The Corruption of Academic Medicine

Businessman Bribing Colleague In Office

Many doctors are genuinely puzzled why much of the general public does not trust what they say. For example, there’s the GOOP story. Gwyneth Paltrow sells lots of scientifically iffy wellness products on her website, and there’s many doctors and ‘health professionals’ frothing at the mouth trying to ‘debunk’ her theories. But, in the end, GOOP is selling millions of dollars of product. The public has voted with its money, and it chooses Gwyneth over the doctors. Why?

Then, there’s the anti-vaxxers/ vaccine controversy. Once again, celebrities like Jenny McCarthy claim that vaccines cause autism. Many doctors are frothing at the mouth and loudly ‘debunking’ these theories. Despite these protestations, we have occasional mumps outbreaks where children have not been properly vaccinated. Again, the public has voted with its children, and it chooses Jenny over the doctors. Once again, why?

COI1There’s also the ongoing statin controversy. These popular cholesterol lowering medications may have benefits in those with known cardiovascular disease, but are increasing prescribed for ‘primary prevention’, that is, in healthy people to prevent heart disease. While it sounds good, this ignores the fact that all medications have side effects and that the benefits in a lower risk population is by definition, much smaller. Taking a tablet to prevent a single episode of heart disease may mean treating hundreds or even thousands of people for decades unnecessarily.

Many doctors blame ignorance and the media for these phenomena, but this is simply a patronizing attitude. The truth is this. Many people simply do not believe doctors any more.

The answer is money

But why? The answer is $$$$. Simply, the public does not trust doctors because they know that many doctors, especially those in academic medicine and the universities are on the take. A terrific study from Dr. Vinay Prasad illustrates the problem precisely. He reviewed 37 ‘expert’ physicians who spoke on behalf of drug companies. Not surprisingly, they were all getting significant amounts of money from Big Pharma – a median of $39,316. These were not simply run-of-the-mill doctors either.

There is a clear correlation between the number of articles they had written (or been cited) and the amount of money received. This means that these ‘experts’ are those professors and doctors at all the best universities all over the world. These are the doctors that lecture other doctors and medical students. In general, the more prominent a physician, the more money he is taking from industry.

COI2Some are receiving hundred of thousands of dollars. One was literally off the chart, claiming a ridiculous $2.8 million dollars from Big Pharma. $2.8 MILLION!!!

The sad part is that everybody recognizes the inherent conflict of interest. If a doctors is getting millions of dollars from a drug company, then there’s a good chance that his public opinion reflects this huge payment and is not an unbiased opinion. Further, doctors often try to hide this huge sponsorship from the public eye, making them far less believable.

Is sugar good for you?

For example, if LeBron James appears in a commercial for Sprite, we know that he is being paid for it. We aren’t exactly surprised if we find out that he probably rarely drinks sugary drinks, because, well, it’s bad for athletic performance and he’s not stupid. But LeBron never tries to hide his sponsorship, and may well be proud of it. That’s not the case with doctors. They try to obscure this fact everywhere they go.

fructoseLet’s look at the sugar controversy. Here’s Dr. Sievenpiper, a physician at St. Michaels Hospital at the University of Toronto arguing that fructose and sugar are actually GOOD for you. WTF???

Everybody and their grandmother knows that sugar is not good for you. Even if you think it is only empty calories (it’s way worse than that), you’d have to be kind of an idiot to believe that fructose should be ‘endorsed again’ as healthy. But here’s Sievenpiper saying exactly that.

But he’s a doctor, isn’t he? Well, he’s also massively on the take from the Corn Refiners Association. The National Post’s headline says it all “Canadian researcher have received hundreds of thousands from soft-drink makers and the sugar industry”. Sievenpiper has written 22 studies or opinions in the last 3 years that, surprise surprise, claim that sugar is not the culprit.

The statin controversy

COI5You could also look at the example of the statins. Dr. Aseem Malhotra, a leading cardiologist from the UK, along with Dr. Maryann Demasi and Dr. Robert Lustig, and who does not take any money from drug makers wrote an excellent commentary arguing that the cholesterol hypothesis is dead. In response, cardiologist Dr. Steven Nissen claimed that “internet-driven cults” were scaring people away from statins. Both are cardiologists. Who is right and who is wrong? The public has no way to know.

