What’s Up With Doctors Making Money On Their Own Mistakes?
Americans are so over-prescribed and over-operated on that you’d think our health is on the mend, but trends suggest otherwise. So, why are physicians and pharmaceutical companies celebrating a hefty payday while public health is on the decline?
There’s a lot of money at stake in the medical industry, particularly when Americans actually seek out too much medical care. Overtreated, and yet paradoxically unhealthier than ever before, we’d all hope that the drive for better public health is an honorable one, but unfortunately that’s far from the truth. From sheer malpractice to unnecessary medical services to purposeful prescriptions that bring both Big Pharma and physicians alike a hefty payday, it’s about time we stop accepting the status quo that keeps us growing poorer and sicker.
While there are certainly a large number of medical practitioners who mean no harm and genuinely care about providing their patients with the best, least burdensome healthcare, you might be shocked to know just how many doctors are profiting from America’s worsening state of health.
Our Healthcare Resources Are Wasted and Mismanaged
Every year, Americans spend an excess of $210 billion on unnecessary medical services like extra tests, procedures, and prescriptions. Some of this is a patient’s choice, and in other cases it’s medical malpractice. Medical malpractice manifests in a few different ways, from opting to do a procedure which a less invasive treatment could have solved to accidentally operating on the wrong body part to leaving equipment inside a patient’s body. Though these types of mistakes are not as common and certainly not fatal, doctors mistakenly leave objects (cotton balls, towels, sponges, etc.) inside patient’s bodies about 39 times per week. That said, doctors also make tragic, if not fatal, errors far too often as well. America’s third-leading cause of death behind heart disease and cancer is medical errors, with some reports saying that over 250,000 people die in America each year because of medical errors. Other reports suggest the number to be as high as 440,000.
Even if patients aren’t dying from a doctor’s mistake, it’s worth recognizing that Americans are over-operated on and over-prescribed pills and potions in a vicious cycle. Some physicians have come forward to admit that this healthcare waste is often thanks to the profit margins. The income that a doctor receives is greatly impacted by how many procedures they do, and if they keep their numbers high enough, then they have additional incentives like memberships at better practices or privileges at high-ranking hospitals.
Some of these profit-boosting procedures and prescriptions are less egregious than others, but some cases are frankly disturbing. Back in 2011, a cardiologist in Maryland was sentenced to prison for placing cardiac stents and performing cardiac catheterizations on over 100 patients who didn’t need them in an attempt to get money from private insurers, Medicare, and Medicaid. He allegedly banked up to $711,583. Cardiac procedures, pacemaker implants, spinal surgeries, cesarean sections, hysterectomies, and knee replacements rank as some of the most over-performed surgeries, and innocent people are paying the price.
America’s third-leading cause of death behind heart disease and cancer is medical errors.
“If patients have operations they don't need, they risk having major problems – infections, paralysis, heart attacks, strokes,” explained neurosurgeon Nancy Epstein in USA Today, one physician who has come forward to blow the whistle on industry corruption.
In Some Cases, You Might Be Asking for It
While many of these over-performed procedures appear at face value to be necessary care, there are also many elective surgeries that Americans opt to get which doctors profit from. Look no further than the predatory plastic surgery industry which regularly cranks in over $16.7 billion in annual revenue.
Plastic surgeons and medical device distributors often tout the safety of elective procedures like breast implants, for example. Co-founder of the Global Patient Advocacy Coalition, Robyn Towt, reported that a small group of surgeons in particular appears to be at the helm of the positive public narrative surrounding breast implants. Manufacturers of breast implant devices paid them hundreds of thousands of dollars through their speaking engagements, travel, consulting fees, food and beverage, and other gifts.
In exchange, it would appear that these physicians were the ones we can thank for the FDA allowing silicone breast implants to go back on the market in the early 2000s. This same group also led the clinical trials for Allergan’s now-recalled textured silicone implant which caused cancer and breast implant illness. Then, take into consideration this group’s positions on various executive boards for research foundations, medical societies, and medical journals. All of these factors could lead you to wonder if they have a stranglehold on what the public and the medical community gets to know about breast implants.
In addition, in many cases where breast implant illness is present, the suffering patient also has to pay a surgeon to get their implants removed simply to improve their health, resulting in double the profits for the plastic surgery office. How convenient. Time after time, mismanagement of women’s healthcare appears to turn major profits for physicians and Big Pharma alike. We’re only just scratching the surface with breast implants, so let’s take a look at a few of the other major offenders.
