Once again, I salute the British Medical Journal for providing all articles online. This is a tremendous service to people worldwide.

The article below articulates a major problem very well. Some diseases are now “fabricated” by the medical industry and drugs are created and prescribed that you must be on for a lifetime to treat this fabricated disease. Some of these drugs cause side effects which can not only be deadly, but can make it impossible to get off the drug. Thus the holy grail is achieved. A self sustaining disease state is created that requires buying the drug for the rest of your life.

I find it difficult to talk about these issue with people. My wife, who is the daughter of several generations of devoted physicians, accuses me of paranoia (at best) or libel (at worst) for even mentioning it. Yet the leading medical journals all have articles that should be read by every personal who uses the healthcare system. Beware of your local drug dealer, even if they appear to be reputable professionals!

As a businessman, I understand “disease mongering” is just “business as usual.” In the computer industry, where I work, things are even more ferocious in the battle for market share. However, the fact that in the last two weeks the CEO’s of major health care companies underwent some of the same fate as the leaders of Enron and Worldcom should cause the average person to ask deeper questions than they might have asked in the past. Cooking the books in healthcare can mean cooking the patients as well.

Selling sickness: the pharmaceutical industry and disease mongering

Ray Moynihan, Iona Heath, David Henry

British Medical Journal 334:13:886-891, 13 Apr 2002

A lot of money can be made from healthy people who believe they are sick. Pharmaceutical companies sponsor diseases and promote them to prescribers and consumers. Ray Moynihan, Iona Heath, and David Henry give examples of “disease mongering” and suggest how to prevent the growth of this practice. There’s a lot of money to be made from telling healthy people they’re sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments. Pharmaceutical companies are actively involved in sponsoring the definition of diseases and promoting them to both prescribers and consumers. The social construction of illness is being replaced by the corporate construction of disease.

Whereas some aspects of medicalisation are the subject of ongoing debate, the mechanics of corporate backed disease mongering, and its impact on public consciousness, medical practice, human health, and national budgets, have attracted limited critical scrutiny. Within many disease categories informal alliances have emerged, comprising drug company staff, doctors, and consumer groups. Ostensibly engaged in raising public awareness about underdiagnosed and undertreated problems, these alliances tend to promote a view of their particular condition as widespread, serious, and treatable. Because these “disease awareness” campaigns are commonly linked to companies’ marketing strategies, they operate to expand markets for new pharmaceutical products. Alternative approaches—emphasising the self limiting or relatively benign natural history of a problem, or the importance of personal coping strategies—are played down or ignored. As the late medical writer Lynn Payer observed, disease mongers “gnaw away at our self­confidence.”

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