Oh, but let’s look at Dr. Nissen’s payments from Big Pharma. According to ProPublica, Dr. Nissen had scored a cool $80,000 payday from drug firms last year. Nice. Oh, right, further he received money from 3 of the biggest drug firms (Amgen, Pfizer, and Astra Zeneca) on the planet to do research and write papers. Dr. Nissen hysterically claims that cults are scaring people away from life saving statins and that if we listened to them, everybody would die. Funny, Dr. Nissen seems to be engaging in a lot of fear mongering himself to scare people into taking their (highly-profitable) medications.

COI8

Is it true? Would people start dying in droves if they all stopped their statins? Well, this paper answers that question. In France, an intense statin controversy in 2013 drove discontinuations of that drug up by 50% compared to 2012 and 2011. Lots of people died as a result, right? Not at all.

No ‘Health Tragedy’ occurred despite the hysterical hand-wringing of doctors. There were 2000 LESS deaths in 2013. For heart disease deaths, there were 1200 LESS deaths. Yes, you read that correctly. There were less deaths when people stopped their medication. I can’t say that one resulted from the other, but certainly the predicted disaster never happened. Once again, people are predicting disaster, as they did when Dr. Demasi produced her brave documentary ‘Heart of the Matter’.

COI6The general public is not stupid. They understand that many doctors are on the payroll of Big Pharma but are desperate to hide this fact. They understand that the people that should be the most expert – the university professors and the physicians at the teaching hospitals and the researchers who write the articles are the ones that are taking the most $$$. They’re trading their academic prestige for cold hard cash in a form of intellectual prostitution.

Of the 22 members of the Canadian Cardiovascular Society, 20 received money from Big Pharma. The CCS is responsible for writing all kinds of guidelines that doctors follow in the treatment of heart disease. Yet 91% of the doctors writing these influential guidelines are directly in the pay of Big Pharma. Not surprisingly, these guidelines heartily endorse the liberal use of statins. It should be in the drinking water! The very people who should be safe-guarding the public have sold them out.

Then, there’s the money being funneled in things like the impressive sounding Canadian Heart Research Centre, with many University of Toronto professors. This is really just a money-laundering operation of the pharmaceuticals. All the big drug companies pour millions of dollars into this ‘Research Centre’ which produces thinly disguised infomercials aimed at your local physician.

Insulin for type 2 diabetes

For example, consider this program from a similar organization. “Insulin in Diabetes” How exciting. Too bad that there is not a single study in the history of mankind that shows that insulin in type 2 diabetes improves health outcomes. Since 90% of diabetes is type 2, then this title implies a complete lie – that insulin benefits type 2 diabetes.

But yet, here’s the physicians who have agreed to participate. Dr Zinman, professor, University of Toronto. Dr. Cheng, professor U of T. Dr. Gerstein, professor McMaster University. Dr. Perkins, professor U of T. Dr. Yale, professor, McGill. Virtually the heads of all the endocrine departments in the major universities of Canada.

Did they all decide to give up their Saturday to educate GPs. Hardly. They are each taking thousands of dollars home while promoting obesity inducing insulin. Not a single lecture of this 8 hour program is devoted to proper diet or exercise. Nope. Drugs, drugs, drugs is what pays the private school bills. They are taking money from a cabal of insulin profiteers to deliver a biased, thinly disguised sales message at the behest of their pharmaceutical overlords.

Drug companies can pay these sham research organizations to put on these events (infomercials) and pretend they are supporting ‘research’. Money successfully laundered. It’s an open secret amongst the doctors. We all know that these things are not free to organize. Everybody gets paid.

For the GPs attending, there is free breakfast, lunch and snack. They take this tainted and biased presentation to heart, believing they are learning about the most recent developments in the field. They then pass this propaganda on to their patients in good faith, but bad medicine.

Of course, Big Pharma has bankrolled the entire thing to the tune of tens or hundreds of thousands of dollars. And they know they are getting a good return on their investment. The Journal of Clinical Oncology published an article which shows that in oncology (cancer), payments to doctors results in up to a 78% increase rate of prescription of medications.

So, why is the general public so mistrusting of doctors? Well, the public would have to be crazy to trust us, given the money sloshing around the system. But the fault is our own. A great first step is disclosure, as done in the USA and there is a movement in Canada for this, too. But that’s not enough. The only way to restore trust is to stop all these payments altogether.

