing side effects, the FDA is quick to warn the public and likely to restrict its use or remove it from the market place entirely. Medicine's close relationship with the FDA is also evident in the FDA's practice of continuously scrutinizing nonmedical products and services so that it is difficult for nonmedical care to maintain its ground, let alone progress. This can be seen with the FDA's revived activity aimed at limiting the public's access to information regarding dietary supplements (Dietary Health and Education Act/DSHEA). This is an ongoing attempt to set back the major threat to the drug industry today, the food supplement industry.
Following politics, medicine's machine incorporates propaganda which takes shape in several forms. Their ongoing campaign to convince the public that medicine is the only legitimate game in town is their stepping stone. This misinformation is disseminated by medical doctors, medical experts/spokespeople and the government.
However, a further objective voice, or what appears to be an objective voice, is yet another insurance policy. These voices take shape in the form of foundations, councils and organizations that serve as research and information dissemination operations. These operations include the American Cancer Society, the American Heart Association and the National Mental Health Association.
Under the guise of objectivity, these organizations serve as mouthpieces for medicine. Virtually every health-oriented group in this category receives financial support from the medical industry, although every president, CEO and director of any one of these organizations will deny any conflict of interest exists in spite of drug company support.
While researching my book, The Drug Lords ... America's Pharmaceutical Cartel, I came across countless examples of this practice. Here are two examples:
1. Ciba Geigy played a significant role in the development of specific educational materials surrounding the issue of children with ADD (attention deficit disorder) and ADHD (attention deficit hyperactivity disorder). The common treatment is Ritalin, which is manufactured by Ciba Geigy. In a mid-1990s television special, a report questioned the drug manufacturer's donation to CHADD, a support group for ADD and ADHD sufferers and their families. Geigy donated $800,000 to the organization. CHADD literature in turn demonstrated an overwhelming support for Ritalin in the treatment of attention deficit disorder.
Ciba Geigy has also enjoyed government support in the form of a U.S. Department of Education video that evidenced strong support of Ritalin for the same disorders in spite of Ritalin's known side effects, including addiction.
2. Eli Lilly sponsored a promotional campaign designed to reach 93 percent of American adults. According to a Wall Street Journal article (April 15, 1993), Eli Lilly paid between $3-4 million for a National Mental Health Association (NMHA) three-week promotional blitz. The goal was to encourage the public to seek professional help for depression. Eli Lilly, the manufacturer of Prozac, also gave the NMHA nonprofit organization $500,000 to conduct a nine-month public education program to identify potential candidates for treatment of depression.
Critics viewed this "public service" campaign as merely an avenue to gain new customers for Prozac, the world's best-selling antidepressant. The American Psychological Association pointed out that these public service ads direct people to consult their medical doctor if they believe they are suffering signs of depression. Psychologists, who generally can't prescribe medication, believe this advice ultimately leads people to their primary care physicians who are inclined to prescribe medication in lieu of the less invasive approach of therapy and lifestyle changes.
Eli Lilly and the NMHA objected to criticisms, contending that the ads were designed to encourage intervention, period, not just medical intervention. The NMHA stated that it endorses no product and that Eli Lilly is not mentioned in the main text of the ad (although the company is credited with paying for the advertisement).
Eli Lilly defended their participation in the promotion by saying that this type of campaign saves lives. The company also insists that these programs do not promote product. Critics say, however, the profit motive is not hard to discern. It's a profit motive masquerading as a public interest effort, a public service industry today.
About the author: Tonda Bian speaks on topics regarding the drug industry and is the author of The Drug Lords...America's Pharmaceutical Cartel, an expose' on the lack of marketing ethics throughout the drug industry and medicine's attempt to keep all forms of non-medical care non-competitive. The book is available through No Barriers Publishing, 1201. S. Westnedge Av., Kalamazoo, MI. 800/828-3057.
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