On the Take

September 27, 2004
"Some physicians become known as whores." This is strong language in Kassirer's mostly temperate but tough look at how big business is corrupting medicine—but according to Kassirer, one doctor's wife used the word "whore" to describe her husband's accepting high fees to promote medical products. Such personal anecdotes distinguish Kassirer's look at the conversion of America's health-care system into a commercial enterprise. Kassirer, former editor-in-chief of the prestigious New England Journal of Medicine,
notes the range of conflicts of interest between profit-centered business and people-centered medicine, such as the drug industry's huge expenditures (in the billions) for courting doctors to use their products, for recruiting physicians to tout their drugs or, more slyly, to present seemingly objective medical discussions that, on closer examination, do favor the company's product over others. Kassirer also covers the abuses of both fee-for-service (which can lead doctors to perform unnecessary but lucrative tests and procedures) and HMOs (which reward doctors for keeping costs down). The author calls for more scrutiny of the health-care industry by Congress and a "sustained public outcry against inappropriate practices"; the banning of industry gifts to medical personnel; and—difficult to imagine—disclosure to patients by doctors of financial incentives they are receiving. Agent, Theresa Park at Sanford J. Greenburger Assoc.