Honestly, is it really too much to ask that the ‘experts’ (American Heart Association, American Diabetes Association, Canadian Cardiovascular Society) that advise the public on the best drugs, the best diets do NOT take money from drug companies or food companies?


Dr. Jason Fung

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20 comments

  1. Lorletha
    You can't get much hard hitting in your analysis than this. Thank you Dr. Fung for being brave enough to put this article out there and give your honest opinion. Hopefully, doctors will begin re-focusing on the health of their patients and not the wealth in their pockets.
  2. Jean
    I agree. This is hard hitting and brave. Thank you Dr Fung. You do your profession proud.
  3. Birgit
    To many doctors' defense: I think many of them are victims like ourselves. And like us they tend not to think out of their box.
    As a person who kind of stumbled into these "boxes" accidentally several times, I had to learn about their existence more consciously than probably the vast majority of people.
    Having learned them I just cannot abolish my way of thinking and thus making arbitrary connections immediately and decide later to weed them out or not.
    Having this kind of mindset i have issues understanding why any doctor would even bother taking measurements even if that particular patient is known to have wildly different values when doing the test himself at home. That doctor shall not be surprised if i cannot take him very seriosly, even though it is probably not his fault.
  4. Carol
    Thank you Dr Fung. Only yesterday I cut an article out of The Australian which quotes Dr Steven Nissans opinion as verbatim. I showed a friend and we discussed how disappointed we are with The Australian for putting this scare mongering on the front page of a paper that Drs would read thinking this is scientific journalism. I wish we could send your article to The Australian and they would print it front page of course.
  5. Theresa Sidrow
    It's "fewer" deaths. Not "less" deaths.
    Replies: #6, #20
  6. bill

    It's "fewer" deaths. Not "less" deaths.

    ...only if you're a prescriptivist. Otherwise either
    word is okay to use. http://www.npr.org/2014/12/06/368712564/fewer-or-less-the-express-lan...

  7. Theresa
    Then I guess I am a prescriptivist. Just because an error has become common does not mean it is any less an error.
    Reply: #10
  8. FAS
    This is the same thing happening with the "science" of climate change. Too much research money going to "prove" it.
  9. tz
    The vaxxer - anti-vaxxer controversy isn't as clear as you make it out to be.
    Have you looked at the package insert with all the "possible side-effects"?
    On Mumps, MANY WHO GOT MUMPS WERE VACCINATED. The vaccine didn't work.
    Then our environmental ministries are saying ANY mercury or aluminum is toxic, while they are used as preservatives in vaccines (Thimerasol). I have to evacuate the room if I break a CFL, but mercury is safe to inject directly in a newborn's blood stream?

    Vaccines are just as big a business making the same $$$$ for Big Pharma as the statins, the type 2 diabetes drugs, and even worse, if a vaccine injures a child in the USA, there is NO RECOURSE - there is a VACCINE KANGAROO COURT instead of a judge and jury. Everyone knows there will be the one in ten-thousand that will have a bad reaction.

  10. bill

    Then I guess I am a prescriptivist. Just because an error has become common does not mean it is any less an error.

    ...she says, completely misunderstanding how
    languages evolve. (...he says caringly.)

