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Healthy Skepticism Library item: 8517

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Mansfield PR.
Doctors as lapdogs to drug firms: Independence may be most cost effective way to improve health care.
BMJ 2006 Nov 25; 333:(7578):1121-2


I hope Fugh-Berman’s talk is effective in prompting drug companies to cease their involvement in medical education.1 If so, stopping such talks could be the most cost effective way to improve health care because exposure to drug promotion correlates with suboptimal health care.2 That includes the subtle promotion in disguise that makes involvement in medical education profitable for drug companies.

The main barrier to progress is doctors’ denial that we are often adversely influenced by drug promotion. This denial arises partly from ignorance of the evidence about drug promotion,3 4 partly from overconfidence,2 and partly from refusal to believe that evidence because it is seen as insulting our self esteem.5 We need to move from the illusion that being misled is unlikely or shameful to accepting that it is normal for humans to be vulnerable to misleading promotional techniques.5 There is no proved method . . .

MeSH Terms: Delivery of Health Care/standards Drug Industry/standards* Physicians/standards*


Correction in Rapid Response to this letter:
To err is human
Peter R Mansfield, 24 Nov 2006


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909