Friday, April 23, 2010

More nurses, less death | Philadelphia Inquirer | 04/20/2010

By Stacey Burling | Inquirer Staff Writer

Ten to 13 percent fewer surgical patients in New Jersey and Pennsylvania would die if hospitals in those states had as many nurses as California law requires, according to a University of Pennsylvania study published Tuesday.

The study of 1.1 million patients in 2005 and 2006 found that the nurse-to-patient ratios mandated in California could have saved the lives of 468 patients in New Jersey and Pennsylvania over a two-year period.

Linda Aiken, who led the study and directs the Center for Health Outcomes and Policy Research at Penn, said improved nurse staffing likely could save "many thousands a year" nationally.

The study was based on reports to states of deaths within 30 days of surgery and surveys completed by 22,336 nurses. It was published in the journal Health Services Research. Aiken said 18 states, including Pennsylvania, were considering legislation on nurse-staffing levels.

She decided to compare California to other states rather than look at what happened in California before and after the law so that people would see this as a broader issue. "What happens in California," she said, "is relevant for other parts of the country."

California became the first, and only, state to enforce minimum nurse-to-patient standards in 2004. For example, it says one nurse can be responsible for no more than five patients on a medical-surgical unit and two in an intensive-care unit.

Aiken's study found that, on average, nurses in California medical-surgical units cared for two fewer patients than nurses in New Jersey and 1.7 fewer than in Pennsylvania. It also found that nurses in California liked their jobs better and were less likely to feel burned out, an important finding because of the projected shortage of nurses.

Bills have been introduced in Pennsylvania that would either set minimum ratios or require hospitals to establish committees that would develop a "safe staffing plan" for nurses. New Jersey last year began requiring hospitals to report staffing ratios to the Department of Health and Senior Services.

Nurse-to-patient ratios are among the issues dividing 1,500 striking workers and their administrators at Temple University Hospital.

The strikers, who are nurses and allied professionals represented by PASNAP, the Pennsylvania Association of Staff Nurses and Allied Professionals, have proposed staffing requirements similar to those in California.

Patricia Eakin, PASNAP's president, said nurses often encountered staffing levels at Temple they considered "unsafe." The union has only one contract that includes staffing ratios, at Mercy Suburban Hospital in East Norriton.

When nurses have to care for too many patients, they may not be able to deliver pain drugs on time or keep a close enough eye on patients with troubling symptoms, Eakin said. It can take 90 minutes to stabilize one patient whose heart stops. "Then you're behind on everything else," she said. ...

Print: Disposable Soldiers

The mortar shell that wrecked Chuck Luther's life exploded at the base of the guard tower. Luther heard the brief whistling, followed by a flash of fire, a plume of smoke and a deafening bang that shook the tower and threw him to the floor. The Army sergeant's head slammed against the concrete, and he lay there in the Iraqi heat, his nose leaking clear fluid.

...

Doctors at Camp Taji's aid station told Luther he was faking his symptoms. When he insisted he wasn't, they presented a new diagnosis for his blindness: personality disorder.

"To be told that I was lying, that was a real smack in the face," says Luther. "Then when they said 'personality disorder,' I was really confused. I didn't understand how a problem with my personality could cause deafness or blindness or shoulder pain."

For three years The Nation has been reporting on military doctors' fraudulent use of personality disorder to discharge wounded soldiers [see Kors, "How Specialist Town Lost His Benefits," April 9, 2007]. PD is a severe mental illness that emerges during childhood and is listed in military regulations as a pre-existing condition, not a result of combat. Thus those who are discharged with PD are denied a lifetime of disability benefits, which the military is required to provide to soldiers wounded during service. Soldiers discharged with PD are also denied long-term medical care. And they have to give back a slice of their re-enlistment bonus. That amount is often larger than the soldier's final paycheck. As a result, on the day of their discharge, many injured vets learn that they owe the Army several thousand dollars.

According to figures from the Pentagon and a Harvard University study, the military is saving billions by discharging soldiers from Iraq and Afghanistan with personality disorder.

