Overdosed America Paperback Edition Available

"Some of the nation's worst drug dealers aren't peddling on the street corners, they're occupying corporate suites. Overdosed America reveals the greed and corruption that drive health care costs skyward and now threatens the public health. Before you see a doctor, you should read this book." - Eric Schlosser, author of Fast Food Nation

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Excerpts: Introduction | Chapter 13 | Chapter 14


Just before I left my practice to write this book, one of my longtime patients, Mrs. Francis, came in for a visit. I always enjoyed seeing Mrs. Francis, a widow then in her mid-eighties. Her greeting was warm and her presence made the exam room feel comfortable - an oasis in the midst of daily time pressures, multiple tasks, and complex patient challenges. During this visit, Mrs. Francis asked why I was leaving. This wasn't just a casual question, nor did I feel that she was prying. Over the years, we had enjoyed many conversations, and I felt as if she genuinely wanted to understand what had gone into my decision. I did my best to explain.

I told her that over the last few years a profound shift had been taking place in the culture of American medicine. I explained that tests unlikely to improve patient care were being routinely ordered and expensive drugs that had not been shown to be any more effective or safer than the older drugs they were replacing were being routinely prescribed. I told her that the research I had been doing at night and on weekends was confirming my sense that much of the �scientific evidence� on which we doctors rely to guide our clinical decisions was being commercially spun, or worse; and that many of the articles published in even the most respected medical journals seemed more life infomercials whose purpose as to promote their sponsors' products rather than to search for the best ways to improve people's health.

I told her that many of my patients were being drawn in by the growing number of drug ads and medical news stories; that patients were increasingly arriving for their visits with a firm (if not fixed) idea of the outcome they wanted instead of the expectation that the best medical care would emerge from open discussion of their symptoms, concerns, and exam and then mutual consideration of the options. I told her that when I tried to refocus patients on interventions proved to be safe and effective, many were reacting as if I were purposely trying to withhold the best treatment, making me choose between providing the best care and yielding to their demands in order to maintain the healing potential of our relationship. Finally, I told her that I had come to the conclusion that the best way I could help people to achieve better health was to find out what the scientific evidence really shows and explain this to the public - in much the same way that she and I had talked over the years - and to other medical professionals.

That was the best answer I could give Mrs. Francis at the time. I wasn't sure what I was going to find when I turned my full attention to these issues. But it was becoming clear that American medicine was like a runaway train picking up speed, fueled by the commercially generated belief that ever-increasing medical spending is necessary to achieve good health. It was also becoming clear that the train's brakes were failing. It seemed to me that, despite a few clear and brave voices, there was no effective counterbalance to the influence of commercially sponsored research. Nor was there even a way to determine whether all this expensive new care actually led to better health. And it as also clear that this crisis would soon come to a head when the burden of relentlessly increasing medical costs became more than many Americans could bear.

What I found over the next two and a half years of �researching the research� is a scandal in medical science that is at least the equivalent of any of the recent corporate scandals that have shaken Americans' confidence I the integrity of the corporate and financial worlds. Rigging medical studies, misrepresenting research results published in even the most influential medical journals, and withholding the findings of whole studies that don't come out in a sponsor's favor have all become the accepted norm in commercially sponsored medical research. To keep the lid sealed on this corruption of medical science - and to ensure its translation into medical practice - there is a complex web of corporate influences that includes disempowered regulatory agencies, commercially sponsored medical education, brilliant advertising, expensive public relations campaigns, and manipulation of free media coverage. And last, but not least, are the financial ties between many of the most trusted medical experts and the medical industry.

Excerpted from Overdosed America. Copyright © 2004 by John Abramson, M.D. All rights reserved. Harpercollins Publishers.