We talk a lot about Big Pharma throughout this podcast but today we discuss its many tentacles. Soon after making the podcast, Alan watched a hockey game and there was a drug ad on the ice! The Pharma industry controls virtually all medical research; subsidizes medical schools whose "expert" physicians are dependent on Pharma funds to pay for their grants; finances and provides leadership for many respected institutions such as the FDA, CDC, American Diabetes Association, Alzheimer's Association, American Cancer Society, American Heart Association, and virtually every medical professional society; is one of the biggest doners and lobbyists in Congress; is (with Big Food) the top advertiser in the media, print, TV, and internet; is the biggest advertiser in medical journals and medical conferences; and of course regularly bribes doctors. We speak a lot about these tentacles in our book Return to Healing, as does Gardiner Harris in his book No More Tears, as do so many health reformers, but the deep penetration of their financial power to manipulate our perception of what healthcare should be has become so normalized as to make it invisible. Few doctors realize that the protocols they use, the calculators they dazzle patients with, the articles they read, the conferences they attend, the organizations they follow, and the "experts" they listen to are all tentacles of Big Pharma. And of course, since Medicare is contingent on Congress to determine what it will pay for, and since Congresspeople are heavily supported by generous Pharma gifts, it's no wonder that the most expensive drugs are always passed by the FDA, endorsed by the CDC, and paid for by Medicare. We will give a brief synopsis of this problem and a few ideas how to fix it.

This week Andy was reported to the Maryland Board of Medicine by a local cardiology group because some studies he included in his practice newsletter offended them. These were major studies, peer reviewed, but did not coincide with the dogmatic messaging they seek to spread, and thus they accused Andy of spreading dangerous misinformation. They want the Board to silence him or take away his medical license, merely for sharing medical data with which they disagree. These cardiologists, as well as many specialists, practice by using protocols that are written by self-interested specialty societies and by drug companies. Such protocols are usually buttressed by garbage observational drug company studies and do not include more robust data that gets in the way of their narrative. Many specialists, including the local cardiology group that wants to censor Andy, robotically follow the protocols and denounce any study or doctor who dares question them. But isn't science, isn't medical care, all about dialogue, divergent arguments, nuance, concern about the whole person rather than his/her organ of interest or numerical measurements? Not according to the cardiologists, and we'll see if the Medical Board agrees. But if we must simply be AI robots who obey flawed protocols and are punished for using our brain and common sense, what is healthcare becoming? As Osler said: "The greater the ignorance, the greater the dogmatism." And as Einstein reminded us (likely thinking about the cardiologists who are so offended by facts and data that they seek to censor another doctor): "Great spirits always encounter violent from mediocre minds." Sadly, in our system, the mediocre minds run the show!

We also discuss a documentary Andy was in recently, and a link to that documentary is: https://www.theepochtimes.com/epochtv/video-series/healthcare-decoded-6006002?=epochHG

The first half of American Medical History ends at the Flexner Report, which entirely morphed American Healthcare into a monolithic corporate entity under the complete control of the AMA. Every aspect of healthcare transformed, from education, to payment, to philosophy, to licensing, to dogma. The Medical Racial Script, long unspoken and oft ignored, became the law of the land. What are the repercussions of Flexner today? We will discuss some of the ramifications of the AMA's cooptation, and the corporate ownership of, healthcare before moving on two the second part of the course.