In July 2007 the House Committee on Veterans' Affairs called a hearing to investigate PD discharges. Barack Obama, then a senator, put forward a bill to halt all PD discharges. And before leaving office, President Bush signed a law requiring the defense secretary to conduct his own investigation of the PD discharge system. But Obama's bill did not pass, and the Defense Department concluded that no soldiers had been wrongly discharged. The PD dismissals have continued. Since 2001 more than 22,600 soldiers have been discharged with personality disorder. That number includes soldiers who have served two and three tours in Iraq and Afghanistan.

"This should have been resolved during the Bush administration. And it should have been stopped now by the Obama administration," says Paul Sullivan, executive director of Veterans for Common Sense. "The fact that it hasn't is a national disgrace."

On Capitol Hill, the fight is not over. In October four senators wrote a letter to President Obama to underline their continuing concern over PD discharges. The president, almost three years after presenting his personality disorder bill, says he remains concerned as well.

Veterans' leaders say they're particularly disturbed by Luther's case because it highlights the severe consequences a soldier can face if he questions his diagnosis and opposes his PD discharge.

Luther insisted to doctors at Camp Taji that he did not have personality disorder, that the idea of developing a childhood mental illness at the age of 36, after passing eight psychological screenings, was ridiculous. The sergeant used a vivid expression to convey how much pain he was in. "I told them that some days, the pain was so bad, I felt like dying." Doctors declared him a suicide risk. They collected his shoelaces, his belt and his rifle and ordered him confined to an isolation chamber.

Extensive medical records written by Luther's doctors document his confinement in the aid station for more than a month. The sergeant was kept under twenty-four-hour guard. Most nights, he says, guards enforced sleep deprivation, keeping the lights on and blasting heavy metal music. When Luther rebelled, he was pinned down and injected with sleeping medication.

Eventually Luther was brought to his commander, who told him he had a choice: he could sign papers saying his medical problems stemmed from personality disorder or face more time in isolation.

'Every Night It Was Megadeth'

Luther entered the Army in 1988, following in the footsteps of his grandfathers, both decorated World War II veterans. In 2005, after Hurricane Katrina, he and his unit were deployed to New Orleans, where he helped evacuate residents and dispose of bodies left in the street. In 2006 he was deployed from Fort Hood in Texas to Camp Taji, where he performed reconnaissance with the First Squadron, Seventh Cavalry Regiment, led by Maj. Christopher Wehri. "Luther was older and more mature than most of the soldiers. He was forthcoming, very polite," says Wehri. "He seemed to have a good head on his shoulders."

Doctors at the aid station didn't see him that way. Following the May 2007 mortar attack, Luther entered the base's clinic and described his concussion symptoms to Capt. Aaron Dewees. Dewees, a pediatrician charged with caring for soldiers in the 1-7 Cavalry, grew suspicious of Luther's self-report. "It is my professional opinion," Dewees wrote in his medical records, "that Sgt. Charles F. Luther Jr. has been misrepresenting himself and his self-described medical conditions for secondary gain." The doctor suggested that Luther was faking his ailments to avoid reconnaissance duty. He called the sergeant "narcissistic" and said Luther's descriptions of his injuries were a mixture of "exaggeration and flat-out fabrication."

Luther's medical records document severe nosebleeds and "sharp and burning" pain. Still, the sergeant says he could sense that his doctors didn't believe him. It was at that point--frustrated, plagued by blinding migraines--that he spoke of pain so severe he wished he were dead. "I made clear that I was not going to kill myself, that it was just a colorful expression to explain how much pain I was in." Dewees agreed. In their records, Luther's doctors note a "suicide gesture" and "'off-handed' comments" that the sergeant was going to kill himself, but Dewees said those gestures were "unlikely to have been a serious attempt" at self-harm. Nonetheless, Dewees wrote, such statements "must be taken seriously and treated as such," that Luther "remains a threat to himself and others given his need for attention, narcissistic tendencies and impulsive behavior."

Luther was taken to an isolation chamber and told this was his new sleeping quarters. The room, which Luther captured on his digital camera, served as a walk-in closet. It was slightly larger than an Army cot and was crammed with cardboard boxes, a desk and a bedpan. Through a small, cracked window, he could look out onto the base. Through the open doorway, the sergeant was monitored by armed guards. ...

