A Bitter Pill to Swallow: The Erosion of Trust

If my 35-year marketing career taught me anything, it was the reality of “back room” deals…from large, influential clients angling for better rates to physicians being courted by drug manufacturers with all-expenses-paid trips to the Caribbean. I cover more of this topic in my book — and it’s an evolving topic. Corruption usually gets shut down when it becomes problematic, but it soon finds a new way in.

As a 50-something Canadian born at the height of the baby-boom, I’m keenly aware that our aging population is going to hit an already weak healthcare system like a tsunami. We’re ill prepared, pun intended. In the midst of this storm, “trust” between patient and health care provider is either going to disappear altogether, or become increasingly valuable. I don’t mean the kind of blind trust that my parents offered to their physicians – that’s a societal dynamic that is unlikely to return post-Internet. I mean a trust engendered and bolstered through knowledge, peer review (listening to each other), and awareness of the potential shenanigans going on behind the scenes. One thing the Internet has proven to be extremely useful for is promoting transparency. Whether you like it or not, the digital highways are jammed with people trying to be heard as individuals over the collective din. Our stories have begun to surface, and to matter more, and to make a difference.

One of the biggest problems arises when the reward system creates a conflict of interest. Does your physician have your best interests at heart if he’s getting a kick-back every time he prescribes a certain medication? In some cases yes, in some cases no. But in either case, how would the average patient even know? And should they care? Let’s face it, whenever a new drug is introduced to the market, no matter how well it performed in clinical research, it remains an unknown for decades, or until the number of people using it have lived long enough to prove that it has no serious long-term adverse events. That’s medical talk for “If it didn’t kill a lot of you after all this time, it’s probably as good as we thought it was.”

Don’t be mindless, be aware. I encourage you to listen to this young woman, who thinks that physicians should declare their associations with drug makers to their patients. Her TED.COM presentation is called “What Your Doctor Won’t Disclose“, and it’s a very enlightening 15 minutes. This morning, The New York Times ran an article called “Using Doctors With Troubled Pasts to Market a Painkiller“, which reveals an even more disturbing practice of exploitation and nepotism within the ranks of high-prescribers and marketers.

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