Clash of Civilizations

The wooly-headed position taken by the authors of a “special communication” in the Journal of the American Medical Association (“Health Industry Practices That Create Conflicts of Interest,” Jan. 25, 2006) seems to be that the cure-all for the ills that permeate US healthcare is to demonize the Big Business money changers and force them out of the Temple of Medicine. 

Are these people living on another planet, or what?

It’s nice that they have the luxury of George Soros’ money to support their quaint notions. It would be even nicer if they had a real plan for health reform that didn’t amount to Ivory Tower extortion from the pharmaceutical and medical device industries. “Just turn your money over to us, and we’ll decide who gets what” doesn’t quite fit with my idea of collegiality. Or of modern American capitalism either, for that matter. Maybe we can be taxed to death, but I don’t think that mandatory philanthropy is going to fly with Wall Street or Washington.

So where are our industry leaders on this topic? Isn’t it about time that someone stood up and said, “Enough”? The John Wayne—strong but silent—pharmaceutical industry strategy of the past ain’t working, folks. We need someone to ask: “What are you guys smoking inside the Beltway and in that Ivory Tower up there?”

In the late 1930s, when Europe was in turmoil and America was debating about whether to get into the fray, an MIT scientist named Vannevar Bush, who headed up the Carnegie Institute, went to Franklin D. Roosevelt with a one-page plan to bring scientists into the war effort. Roosevelt immediately saw the idea’s merits and asked Bush to head the new Office of Scientific Research and Development. 

Bush (no, not those Bushes) sparked an unprecedented collegial collaboration of federal government, higher education and research community scientists resulting in the Manhattan Project, the development of antibiotics, antimalarials, corticosteroids and many other advances.

With foresight, as the war drew to a close, Roosevelt concluded that there was no reason why that partnership could not continue and be put to work to improve the national health, create new enterprises and jobs, and advance the national standard of living. He asked Bush to develop a blueprint and, in 1945, Bush’s inspiring report, “Science: The Endless Frontier,” was released and embraced by the scientific, industrial and political community. It was a spark that helped create America’s postwar prosperity, and we are its beneficiaries.

Contrast that with the petty bickering and political backbiting of today. If medical schools and professional bodies have failed in their ability to create a more compassionate and ethical body of graduates and practitioners (a sweeping conclusion that I find it difficult to agree with), is that the fault of the pharma industry? Or the societal environment in which we live? Or the professional infrastructure, itself? 

Banning contact with the real world during the formative years of a professional is not an educational experience—it is brainwashing. Maybe we would all be better off if the authors and their devotees followed the biblical admonition “Physician, heal thyself.”