A Pill for Every Ill: The Rise of Corporate Medicine

April 4th, 2016






“If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as a sorry state as the souls who live under tyranny.”

— Thomas Jefferson





With the apparent miracle of antibiotics in widespread use in the early 1930’s came a new wave of optimism. It must have seemed that humanity’s total control of their environment would soon be a reality, ensuring health, safety and prosperity.



A little history…


By the turn of the last century science and technology, riding on the back of the industrial revolution had taken ascendancy over religion as the dominant source of knowledge – at least those concerning the practical matters of day to day life. Einstein’s theory of relativity would soon explode the comfortably smug stance of the scientific community1; Henry Ford would revolutionise mass production techniques; and now it seemed that science, having turned its steely, modern gaze to medicine, was on the verge of eradicating disease forever.


Buoyed by this progress, governments whose people were racked by epidemics like the Spanish flu (which claimed over 20 million lives), tuberculosis, polio and the like, were only too eager to fund the search for yet more miraculous cures.


The sky was the limit – and so were the potential profits.


The rise and rise of Big Pharma




It must have been somewhere along this yellow brick road to medical wizardry that the business opportunities to make obscene amounts of money became just too tempting. It wouldn’t have been the first time. History is littered with different versions of  the ‘Snake Oil’ salesmen of the American West pioneering territories, pedalling outrageous claims for their mysteriously prepared concoctions. They made their profit through exploiting the scared, the desperate and the gullible.



The key difference here is one of scale. Just like warfare has progressed from individuals or groups confronting each other face to face with rocks or spears to the capacity to kill millions at the remote push of a button, modern medicine now has gone from the individual consultation and the ‘exchange of stories’ to the capacity to mass produce medicines and vaccines and pressure governments to administer their products to entire populations at the stroke of a pen.

Of course, that also meant the need to establish dominance over the other, competing philosophies and methods of the time.


The video below shows one version of how this came about.




Everything counts in large amounts


And that’s where the scales shifted out of balance, because the scale itself shifted. A drug company won’t make much profit pushing their product to individual doctors – though they do that too as we will see.


There is more money to be made selling to hospitals and medical centres. There is even more money to be made by selling to governments via regulatory body approval. Which brings us to…


The seal of approval


Unlike the snake oil salesmen of old, modern pharmaceutical companies are required to have their products approved by a regulatory body before they can sell them. The lure of greater profits can lead them astray even here though.




There is a known practice within the industry called ‘going off-label’ where companies get their product approved for a niche application or disease treatment but then convince doctors to also prescribe it for another disease that has a far greater market. How might they convince doctors to do this?


Selling medicine to doctors


There are several methods pharmaceutical companies employ to convince doctors to use their products. Some of them are humorously investigated by John Oliver in the video accompanying this section below. In the meantime here is a breakdown on the art of the corporate medical sales pitch.


The sales representative. The sales representative’s job is to convince the doctor, medical centre or hospital to use more of their product. There are several quasi-legal ways they do this. In some cultures this can be as simple as making sure the particular representative is sexually attractive to the buyer.


This is not to say that actual sexual services are parlayed for a lucrative sales order. It is more that attraction, flattery and attention often midwife a successful sales pitch. It brings to mind the forthright summation of this approach told to me by a client (herself a medical sales rep from New York) many years ago: “Ya gotta jerk ‘em off without jerkin’ ‘em off – ya know what I’m sayin’?.”


Sponsored medical conferences, junkets and ‘think tanks’. In practice, these are little more than thinly disguised ’infomercials’ for the company’s product. There is an inbuilt conflict of interest when the information about a medical product is coming from those who stand to profit most from its success.



Sponsored research. This is probably the most disturbing of all. The medical industry competes for trillions of dollars each year. The conflict of interest inherent in the need to have a positive result to research a product funded by the company making that product is simply too great.


Medical researchers depend upon funding for their scholastic and financial careers. Obtaining that funding is a constant struggle as the normal institutional channels cannot supply financial backing to all the proposed research. That leaves researchers very vulnerable to the dubious, sponsored research practices by the big pharmaceutical companies.


Have you ever wondered why it is always a new drug medicine is searching for and not other methods or cures – let alone a serious study about preventative measures that require no medicine at all? Look no further than who is funding the direction the research will take.


Free lunches. As the old saying goes, “There is no such thing as a free lunch.” It is the job of the sales rep to find out the particular culinary tastes of their target and make sure they just happen to provide for them.


Free ‘trials’ of expensive computer systems equipped with software optimised to make ordering a particular company’s products easier. Often the trial period becomes indefinite and the computer system is kept by the medical centre, effectively making it a gift or bribe depending on one’s legal point of view.


Free trips to exotic locations either as a ‘thank you’ for high volume orders or as an incentive to increase them.


Professional flattery. Influential doctors or buyers for medical institutions in high academic or commercially lucrative positions are professionally flattered by being asked to join medical discussion groups as ‘thought leaders’ (I’m not making this up).


In practice they are using their position to influence the purchasing decision of their peers by sticking to a prepared script supplied by the drug companies. Oh, and of course they are financially rewarded for doing so. How much of a ‘thought leader’ could one claim to be if one is merely parroting a carefully prepared sales pitch whose only purpose is commercial gain? Well, unless that thought is: “How do I leverage my professional status and position of trust to make more money?”


So what business of ours is this form of business?


© Loren Fishman


In other forms of business these legal and ethically dubious practices might be considered relatively harmless ways to grease the wheels of commerce. The trouble here is that we are not discussing designer label clothing or perfume. These are products that have the potential to adversely affect the health of vulnerable people in life and death situations – on a mass scale.


The ramifications for our collective health from the huge scope and influence by corporate medicine will be – by yet another remarkable coincidence that is all too commonplace on the Monday Conscious Health blog – the subject of part two of this look at the big business medicine has sadly become.





Till another Monday shows us the money (and hopefully the truth) once more,


1 An anecdote from 1874 illustrates the mood of the time. Max Plank (who would go on to be the unintentional father of quantum physics) was advised by Philipp von Jolly in Munich against embarking on a physics career because “…in this field, almost everything is already discovered and all that remains is to fill in a few holes.”




(c) Jeremy Halpin, all rights reserved. All images are the author’s own unless otherwise indicated or if the original source is unknown at the time of writing. You can subscribe to this blog by clicking the button in the bottom right hand corner of the page – or share it on the social media of your choice. If you have any wishes or questions regarding subjects to be discussed on this blog use the contact information below. Jeremy is also available for seminars, lectures and personal consultation: info@jeremyhalpin.com

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