Companies that manufacture medications and medical devices have long sought to develop financial relationships with doctors, especially “thought leaders” whom other doctors look to when deciding how to treat patients. To foster these relationships, they offer physicians fees for speaking to other doctors and for conducting research. In these ways, some physicians make tens or even hundreds of thousands of dollars a year, above and beyond what they make practicing medicine.
Up until recently, this flow of money has been impossible to track. But the Affordable Care Act (Obama Care) requires these companies to publicly disclose any and all payments made to doctors of $10 or more. For the first time ever, this information is being collected and put into a national database. It currently shows that during the last five months of 2013, doctors and teaching hospitals in the United States received $3.5 billion from pharmaceutical and medical device companies. This money was spread among nearly 550,000 physicians and more than 1,300 teaching hospitals.
Of course, the fact that a company has paid money to a doctor doesn’t necessarily mean that something is amiss. It takes a lot of money to conduct research and keep doctors up to date with the latest knowledge in medicine. So the companies that fund this are doing the nation a service. But when so much money is given to so many doctors, you have to wonder how much and in which ways it is affecting the way that they practice.
Yoga Positions For Chronic Pain FOLLOW THE MONEY! Photo Gallery
The sad truth is that the treatment of pain is often driven by money: If you want to understand why certain things are the way they are, just follow the money. Ask yourself who is profiting and you’ll often understand why things are done the way they are. In many cases, the system works well and people suffering from a variety of illnesses and other problems are healed. But the way money flows through the healthcare system doesn’t necessarily produce the best pain treatment or support evidence-based treatments like comprehensive, mind-body programs for chronic pain. Instead, the economics support the use of medicines, short-term “solutions,” quick follow-ups, sending patients to specialists, and an overdependence on procedures and surgeries that have not been proven effective in the long run. But when a disease becomes a $600 billion industry with lots of special interests profiting off of other peoples’ pain, change can be hard to come by. I am sorry to tell you that in our current system there is no financial incentive to get people well.
Doctors are under pressure to make enough money to support their practices and please their patients, who can post poor reviews online and possibly cost them their jobs. They’re also pressured by pharmaceutical companies and spinal fusion hardware manufacturers, and by insurance companies who don’t want to pay for other kinds of treatment. But now the pendulum is swinging the other way, with doctors under increasing pressure to be more cautious about prescribing painkillers. Concerned about addiction and overdose deaths due to the over-prescription of painkillers, the government is trying to get doctors to more closely regulate the medications they prescribe. Unfortunately, there is no national policy or consensus guiding this action.
This pressure toward tighter regulation of medications has changed the nature of the doctor-patient relationship for the worse, as doctors have been directed to perform urine drug testing and enforce tougher prescription policies. It makes the doctor’s role more authoritarian, and less about empathy and compassion. I know that I chose my specialty in order to transform my patients’ lives, not police them Yet the government wants tighter monitoring, without insisting on or even encouraging the creation of comprehensive programs that provide better options for people in pain.
You probably won’t learn about better options for relieving chronic pain by talking to your doctor or visiting a pain specialist, for all the reasons I’ve discussed in this chapter. But the techniques and solutions I lay out in this book really do work. You can conquer your chronic pain and get well.