Military's health care costs booming - USATODAY.com

By Gregg Zoroya, USA TODAY

WASHINGTON — Military health care spending is rising twice as fast as the nation's overall health care costs, consuming a larger chunk of the defense budget as the Pentagon struggles to pay for two wars, military budget figures show.

The surging costs are prompting the Pentagon and Congress to consider the first hike in out-of-pocket fees for military retirees and some active-duty families in 15 years, said Rear Adm. Christine Hunter, deputy director of TRICARE, the military health care program.

Pentagon spending on health care has increased from $19 billion in 2001 to a projected $50.7 billion in 2011, a 167% increase.

The rapid rise has been driven by a surge in mental health and physical problems for troops who have deployed to war multiple times and by a flood of career military retirees fleeing less-generous civilian health programs, Hunter said.

ELECTION 2010: Some Dems get boost after health vote

PUBLIC: How health care will change

Total U.S. spending on health care has climbed from nearly $1.5 trillion in 2001 to an estimated $2.7 trillion next year, an 84% increase.

As a share of overall defense spending, health care costs have risen from 6% to 9% and will keep growing, said Navy Lt. Cmdr. Kathleen Kesler, a Pentagon spokeswoman.

That upward trend is "beginning to eat us alive," Defense Secretary Robert Gates told Congress in February.

In addition to mental issues, multiple combat tours have created more strains on joints, backs and legs, Pentagon statistics show. Medical visits for such problems rose from 2.8 million in 2005 to 3.7 million in 2009.

Behavioral-health counseling sessions for troops and family members rose 65% since 2004. The Pentagon paid for 7.3 million visits last year — treatment of 140,000 patients each week, according to TRICARE numbers.

Other factors driving up costs:

• Many new patients are children suffering anxiety or depression because of a parent away at war. Children had 42% more counseling sessions last year than in 2005, TRICARE numbers show.

• The number of TRICARE beneficiaries has grown by 370,000 in the past two years to 9.6 million troops, family members and military retirees.

• Nearly 200,000 prescriptions were filled each day at civilian pharmacies last year.

Active-duty troops and their families receive free health care except for out-of-pocket co-payments of $3 or $9 per prescription at civilian pharmacies.

Retirees receive the same benefits by paying $230 a person or $460 a family each year, along with small co-payments for various types of care. The fees have not gone up since 1995. By contrast, private insurance plans try to limit expenses with frequent increases in premiums and copayments ...

Jeffrey Smith: Genetically Modified Soy Linked to Sterility, Infant Mortality in Hamsters

"This study was just routine," said Russian biologist Alexey V. Surov, in what could end up as the understatement of this century. Surov and his colleagues set out to discover if Monsanto's genetically modified (GM) soy, grown on 91% of US soybean fields, leads to problems in growth or reproduction. What he discovered may uproot a multi-billion dollar industry.

After feeding hamsters for two years over three generations, those on the GM diet, and especially the group on the maximum GM soy diet, showed devastating results. By the third generation, most GM soy-fed hamsters lost the ability to have babies. They also suffered slower growth, and a high mortality rate among the pups.

And if this isn't shocking enough, some in the third generation even had hair growing inside their mouths—a phenomenon rarely seen, but apparently more prevalent among hamsters eating GM soy.

The study, jointly conducted by Surov's Institute of Ecology and Evolution of the Russian Academy of Sciences and the National Association for Gene Security, is expected to be published in three months (July 2010)—so the technical details will have to wait. But Surov sketched out the basic set up for me in an email. ...

...

Preliminary, but Ominous

Surov warns against jumping to early conclusions. He said, "It is quite possible that the GMO does not cause these effects by itself." Surov wants to make the analysis of the feed components a priority, to discover just what is causing the effect and how.

In addition to the GMOs, it could be contaminants, he said, or higher herbicide residues, such as Roundup. There is in fact much higher levels of Roundup on these beans; they're called "Roundup Ready." Bacterial genes are forced into their DNA so that the plants can tolerate Monsanto's Roundup herbicide. Therefore, GM soy always carries the double threat of higher herbicide content, couple with any side effects of genetic engineering.

