Book References Archives

Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Comments?
Misty L. Trepke
http://www.searching-alternatives.com

The hidden big business behind your doctor's diagnosis
By Susan Kelleher and Duff Wilson · Seattle Times staff reporters

http://seattletimes.nwsource.com/html/health/sickintro.html

You walk into your doctor's office for a physical exam and step on
the scale. Last year, the doctor said you were overweight. Now he
says you are obese - at the same weight.

A nurse takes your blood pressure. You have hypertension - with the
same previously healthy reading you've had for years.

The doctor scans your wrist bone. You have a condition
called "osteopenia" - with the same bone density that was fine last
time you were measured.

You mention you are not enjoying sex as much as you used to.
Diagnosis: a new kind of sexual dysfunction.

You leave the office with a head full of worry and a fistful of new
prescriptions, joining more than 40 percent of Americans who take one
or more prescribed drugs daily in the effort to stave off more
serious trouble.

You are suddenly sick, simply because the definitions of disease have
changed. And behind those changes, a Seattle Times examination has
found, are the companies that make all those newly prescribed pills.

The Times found that:

. Pharmaceutical firms have commandeered the process by which
diseases are defined. Many decision makers at the World Health
Organization, the U.S. National Institutes of Health and some of
America's most prestigious medical societies take money from the drug
companies and then promote the industry's agenda.

. Some diseases have been radically redefined without a strong basis
in medical evidence.

. The drug industry has bolstered its position by marketing directly
to the health-conscious consumer, leading younger and healthier
people to consider themselves at risk and to start taking medications.

Every time the boundary of a disease is expanded - the hypertension
threshold is lowered by 10 blood-pressure points, the guideline for
obesity is lowered by 5 pounds - the market for drugs expands by
millions of consumers and billions of dollars.

The result? Skyrocketing sales of prescription drugs. Soaring health-
care costs. Escalating patient anxiety. Worst of all, millions of
people taking drugs that may carry a greater risk than the underlying
condition. The treatment, in fact, may make them sick or even kill
them.

Dartmouth Medical School researchers estimate that during the 1990s,
tens of millions more Americans were classified as having
hypertension, high cholesterol, diabetes or obesity simply because
the definitions of those diseases were changed.

Today, three of every four Americans technically have at least one of
those diseases. But millions of them are not truly sick and may never
be, even without medication. The Dartmouth researchers said it was
unknown whether those people would benefit from early detection and
treatment, while it is "an open question" whether branding them
diseased and feeding them drugs may be causing significant physical
or psychological harm.

The medical profession's term for these people is "the worried well."
They are otherwise healthy people who have risk factors, such as high
blood pressure or high cholesterol, but may never suffer a heart
attack or stroke.

Dr. Alfred Berg, chairman of family medicine at the University of
Washington and a past chairman of a federal task force that fights
drug-industry influence on disease and treatment guidelines, said the
best advice for many people at risk of so-called "lifestyle diseases"
is to simply change their lifestyles.

"Diet and exercise and righteous living - but nobody wants to hear
that," Berg said.

Instead, he says, a "commercial prevention" industry has emerged,
focused on selling drugs to people who don't really need them but who
can pay for them.

"We have a system that nobody but Big Pharma is happy with," says Dr.
John Kitzhaber of The Foundation for Medical Excellence in Portland,
who was Oregon's governor from 1995 to 2003.

But the drug companies can't do it alone. They need, and receive,
support from much of the world's medical establishment.

Treatment guidelines established by international and national health
organizations instruct physicians on diagnosis and treatment of
disease and are meant to be scientifically pristine. But many of
those groups lack any process for preventing or disclosing conflicts
of interest.

The Times found that for a broad spectrum of diseases, the experts
writing the treatment guidelines had drug-company ties ranging from
research contracts to consultancies to stock ownership.

Berg's group, the U.S. Preventive Services Task Force, flatly
prohibits any conflicts of interest, either in money or previous
research. As a result, it is consistently more conservative in its
recommendations than other medicalguideline-writing groups and pushes
fewer drugs.

Dr. H. Gilbert Welch, a Dartmouth medical professor and editor of
Effective Clinical Practice, a journal of the American College of
Physicians, agrees that his profession shares the blame for what he
sees as an overdose of preventive medicine.

The problem begins, he said, with the expanding definitions of
disease.

"You can't tell me that three-quarters of my population is sick
before I start," he said. "That just doesn't pass the laugh test.

"Our business is in a hard place right now," Welch said. "A lot of
docs know it's not right."

Duff Wilson reported and co-wrote this story while working for The
Seattle Times. He now reports for The New York Times. Send comments
to suddenlysick@seattletimes.com or call Susan Kelleher: 206-464-2508

HARLEY SOLTES / THE SEATTLE TIMES

Dr. Robert Saunders checks the blood pressure of Seattle City
Councilwoman Jean Godden, who had a close call with a hypertension
drug. Saunders expresses concern about company-backed research behind
some medicines. "I think the days of getting unbiased information are
gone," he says.

AP

"We have a system that nobody but Big Pharma is happy with," says ex-
Oregon Gov. John Kitzhaber, a doctor with The Foundation for Medical
Excellence.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.

Re: Dr Berg , (Univ of WA) (BIG PHARMA) Our new book. Archive.