There are lots of things you can think of, in passing, or even for a sixty-minute Nightline episode, form a brief opinion on, and then forget about, when you have the luxury of being relatively healthy. But, those things take a central role in your life when your life is dominated by doctor’s appointments, prescription management, and referrals. Life looks different. So,let’s have a heart-to-heart about “big pharma,” for a minute. I’ve mentioned it before; but, let’s delve into a kinda boring topic.
It’s a term that gets thrown around loosely, as if there’s a boogey man out there that is menacingly lurking in the corner of your doctor’s office, sneakily dipping his fingers into your medical treatment, like a Svengali, made of money. While I’m not naïve, and there is a business to medicine, the small-fry patient-doctor relationship is not as adversely affected as I think people want to believe.
When we are truly sick, or chronically sick, we want to blame someone, anyone, or anything for why it’s so. We are angry that no one’s listening to us, or that no one has listened to us for so long. We believe that there are cures out there that are being kept from us, being held back for more profitable ones, or medications being sold to us, instead of being prescribed. This is especially easy to believe when we are sick with something chronic, or with something incurable. It’s easy to feel betrayed by a system that hasn’t felt like it was on our side, when tests weren’t ordered, or results not delivered. That’s why it’s so easy to believe that cancer can be cured by baking soda, or that not your doctor, but some doctor has the key to a cure locked away somewhere, but won’t reveal it, for lack of profits to “big pharma.”
But, when we backup a second and realize that, at the core of a doctor-patient relationship are two people, the idea of an amorphous, threatening indistinguishable and intangible force is difficult to believe. I have a hard time believing that, when I look into the eyes of my doctor, who’s watched me cry, that he doesn’t want what’s best for me. Last weekend, he put his newborn daughter down, when we called him after-hours for help. This is the same newborn daughter for whom he dropped all pretense of “doctor,” during our last appointment, showing me dozens of pictures on his phone. I have a difficult time believing that he’s being secretly manipulated by a cloaked figure called “big pharma.” All of these same doctors that you may want to believe are being manipulated have real daughters (sons, wives, parents) and are real people too; I just can’t personalize them like my doctor because I don’t know them.
I read, all the time, especially on message boards, every time someone gets prescribed a new medication, how it’s probably because a doctor was most likely getting a kickback from that pharmaceutical company, not because he was motivated by patient care. I’d rather not believe that there is a large portion of doctors (or humans!) out there, that would put the health of their patients beneath a free cruise, or a second home. That’s not so simple as insulting someone; it’s cruelty at its basest form. It’d be like telling you that you’d rather collect grocery bonus points on peanut butter, putting your name in the hat for a chance at a sweepstakes trip to the Bahamas, than worry about the fact that your kid is allergic to nuts. “Let them eat cake!” Right? ***
There’s a really amazing website, called Open Payments Data, which allows you to put in your doctor’s name to look up, down to the penny, exactly what pharmaceutical companies have given them money, and for what purposes. I’ve yet to come across any doctor, personally, in any specialty, that has had more than $2,500 of pharmaceutical “influence” per year. Phew. They are practically shills, right? Of course, here's the rub, you have to trust the "government," if you want to trust this site, because it's a .gov site. Don't get me started on you guys, who refuse to trust that.
Although, one of my surgeons made a pretty penny last year from a company called Medtronic, and by “pretty penny,” I mean around $50K. So, I looked up what it means to make money under the heading “licensing.” It turns out that his expertise lead to a breakthrough in his field, and they are paying him for use of his new procedure and equipment, similar to a trademark, or patent. And, they have him lecturing on its potential application in spinal injury and paralysis patients. Having this data lets you ask the right questions, not assume that doctors are automatically been given money from a conglomerate. We want our doctors on the cutting edge, researching, and staying current, but we want them to do it for free? That seems unfair.
In 2013, the article, “The $1M Mistake” was published. It tried to shake our preconceived idea that doctors are the financial elite. In fact, it shed light on the fact that doctors are, mostly, underpaid and their time undervalued. The notion that they start med school wide-eyed and driven to help their fellow-man, but somewhere along the way, take a class about Bentleys and McMansions and fall prey to double-booking patients and the allure of “big pharma” shilling, in order to satisfy their greed is insanity. It turns out that while a doctor might make more than, say, a line-worker, they don’t make the money we think they make, especially considering the education, training, and long hours they work. A patient’s perception of us versus them, rich versus poor, elite versus working, is just another barrier between people helping people, and between people being people, together.
Okay, stepping down from my soapbox now. I have an exciting and weird story to tell you guys tomorrow about Collin's visit to the "therapist," we finally found for him. If I can get my ducks together to type about it today and tomorrow morning. Ducks are so hard to line up. They are always getting feathers and poop everywhere. Plus, the quacking. Dear God, the quacking!
***The Marie Antoinette story about her saying “Qu’ils mangent de la brioche,” which translates to “let them eat cake,” is likely fabricated. According to historians, that line has been attributed to several other women, including Marie Therese. The fact that Marie Antoinette was soft-hearted, and donated often to the poor, and to charity, seems to have been forgotten, and her legacy has lived on in a misquote (probably because she was still aristocracy!).
P.S. I knew I minored in French for a reason. I could translate that French sentence! Don’t let anyone tell you that a French degree is useless! I was also able to order croissants and crepes in Paris, with minimal trouble. And, asking for bathrooms? Forget it! Pas de problem!