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Author: Dan Perry

Date: October 21st, 2010

It seems Dr. Carl Elliott has let his instincts as a provocateur get the better of his perspective as a physician and healer. Promoting his book "White Coat, Black Hat: Adventures on the Dark Side of Medicine,” Dr. Elliott, a frequent contributor to The New Yorker and Atlantic Monthly, finds it deplorable that physicians who use drugs to relieve human misery have any actual contact with companies that research, develop and sell those medicines.

Compared to the storied family doctor who was blessed with endearing bedside manner, physicians today can actually relieve suffering, correct disorders of the body, and allow more of us to live long and healthy lives. And as Dr. Elliott surely knows, effective care and prevention these days most often comes from a prescription pad. On CNN this week Dr. Elliott took aim at pharmaceutical marketers for supposedly “selling diseases” to push nostrums that meet a contrived public demand. He calls it “disease branding” and compares the practice to a classic 1928 work titled “Propaganda”. It is true, as he says, some conditions that people used to keep quiet about (urinary incontinence, impotence, gastric distress, even mental illness) have been made more acceptable and treatable as clinical conditions. But to say that these and other conditions were “rare until a marketing campaign transformed the brand” blithely ignores the quality of life improvements won for millions of people thanks to therapeutic R&D. Medical innovation is our best hope for taming more lethal affronts to life and longevity as well. Not long ago Americans died at twice the rate as now from heart attacks and stroke; cancer was considered shameful, and dementia was accepted as a natural part of aging. I for one am grateful for the yes-we-can attitude of American medicine to combat diseases and improve the quality of our lives. But Dr. Elliott is not interested in that story. He is quite candid about his purposes in his book: “I do not claim to offer a balanced picture of contemporary American medicine," he says right in the introduction. "My intent is in how medicine has gone wrong, not in what there is to admire.” Thank you, Dr. Elliott for that bit of refreshing honesty.






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