Afflictions and Ailments Shouldn’t Be So Lucrative
Back in 2002, the permanent birth control device Essure was officially approved by the U.S. Food and Drug Administration. This female sterilization implant, originally manufactured by Conceptus and purchased by Bayer in 2013, was available to many American women as most health insurance plans covered it. In fact, thanks to President Obama’s Affordable Care Act, many women could get Essure free of cost. In a 16-year period, around 1 million Essure devices were implanted, but horror stories trickled in about serious side effects.
One woman, Angie, who had to undergo seven surgeries to resolve the side effects Essure caused her (heavy vaginal bleeding, chronic pelvic pain, back pain, fatigue, and fevers), formed a Facebook group, and other women filed lawsuits against Bayer. A Netflix documentary was even made to expose the device’s major problems. Funnily enough, a week after Bayer discontinued the Essure device in 2018, word got out that Bayer had paid doctors $2.5 million for a marketing campaign to promote the product and recruit more doctors to prescribe it.
In addition to birth control devices, we know how dangerous abortions can be to a woman’s physical and mental health. Despite this, abortion appears to be a highly profitable industry. One abortion clinic worker revealed back in 1990 that their clinic would rake in up to $15,000 in hard cash each day. That number isn’t adjusted for inflation, but when taking that into consideration, it almost doubles. The profit margin tracks among other evidence.
Public Policy and Administration professor at Jackson State University, James D. Slack, Ph.D, explained the eye-opening profitability of abortion in a model using the name “Michelle” for an abortion clinic owner.
“[Michelle] currently charges $500 for a medical (drug) abortion up to the seventh week; $425 for first trimester surgical abortion with a light anesthetic and $475 for one with a heavy anesthetic; and for a second trimester abortion, about an additional hundred dollars per week and maxing out at $1,100. After hours (privacy) abortion start around $625, maxing out around $1,300. All fees are paid in advance. With an estimated 3,000 clients annually from just one of her clinics, some with second trimester abortions, it is likely that she grosses more than 1.5 million. Assuming this is the same at the ‘Western’ clinic, she probably grosses around $3 million yearly.”
Mismanagement of women’s healthcare appears to turn major profits for physicians and Big Pharma alike.
Then, there’s Diethylstilboestrol, or DES, a synthetic hormone drug that was meant to prevent miscarriages and morning sickness. Prescribed between the years 1938 and 1971, DES was eventually discontinued because of the rare form of cancer it caused in the mother, clear cell adenocarcinoma. Furthermore, the children who were exposed to DES in the womb continue to have long-lasting negative effects and increased cancer risks. Yet after the drug was found to be dangerous, pharmaceutical companies continued to market it. One such company in France, UCB Pharma, kept marketing DES for six years after it was taken off the market in America. Similarly, the company Novartis continued to market the drug under the name Stilboestrol, and as a result, both companies have had to pay millions in damages.
So what about women trying to reduce their breast cancer risk in general? One woman named Wendy Sue shared online how she was trying to do just that, so she sought out a preventative double mastectomy from a top plastic surgeon. The doctor neglected to inform her that he had a major conflict of interest with his research on and promotion of an Allergan device, which he then used on her without her consent and without it having been cleared by the FDA. According to Wendy Sue, “his experiment failed, causing deformity, severe pain and necessitating three additional corrective surgeries to date.”
In return for the research this surgeon conducted by using an off-label device on Wendy Sue and other patients, he profited almost $500,000 from the manufacturer, Wendy Sue discovered through Open Payments. Though it was too late for her to research her surgeon through websites like Open Payments, you should be aware of these resources before you undergo any medical treatment or procedures which can tell you just how much money doctors take from device and drug companies. Open Payments was created by orthopedic surgeon and University of California, Irvine professor Dr. Chuck Rosen, who felt disturbed by his colleagues unnecessarily writing prescriptions and performing procedures because they were getting paid by the companies that provide them with the product.
Which Companies Pay Doctors the Most?
