Doctors on the Take

Drug and device companies continue to pay billions of dollars to physicians. Some of these payments are legitimate research grants or reflect payment for legitimate contributes physicians made in developing drugs or devices. A substantial number are basically just bribes (free dinners and trips) to prescribe or use their drugs or devices, or they are questionable payments to get doctors to write positive articles or teach positive courses about their products. You can read the details here, and search any particular doctor using the second link:

Open Payments Data

Search Payments to Specific Doctors

Research shows that doctors at the top of the list in terms of payoffs from drug and device companies do not reveal such payments a shockingly large amount of the time when writing journal articles (62% of the time in the study cited below!). The system of publishing research about medicine relies on self-disclosure of potential conflicts of interest by authors. Unfortunately, these data show the system is broken. Medical journals need to mandate such reporting, and actually double-check whether authors are telling the truth using these readily available public sources of information.

You might think getting a free meal or two from a drug company wouldn't have a major impact on doctors' medical behavior. Unfortunately, the evidence is clear that such bribes do have an impact. Doctors who get the most meals prescribe the fewest generic (i.e. cheaper, usually) drugs and change their behavior in other ways that favors the drug companies.

Doctors also frequently receive free samples from drug companies. While this seems obviously beneficial to patients, the reality is that such practices also influence doctors to then prescribe those drugs more often, and they are usually expensive, patented drugs and not cheaper or generic alternatives.

Basically all major pharmaceutical companies engage in illegal marketing practices, and have paid large fines as a result of them over the years. Arguably though, these fines are a pittance compared to the massive profits these companies make. So it shouldn't surprise us when drug and device companies are trying to influence and corrupt doctors. Though pharmaceutical and medical device marketing has been steadily rising every year, enforcement of rules against deceptive marketing and other malfeasance is on the decline. You can read a detailed reporting of these crimes here:

Pharmaceutical Company Malfeasance

Final note: Dr. Yarnell is president and part owner of Heron Botanicals and does make money off the sale of herbal products produced and marketed by this company. He is also CEO of Red Root Pharmaceuticals which currently has no products but is trying to get a botanical formula approved by the FDA to treated polycystic kidney disease.

References

–Ziai K, Pigazzi A, Smith BR, et al. Association of compensation from the surgical and medical device industry to physicians and self-declared conflict of interest. JAMA Surg 2018;153(11):997-1002.
DeJong C, Aguilar T, Tseng CW, Lin GA, Boscardin WJ, Dudley RA. Pharmaceutical industry-sponsored meals and physician prescribing patterns for Medicare beneficiaries [published correction appears in JAMA Intern Med. 2016 Sep 1;176(9):1411-2]. JAMA Intern Med 2016;176(8):1114-1122.
Morgan MA, Dana J, Loewenstein G, Zinberg S, Schulkin J. Interactions of doctors with the pharmaceutical industry. J Med Ethics 2006;32(10):559-563.
Schwartz LM, Woloshin S. Medical marketing in the United States, 1997–2016. JAMA 2019;321(1):80-96.