Years of Reproductive Disorders from GMO-Feed

Surov's hamsters are just the latest animals to suffer from reproductive disorders after consuming GMOs. In 2005, Irina Ermakova, also with the Russian National Academy of Sciences, reported that more than half the babies from mother rats fed GM soy died within three weeks. This was also five times higher than the 10% death rate of the non-GMO soy group. The babies in the GM group were also smaller (see photo) and could not reproduce.

In a telling coincidence, after Ermakova's feeding trials, her laboratory started feeding all the rats in the facility a commercial rat chow using GM soy. Within two months, the infant mortality facility-wide reached 55%.

When Ermakova fed male rats GM soy, their testicles changed from the normal pink to dark blue! Italian scientists similarly found changes in mice testes (PDF), including damaged young sperm cells. Furthermore, the DNA of embryos from parent mice fed GM soy functioned differently.

An Austrian government study published in November 2008 showed that the more GM corn was fed to mice, the fewer the babies they had (PDF), and the smaller the babies were.

Central Iowa Farmer Jerry Rosman also had trouble with pigs and cows becoming sterile. Some of his pigs even had false pregnancies or gave birth to bags of water. After months of investigations and testing, he finally traced the problem to GM corn feed. Every time a newspaper, magazine, or TV show reported Jerry's problems, he would receive calls from more farmers complaining of livestock sterility on their farm, linked to GM corn.

Researchers at Baylor College of Medicine accidentally discovered that rats raised on corncob bedding "neither breed nor exhibit reproductive behavior." Tests on the corn material revealed two compounds that stopped the sexual cycle in females "at concentrations approximately two-hundredfold lower than classical phytoestrogens." One compound also curtailed male sexual behavior and both substances contributed to the growth of breast and prostate cancer cell cultures. Researchers found that the amount of the substances varied with GM corn varieties. The crushed corncob used at Baylor was likely shipped from central Iowa, near the farm of Jerry Rosman and others complaining of sterile livestock. ...

Thursday, April 22, 2010

Exclusive: WellPoint routinely targets breast cancer patients | Reuters

Exclusive: WellPoint routinely targets breast cancer patients | Reuters

(Reuters) - One after another, shortly after a diagnosis of breast cancer, each of the women learned that her health insurance had been canceled. First there was Yenny Hsu, who lived and worked in Los Angeles. Later, Robin Beaton, a registered nurse from Texas. And then, most recently, there was Patricia Relling, a successful art gallery owner and interior designer from Louisville, Kentucky.

None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.

The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.

That tens of thousands of Americans lost their health insurance shortly after being diagnosed with life-threatening, expensive medical conditions has been well documented by law enforcement agencies, state regulators and a congressional committee. Insurance companies have used the practice, known as "rescission," for years. And a congressional committee last year said WellPoint was one of the worst offenders.

But WellPoint also has specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies, federal investigators told Reuters. The revelation is especially striking for a company whose CEO and president, Angela Braly, has earned plaudits for how her company improved the medical care and treatment of other policyholders with breast cancer.

The disclosures come to light after a recent investigation by Reuters showed that another health insurance company, Assurant Health, similarly targeted HIV-positive policyholders for rescission. That company was ordered by courts to pay millions of dollars in settlements.

In his push for the health care bill, President Barack Obama said the legislation would end such industry practices. Making the case for reform in a September address to Congress, Obama specifically cited the cancellation of Robin Beaton's health insurance. Aides to the president, who requested they not be identified, told Reuters that no one in the White House knew WellPoint was systematically singling out breast cancer patients like her.

Many critics worry the new law will not lead to an end of these practices. Some state and federal regulators -- as well as investigators, congressional staffers and academic experts -- say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.

"People have this idea that someone is going to flip a switch and rescission and other bad insurance practices are going to end," says Peter Harbage, a former health care adviser to the Clinton administration. "Insurers will find ways to undermine the protections in the new law, just as they did with the old law. Enforcement is the key."

In a statement to Reuters, WellPoint said various specified criteria trigger rescission investigations, including certain types of medical claims. The company said it changed its rescission practices to ensure they are handled appropriately after a 2006 review of its policies prompted by public concern over rescission. ...

Tuesday, April 20, 2010

Dana Ullman: How Scientific Is Modern Medicine Really?

...

Are Our Children and Elders Safe? Not at all.