  11. SW
    Dr Steven Nissen gets a check from big pharma about every 12 days https://projects.propublica.org/vital-signs/doctor/1871685487 Scroll to bottom of the page also,https://www.propublica.org/article/when-evidence-says-no-but-doctors-say-yes
  12. SW
    https://www.propublica.org/article/profiles-of-the-top-earners-in-dol...
    "One of Nissen's colleagues at the clinic, endocrinologist Adi Mehta, earned at least $202,600 from three companies. Mehta said in a statement that he feels "passionately" that such speaking educates his peers, the same rationale drug companies use to defend their reliance on practitioners. The prestigious clinic does not prohibit participation in pharma speakers' bureaus."
  13. Tije Pietersma
    Great writing!
  14. Keyur A. Parikh
    This is the out-of-the-box thinking that's required in our profession. We need to understand what science offers and what science tells us. Some of the evidence based guidelines are biased.
  15. Robert
    Great review. Love how scathing it is. However, many docs in the FM industry started as conventional and simply stood ignorant for years. The ignorant behavior is trained in as docs go through school and push their services. Hard habit to break, but I'm curious about a way to truly jumpstart widespread curiosity that is less about fingering and more about reframing. I don't have it yet. But as I implement what you and many others have uncovered for me I will eventually find a way to do this ... with as many free meals, perks, promises, and friendly calls from rooftops of their customers. I hope you are doing well, Dave Asprey spoke very well of you today and your post went everywhere. God speed.
  16. Andrea
    Great article . Hopefully we r on the edge of a medical revolution that will bring us back from this pharmaceutical prostitution of our medical schools n the physicians they r turning out.Thank you for all your efforts Dr Fung. It can't be easy for u to bring this information to the public. I will do my small part n make sure all I know get the truth.
  17. Peter
    Excellent article. I just have to point out one error in this part: "Once again, celebrities like Jenny McCarthy claim that vaccines cause autism. Many doctors are frothing at the mouth and loudly ‘debunking’ these theories. Despite these protestations, we have occasional mumps outbreaks where children have not been properly vaccinated. Again, the public has voted with its children, and it chooses Jenny over the doctors. Once again, why?"
    First, the mumps outbreaks you mention are for the most part among the vaccinated, not the unvaccinated. Example, the Arkansas outbreak mentioned in this article where 92 percent of the impacted had received 2 doses of MMR. https://www.statnews.com/2017/03/29/mumps-outbreaks/. So in other words, the damn vaccine doesn't work very well. Merck is actually in litigation now because they lied in their claims about the mumps vaccine efficacy.
    Second, people don't choose Jenny McCarthy, she has very little to do with peoples choices in this matter. A large part of those that get accused of being "anti-vaccine" are in fact "ex-vaccinators", myself included. We did as the pediatrician said and saw the damage, woke up and changed our minds. Those of us that started studying this topic quickly find out that there are hundreds of studies that gives reason for concern about vaccines but it's not being discussed in main stream media. Here's a sample, look for yourself.
    There is no science that shows vaccines cause Autism, except in all these government published studies which show vaccines cause Autism.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878266/
    http://www.ncbi.nlm.nih.gov/pubmed/21623535
    http://www.ncbi.nlm.nih.gov/pubmed/25377033
    http://www.ncbi.nlm.nih.gov/pubmed/24995277
    http://www.ncbi.nlm.nih.gov/pubmed/12145534
    http://www.ncbi.nlm.nih.gov/pubmed/21058170
    http://www.ncbi.nlm.nih.gov/pubmed/22099159
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364648/
    http://www.ncbi.nlm.nih.gov/pubmed/17454560
    http://www.ncbi.nlm.nih.gov/pubmed/19106436
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3774468/
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3697751/
    http://www.ncbi.nlm.nih.gov/pubmed/21299355
    http://www.ncbi.nlm.nih.gov/pubmed/21907498
    http://www.ncbi.nlm.nih.gov/pubmed/11339848
    http://www.ncbi.nlm.nih.gov/pubmed/17674242
    http://www.ncbi.nlm.nih.gov/pubmed/21993250
    http://www.ncbi.nlm.nih.gov/pubmed/15780490
    http://www.ncbi.nlm.nih.gov/pubmed/12933322
    http://www.ncbi.nlm.nih.gov/pubmed/16870260
    http://www.ncbi.nlm.nih.gov/pubmed/19043938
    http://www.ncbi.nlm.nih.gov/pubmed/12142947
    http://www.ncbi.nlm.nih.gov/pubmed/24675092
    http://www.ncbi.nlm.nih.gov/pubmed/25198681

    PLUS:

    http://www.scribd.com/…/124-Research-Papers-Supporting-the-…

    Vaccines caused autism here in this federal court case http://www.uscfc.uscourts.gov/…/opin…/ABELL.ZELLER073008.pdf
    And here page 2 http://www.uscfc.uscourts.gov/…/CAMPBELL-SMITH.MOJABI-PROFF…
    And here -
    https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc…

    Here are 83 cases reviewed by lawyers http://digitalcommons.pace.edu/cgi/viewcontent.cgi…

    Oh look here's a dead kid compensated https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc…

    If you ever need a lawyer http://www.mctlawyers.com/vaccine-injury/cases/

    Here are 127 separate studies linking vaccines and autism. https://www.scribd.com/…/124-Research-Papers-Supporting-the…

    Read this about Hannah Brusewitz case and how she was harmed by DTP
    https://www.law.cornell.edu/supct/cert/09-152

    Supreme Court Unavoidably Unsafe
    http://www.supremecourt.gov/opinions/10pdf/09-152.pdf

