The quality of the American medical system has deteriorated to such a point that if the Doctors are not the grifters they may at least be culpable for enabling the grift.
Why? Because of a pyramid scheme.
That might not be a direct "lie," but it is misleading. Doctors mislead constantly. They tend to accept norms that are harmful because they are systems outside of their control.
Would you be better off with no dental work or healthcare? Zero harm is being done in this case IMO.
If Im alone in the desert dying, I dont think others are harming me for my lack of water and food. That is simple neutrality and indifference.
Better preventative medicine and proactive treatment is one of the perks of having good insurance, so I would expect a recommendation from a good dentist to take it into account.
Ideally there is some discussion, but at the same time, the idea that someone with great insurance would want to use it seems a reasonable assumption.
Meet Dr. Stella Immanuel who tells her patients that medications are made from alien DNA and that their illnesses are caused by demon sperm. In the USA she gets to keep her medical license/practice. (https://en.wikipedia.org/wiki/Stella_Immanuel)
See also: every doctor that accepted bribes from Purdue Pharma in exchange for knowingly prescribing excessive amounts of opioids to people who never needed them.
The fact that they exist doesn't bother me. Some will always exist. What matters is how common it is and what the average experience is.
I don't think most doctors treat their patients the same as Stella Immanuel. Same for the two doctors that perdue was convicted of bribing
One thing that the article touched on that I like is the role of non-industry associations, which I think could do a lot more to spread information. However, there's no one that will pay them to do it.
You aren't at all worried that paying those doctors will result in them prescribing something to a patient when they might not have otherwise or influence their choice for one option over another? I'm not talking about the education or awareness a doctor might get, purely the influence of the money/benefits and perhaps their hope to get more of the same from you later.
At a high level, companies actually think their products have value to patients and want doctors to know about what it can do. It is virtually impossible to decouple knowledge sharing from influence. The point of knowledge sharing is to impact choice and behavior.
On the services front, If I want to hire a doctor to fly across the country and do Brian surgery on a pig or cadaver, I expect to have to pay them. Similarly, if they are running a clinical trial, I expect to fly them to the surgical training and feed them, and pay for their time.
>purely the influence of the money/benefits and perhaps their hope to get more of the same from you later.
Direct kickbacks for prescriptions are a thing of the past. It is pretty hard to come up with a situation where future benefits is conditional on the behavior. Like, I suppose you wouldn't invite a doctor that doesnt use your product to give feedback on it or be part of a clinical trial, but that is a niche feedback to worry about.
Lastly, articles like are very misleading when it comes to the details. In their reference for $2B in payments [1], includes things like Royalties.
>The greatest proportion (27.3%) of value was from royalty or license payments (≈$484 million of $1.8 billion) followed by service fees (26.6%), such as faculty lectures ($472 million of $1.8 billion).
If they are claiming paying royalty or license payments for inventions (like developing a hip implant) are a kickback, it frames the whole argument as rhetoric.
Direct kickbacks were an actual problem decades ago. That has long been “solved” all the way to the typical over correction the industry is known for.
The same holds true for the opioid epidemic and folks still thinking pill mills and the medical industry as a whole are the primary way folks get hooked.
It’s fighting last decades battles that have long since moved on. The zeitgeist seems to “stick” each generation and does not seem to keep up with current reality.
Perdue engaged in criminal actions, but it did not cause the epidemic. It is just a small part of the story. Deceitful labeling and aggressive marketing of OxyContin in the 90's has zero bearing on people dying from fentanyl laced weed in 2024.
I think the biggest factor in all of this misinformation is a human desire to compress the complexity of life into simple soundbite narratives that make sense.
The more emotionally charged or pressing an issue is, the greater the human desire is to think/feel like they have it all figured out. Even if that means sacrificing truth.
Humans have a compulsion to categorize and explain everything they encounter. Failure to do so is cognitively painful so anything too difficult is simplified until it "makes sense".
In my opinion, this compulsion is at the heart of all human problems, but also all of our achievements.