We all want drugs given to infants to be as safe as possible, but mothers and fathers will be surprised and perhaps shocked to know that very few drugs are ever tested on infants. A 2007 study of over 350,000 children found that a shocking 78.7 percent of children in hospitals are prescribed drugs that the FDA has not even approved for use in children (Shah, Hall, Goodman, et al, 2007). If this isn't shocking enough, a survey in England found that 90 percent of infants were prescribed drugs that were not tested for safety or efficacy in infants (Conroy, McIntyre, Choonara, 1999).

There is almost a 350 percent increase in adverse drug reactions in children prescribed an off-label drug than children who were prescribed a drug that had been tested for safety and efficacy (Horen, Montastruc, and Lapeyre-mestre, 2002). Doctors are committing "medical child abuse" on a regular basis (I wrote a more detailed article about this subject, here).

...

Big Pharma, Big Bucks, and the Guise of Science

... The good news about conventional medicine and one of its remarkable features for which it should be honored is its history of consistently and repeatedly disproving its own treatments. The fact that only a handful of conventional drugs have survived 30 or more years is strong testament to the fact that conventional medicine is honorable enough to acknowledge its mistakes. But then again, because drug patents only last for a certain limited period of time, there are real substantial benefits when drugs have a relatively short lifespan. Big Pharma can charge big money during this time-frame, and then, let go of it when it goes off-patent, at which time a new, high-priced drug is conveniently developed to replace it. Like the fashion industry, medical fashion changes with rapidity, supporting a powerful economic arms race.

In 2002, the combined profits ($35.9 billion) of the 10 largest drug companies in the Fortune 500 were more than the combined profits ($33.7 billion) of the remaining 490 companies together (Angell, 2004, 11).

The only reason these drug companies did not maintain this shocking financial advantage is that the oil companies' profits have increased considerably with the Iraq War, thus raising the 490 non-drug companies' profits slightly higher. But then again, one would assume that the profits of 490 of the largest companies in the world would be substantially more than just 10 companies in one commercial field.

...

Drug companies defend their large profits by asserting that they spend tremendous amounts of money on research and development, but they tend to hide the fact that they spend approximately three times more money on marketing and administration. And the obscenely high profits of the drug companies take into account all known expenses. Ultimately, drug companies are wonderfully creative in convincing us all that their drug treatments are "scientific," and too many of us actually believe them. ...

Dana Ullman

Expert in homeopathic medicine

Posted: April 20, 2010 08:41 AM

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Doctors today commonly assert that they practice "scientific medicine," and patients think that the medical treatments they receive are "scientifically proven." However, this ideal is a dream, not reality, and a clever and profitable marketing ruse, not fact.

The British Medical Journal's "Clinical Evidence" analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found:

• 13 percent were found to be beneficial

• 23 percent were likely to be beneficial 13 percent were found to be beneficial

• Eight percent were as likely to be harmful as beneficial

• Six percent were unlikely to be beneficial

• Four percent were likely to be harmful or ineffective.

• 46 percent were unknown whether they were efficacious or harmful

In the late 1970s, the US government conducted a similar evaluation and found a strikingly similar result. They found that only 10 percent to 20 percent of medical treatment had evidence of efficacy (Office of Technology Assessment, 1978).

Doctors like to point to the "impressive" efficacy of their treatments in real serious diseases, like cancer, and doctors (and drug companies) are emphatic about asserting that anyone or any company that says (or even suggests) that they have a treatment that might help people with cancer are "quacks." However, do they maintain this same standard when evaluating their own treatments? Even a recent issue of Newsweek highlighted the fact that "We Fought Cancer, and Cancer Won" (Begley, 2010). Despite the truly massive amounts of money that doctors, hospitals and drug companies are effectively extracting from patients, employers, insurance companies and governments, we are certainly not getting our money's worth.

Even when there is "proven efficacy of treatment" in studies, the bigger question is how common is this proven efficacy utilized in medical care today? Be prepared to be shocked.

"Quackery" is commonly defined as the use of unproven treatments by individuals or companies who claim fantastic results and who charge large sums of money. Although modern physicians may point their collective finger at various "alternative" or "natural" treatment modalities as examples of quackery, it is conventional medical treatments today that are out-of-this-world expensive, and despite real questionable efficacy of their treatments, doctors give patients the guise of "science."