    A dose-response relationship between organic mercury exposure from thimerosal-containing vaccines and neurodevelopmental disorders.
    http://www.ncbi.nlm.nih.gov/pubmed/25198681

    Relative trends in hospitalizations and mortality among infants by the number of vaccine doses and age, based on the Vaccine Adverse Event Reporting System (VAERS), 1990-2010.
    http://www.ncbi.nlm.nih.gov/pubmed/22531966

    Is infant immunization a risk factor for childhood asthma or allergy?
    http://www.ncbi.nlm.nih.gov/pubmed/9345669

    Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity?
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170075/

    Infection, vaccines and other environmental triggers of autoimmunity.
    http://www.ncbi.nlm.nih.gov/pubmed/16126512

    DTP with or after measles vaccination is associated with increased in-hospital mortality in Guinea-Bissau.
    http://www.ncbi.nlm.nih.gov/pubmed/17092614#

    Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646939/

    A positive association found between autism prevalence and childhood vaccination uptake across the U.S. population.
    http://www.ncbi.nlm.nih.gov/pubmed/21623535

    Hepatitis B vaccination of male neonates and autism diagnosis, NHIS 1997-2002.
    http://www.ncbi.nlm.nih.gov/pubmed/21058170

    Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism.
    http://www.ncbi.nlm.nih.gov/pubmed/12145534

    The plausibility of a role for mercury in the etiology of autism: a cellular perspective
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3173748/

    Detection of RNA of Mumps Virus during an Outbreak in a Population with a High Level of Measles, Mumps, and Rubella Vaccine Coverage
    http://jcm.asm.org/content/46/3/1101.long

    A case series of children with apparent mercury toxic encephalopathies manifesting with clinical symptoms of regressive autistic disorders.
    http://www.ncbi.nlm.nih.gov/pubmed/17454560

    Aluminum in the central nervous system (CNS): toxicity in humans and animals, vaccine adjuvants, and autoimmunity.
    http://www.ncbi.nlm.nih.gov/pubmed/23609067

    Unvaccinated Children are Healthier
    http://www.mednat.org/vaccini/dannivacc_study.pdf

    Self-Organized Criticality Theory of Autoimmunity
    http://www.plosone.org/.../10.1371/journal.pone.0008382

    Combination MMRV vaccine linked with 2-fold risk of seizures
    http://www.eurekalert.org/pub.../2010-06/kp-cmv062310.php

    Impact of environmental factors on the prevalence of autistic disorder after 1979
    http://www.ms.academicjournals.org/.../article1409245960...

    Increased risk of noninfluenza respiratory virus infections associated with receipt of inactivated influenza vaccine.
    http://www.ncbi.nlm.nih.gov/pubmed/22423139

    Effectiveness of trivalent inactivated influenza vaccine in influenza-related hospitalization in children: a case-control study.
    http://www.ncbi.nlm.nih.gov/pubmed/22525386

    Speciation of methyl- and ethyl-mercury in hair of breastfed infants acutely exposed to thimerosal-containing vaccines.
    http://www.ncbi.nlm.nih.gov/pubmed/21575620

    Comparison of VAERS fetal-loss reports during three consecutive influenza seasons
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888271/
    ---------
    FDA concludes vaccines cause Autism
    http://www.getcancercure.com/fda-announce-that-dtap-vaccin…/

  18. Dana
    The insurance industry and pharmaceutical industry has hijacked the medical "profession"... no longer is there passion for healing but rather, a medical procedure framework created by those that protect their bottom line. Medical academia has been corrupted to the point that a NEW education protocol has emerged. The best thing is to look for those physicians and practitioners that have abandoned the failure that is conventional medicine. Just like biological based small farmers look for doctors that are educated in and embrace the biochemistry of the human body as a method of optimizing health. Anything else just perpetuates disease. This is true in medicine and food production. Both an integral part of health.
  19. Sheryl
    The problem isn't doctors who are "on the take" from Big Pharma. The problem is medical schools, clinics, medical boards, and insurance companies who are overly controlled by Big Pharma. Doctors who dare to tell the truth about harmful medications risk being fired and losing their license to practice medicine.
  20. Ken
    I love the way everyone has become grammar pedant on the great, who gives a shit fewer/less bus like anyone gives a shit or doesn't know what is meant. Less pedantry, fewer pedants please.

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