It’s no secret that physicians are highly influenced by money from the pharmaceutical industry. Nonprofit news publication ProPublica reported that doctors prescribe more brand-name drugs if they receive more money or get other kickbacks. One particular kickback is shameful and in my eyes, inexcusable. ProPublica shared that when drug company representatives meet with doctors at their offices, the free lunch they provide can actually sway a physician to implant their devices or prescribe their pills. Does a free lunch really mean that you’re getting optimal treatment? It could, but it also very well couldn’t.
“When I am choosing between recommending Lexapro or Paxil [two antidepressants] for a patient, I often go with the Paxil because the Paxil rep brings the best lunches,” one psychologist shared.
Though generic drugs are widespread and work just as well as top name brands, they are regularly overlooked by physicians. Analysis has found that as brand-name drug companies increase their payments to doctors, their rates of prescription go up. If a doctor received over $5,000 from a company, they are more likely to prescribe that brand-name drug. In 2015, Bayer and Johnson & Johnson’s Xarelto collectively paid doctors a chart-topping $30.7 million for the blood thinning drug, which has caused 25,000 lawsuits totaling $775 million in settlements over massive bleeding episodes.
Doctors prescribe more brand-name drugs if they receive more money or get other kickbacks.
It’s not just a few coincidental cases either, it’s widespread. In America, 90% of cardiologists who were paid by drug and device companies wrote at least 1,000 prescriptions for their patients. Nationwide, up to three-quarters of doctors received payment from at least one pharmaceutical company back in 2014.
Johnson & Johnson subsidiary DePuy Synthes has paid doctors $238 million. $15.7 million of that went into the promotion of their hip replacement implant Pinnacle, which has seen up to 9,700 individual lawsuits against it due to complications. Allergan, which makes Botox and Natrelle breast implants, has paid doctors $172 million. Pfizer has paid doctors $175 million. AstraZeneca has paid doctors $189 million. Genentech has paid doctors $1.08 billion. Do you get the picture? The list could go on and on.
Ultimately, according to Open Payments, over 615,000 doctors raked in $2.3 billion in cash from Big Pharma in 2019 alone, and that number jumped to over 766,500 doctors making $2.5 billion collectively in 2021. This doesn’t account for the doctors’ personal ownership or investment interest, nor research payments, which collectively earn them over $1.26 billion and $7.09 billion, respectively. If this doesn’t scream conflict of interest, I don’t know what does.
Personal ownership of medical device companies is known as physician-owned distributorship (POD). Research has shown that doctors who have PODs are more likely to operate on patients to the tune of 23%. While some may say that PODs inherently provide quality control for the procedures, since a doctor might feel best operating a product they crafted, our government has actually set up a special fraud alert against PODs due to the conflict of interest and profit margins.
It’s Possible for Us To Push Back
While there’s no stopping drug companies from offering custom mugs or free lunches during their visits to doctor’s offices, we should continue to demand transparency from doctors. If doctors are making a pretty penny per each prescription written, there should be an open chain of communication as to why the pharmaceutical company is ponying up cash and why the doctor is choosing to take it. Some have even gone so far as to suggest that American physicians are overpaid in general, comparing our system to a cartel and proposing that there needs to be better competition in the field.
The volume of cash that flows to market a cure – which often has adverse effects – should be scrutinized.
Regardless of if you believe doctors are under or overpaid, it’s clear that public pressure to increase transparency works. After all, once word got out about the worsening opioid epidemic, drug makers significantly cut back on their marketing payments.
Here’s a hypothetical situation to chew on: You take your car to the mechanic, and when you get it back, new problems arise that need fixing. These problems didn’t exist before, but now you’re left needing to go back to the mechanic and pay them more to fix the problems they caused. Would you pay full price? Or would you insist that, on their honor, the mechanics should solve the problems that they caused without you needing to break out a checkbook?
How about if you order a vanilla latte, and when you take a sip, you realize the barista gave you black coffee? It’s not what you ordered, so would you take it back to the counter and pay full price for a new drink? Or would you expect the barista to make you a replacement latte because that’s just good customer service?
There have been far too many instances of Big Pharma touting a cure which instead leads to new issues that need an entirely separate line of treatment. I must reiterate that while there are many well-meaning medical professionals who don’t take payments from device and drug companies, the sheer volume of cash that flows to promote and market a cure – which often has adverse effects – should be intensely scrutinized. Whether it’s Adderall or opioids, plastic and cosmetic surgery procedures or non-elective surgical needs, if doctors aren’t actually keeping us in good health, then perhaps they shouldn’t be turning a profit.
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