I certainly realize that many of us have benefited greatly from modern medicine, but I also realize that many of us have been hurt greatly from it too. The challenge for all of us is to determine how can we make modern medicine more "scientific," more effective and more safe. I have previously made clear that my own point of view on this subject is that we must develop a more "integrative model" of medicine and healing and that we should utilize various naturopathic and homeopathic methods as a way to honor the Hippocratic tradition of "First, do no harm."

Sadly, however, it seems that too few doctors understand or respect this Hippocratic dictum.

Today in America, every man, woman, and child is prescribed around 13 prescription drugs per year (and this doesn't count the many over-the-counter drugs that doctors prescribe and that patients take on their own) (Kaiser, 2006). Just 12 years earlier, Americans were on average prescribed less than eight drugs per person, a 62 percent increase! The fact of the matter is that drugs are not tested for approval in conjunction with other drugs, and the safety and efficacy of the use of multiple drugs together remains totally unknown.

This practice of "polypharmacy" is increasing substantially, and Big Pharma is pushing it hard and benefiting from it in a big big way.

According to a 2008 nationwide survey, 29 percent of Americans used at least five prescription medications concurrently (Qato, Alexander, Conti, 2008), while just three years previously, 17 percent took three or more prescription drugs (Medscape, 2005). Even conservative publications such as Scientific American can no longer deny the increasing serious problems from pharmaceuticals. A recent article highlighted the fact that there has been a 65 percent increase in drug overdoses leading to hospitalization or death just in the past seven years (Harmon, 2010).

Are Our Children and Elders Safe? Not at all.

An even stronger case can be made for the epidemic of "elder medical abuse" due to the much larger number of drugs prescribed to and for our senior citizens. It is no wonder that so many of them have become mental zombies, while Big Pharma profits big time and insurance companies simply raise their rates.

If we were living a lot longer and the quality of our lives was improved by medical care, one could make a case for why today's medical care is providing more benefits than problems, but this is simply not true.

Although we are commonly told that we are living longer than ever now, this is simply a clever, even tricky, use of statistics. The fact of the matter is that there has been a considerable reduction in deaths during the first five years of life ... and this reduction in deaths has resulted primarily from a medicinal agent called "soap," not from the use of any specific conventional pharmaceutical agent.

Ultimately, an American who was 40 years old in 1900 and an American who was 40 years old in 2000 has a similar chance of living to 80 years old today.

Big Pharma, Big Bucks, and the Guise of Science

Adherents of conventional medicine have consistently asserted that its methods are scientifically verified, and they have ridiculed other methods that are suggested to have therapeutic or curative effects. In fact, conventional physicians have consistently worked to disallow competitors, even viciously attacking those in their own profession who have questioned conventional treatments or provided alternative modalities. More recently, medical organizations simply work with insurance companies to help them determine what should and shouldn't get reimbursed, a clever way to kill competition bloodlessly.

And yet, strangely enough, whatever has been in vogue in conventional medicine in one decade has been declared ineffective, dangerous and sometimes barbaric in the ensuing decades. Surprisingly, despite this pattern in history, proponents and defenders of "scientific medicine" tend to have little or no humility, continually asserting that today's cure is truly effective ... and in any case, strongly asserting that any "alternatives" to this ever-changing treatment are quackery, sheer quackery, whether they know anything about these alternative treatment modalities or not.

The good news about conventional medicine and one of its remarkable features for which it should be honored is its history of consistently and repeatedly disproving its own treatments. The fact that only a handful of conventional drugs have survived 30 or more years is strong testament to the fact that conventional medicine is honorable enough to acknowledge its mistakes. But then again, because drug patents only last for a certain limited period of time, there are real substantial benefits when drugs have a relatively short lifespan. Big Pharma can charge big money during this time-frame, and then, let go of it when it goes off-patent, at which time a new, high-priced drug is conveniently developed to replace it. Like the fashion industry, medical fashion changes with rapidity, supporting a powerful economic arms race.

This economic information is important, even essential, because learning how to separate the "science" of medicine from the business of medicine has never been more difficult. The combined efforts of the drug companies and the medical profession, which together may be called the "medical-industrial complex," have been wonderfully effective in convincing consumers worldwide that modern medicine is the most scientific discipline that has ever existed.

