EXACTLY. They get kickbacks for selling drugs. They get no money for suggesting you eat well or take x supplements. In fact, they get no money for you being healthy and drug free.
There are examples at both ends of this spectrum.
You hear stories of those in assisted living in a quasi-vegetative state, and when they get weaned off their meds for an upcoming operation, suddenly their old selves are back! It's the stuff of paranoid nightmares...institutionally doped into complicity.
On the other end of the spectrum, in the past couple of years I've seen a cardiologist and his Fellow at one practice, and a cardiologist at another practice. All three of them told me to "go vegan," or to eat a "plant-based diet." We could argue the relative merits of that advice, but not a single one of them asked a single question about anything that I eat. There was no evaluation of my dietary habits...just "Go vegan, young man" right out of the gate as the conversation starter. One visit was a referral for cholesterol that's high if untreated. The other was when I went in after having a small stroke (TIA), cause unknown. I don't have heart issues or blocked arteries or high blood pressure...those are all fine. They don't make money from giving that advice, but it's not really informed advice for a specific patient, nor is it detailed enough. There's way more to a life-sustaining diet than just "eat plant-based." It felt more ideology-driven than medical.
That doctor I had for 25 years had a bunch of lifestyle questionnaires as part of my annual physical, including diet. At least that had some data behind the advice, and always came out that I was reasonably balanced...as defined by that one-size-fits-all standards. When I quit drinking I went on a pretty extreme reparative supplement program arrived at by a
lot of self-study. My doctor helped me tweak it. So there
have been pockets of prevention-focus (this guy was a nephrologist.)
Some amount of the prescription drug problem is demand-pull. When I was first diagnosed with high cholesterol, I cut out all red meat and ate all sorts of whole grain and bean foods. I did this for 6 months. I pounded 20 points off of my cholesterol real fast, but I could not maintain that diet forever...I felt too deprived. So now I have the reasonably balanced diet I've always had and take statins to keep the numbers down, even though I could do it through sacrifice alone.
Then there are all these "talk to your doctor about" commercials that are on television because they work. We all know of the "If you don't prescribe it, someone else will" stories (personally, I don't think this excuses doctors.)
The people I feel sorry for in this mess are those who genuinely lack the capacity to evaluate the advice they are given and to make informed choices. It's the luck of the draw for them.
