Evidence-Based Medicine

Financial Conflicts of Interests and the End of Evidence-Based Medicine

Evidence-based medicine

“Evidence-based medicine is actually so corrupt as to be useless or harmful,” Marcia Angell wrote in 2009. The statement was less a revelation than something many already knew, but it made waves because of its source. Angell, a medical insider, had spent two decades as the editor-in-chief of the New England Journal of Medicine.

Dr Jason Fung is also a medical insider who has become wary of scientific research that purports to be “evidence-based.” A well-known nephrologist and author, Fung often speaks about Type-2 diabetes reversal and the metabolic effects of intermittent fasting, but in this presentation from Dec. 15, 2018, he turns his focus toward the many ways the foundations of evidence-based medicine have become corrupted by financial conflicts of interest.

Conflicts of interest

The first conflicts of interest he highlights pertain to the corruption of doctors. Practising physicians who accept gifts from Big Pharma are 225-335% more likely to prescribe drugs from the gift-giving company than those who do not, Fung explains.

The corruption of doctors in prestigious universities is even worse, he claims. “There’s a clear correlation: The more prestigious a doctor, the more money they’re getting from the pharmaceutical.” Anecdotally, he says, you may be better off seeking medical advice from a family physician than a Harvard professor; the former probably just accepted a $10 pen from Big Pharma while the latter is on the take for $500,000. “It just is a terrible system,” he says. “Yet, these people are the people that are in the newspaper. They’re the ones that are teaching medical students, are the ones who are teaching the — the dietitians, the pharmacist — everybody.”

The most insidious corruption affects the published research on particular drugs. Fung highlights the influence industry can have when it finds a medical journal editor willing to take its money. Another problem arises in the form of industry-funded medical research. This conflict of interest leads to the selective publication of positive trials, which can skew the science of particular drugs and lead to unnecessary or even dangerous overprescription. Fung notes how statin prescriptions illustrate the scope of this particular problem.

“We accept this of drug companies … but the problem is that people die,” Fung says. He later adds: “You can make arguments that sugar is a healthy food, that opioids are good for you … but it harms patients, and we always must remember that at the end of the day, this is not why we became doctors. We became doctors to help people, but we’re not until we set those same rules as everybody else.”

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