Physicians today rarely run drug companies. Instead, businessmen run them. It is, therefore, not surprising that Marcia Angell, MD, a Harvard professor of medicine and former editor of the famed New England Journal of Medicine, wrote:

Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs ... Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself. (Levi, 2006)

There is big big money to be made in drug sales, and brilliant marketing has led too many of us to ignore or excuse this bully side of medicine.

The New York Times recently uncovered the fact that Pfizer admitted to paying $20 million in the last six months of 2009 alone to 4,500 doctors to "consultation" and to speak on their behalf (and this doesn't include payments to doctors outside of the US) (Duff, 2010). It seems to be time to stop calling them "drug companies" and call them "drug pushers."

Yes, a gorilla is in the house, but anyone who refers to him as a gorilla is usually called a quack or a crank. This gorilla was not born yesterday; he has been growing for generations. A part of his self-defense propensities is to eliminate competing forces, whether the other side seeks cooperation or not. Any competitive force is frequently and soundly attacked.

The history of homeopathy shows this dark side of medicine. From 1860 to the early 20th century, the AMA had a consultation clause in its code of ethics that members were not allowed to consult with a medical doctor who practiced homeopathy and weren't even allowed to treat a homeopath's patients. At a time in medical history when doctors bloodlet their patients to death and regularly prescribed mercury and various caustic agents to sick people, the only action that the AMA considered reprehensible and actionable was the "crime" of consulting with a homeopath.

In fact, the entire Medical Society of New York was kicked out of the AMA in 1881 simply because this state's medical organization admitted into its membership any medical doctors who utilized homeopathic medicines, no matter what their academic credentials were. They only rejoined the AMA 25 years later (Walsh, 1907, 207).

This King Kong, however, is not a monster to everyone. In fact, this big gorilla is wonderfully generous to executives, to large sales and marketing forces, to supportive politicians and to the media from whom he buys substantial amounts of advertising (and thus, an incredible amount of positive media coverage). And this gorilla is wonderfully generous to stockholders. While it may seem inappropriate to criticize profits, it is important and appropriate to do so when profits are unbelievably excessive, when long-term efficacy hasn't stood the test of time, and when common use of more than one drug at a time is rarely if ever scientifically tested for efficacy.

Although these observations just mentioned may seem harsh and offensive to some people, they are made with the concurrent acknowledgment that most of us know someone whose life was saved or at least whose health was significantly restored by conventional medical treatments. I myself am the son of a fabulous father who was a physician and insulin-dependent diabetic. In other words, I would not be alive today if it were not for some important conventional medical discoveries such as insulin.

We should not "throw the baby out with the bathwater," nor do we want to ignore the bathwater in which we place our babies. Most of us also know someone whose health has been seriously hurt, or whose life was cut short, by modern medical treatments.

It is therefore important to understand what is truly meant when drug companies and the media assert that drugs are "scientifically proven."(to be discussed in PART II)

(NOTE: This article focuses on the issue of the amount of "science" in medical care today. I predict that many commenters below will choose to attack me or the subject of homeopathy, even though THIS is not the subject of this article. I sincerely hope that commenters will stick to the subject at hand. For those of you who wish to comment on homeopathic medicine research, I urge you to do so at articles on that subject.)

References
Angell, M. The Truth about Drug Companies. New York: Random House, 2004. This fact is extremely startling, but the source is reputable: Marcia Angell, MD, is former editor of the New England Journal of Medicine.

Begley, Sharon. "We Fought Cancer, and Cancer Won," Newsweek, September 15, 2008.http://www.newsweek.com/id/157548

BMJ, 2007. http://clinicalevidence.bmj.com/ceweb/about/index.jsp;http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp

Conroy S, McIntyre J, Choonara I. Unlicensed and off label drug use in neonates. Archives of Disease in Childhood - Fetal and Neonatal Edition 1999;80:F142-F145. doi:10.1136/fn.80.2.F142

Consumer Reports, "High Anxiety." January 1993, 19-24.

Darwin, F. (ed.). The Life and Letters of Charles Darwin. New York, D. Appleton & Co., 1903.

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