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White Coat, Black Hat: Adventures on the Dark Side of Medicine 1st Edition

4.3 out of 5 stars 45 customer reviews
ISBN-13: 978-0807061428
ISBN-10: 0807061425
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Editorial Reviews

From Publishers Weekly

While most people are vaguely aware of the uncomfortable symbiosis between doctors and the pharmaceutical industry, few would believe the flagrant bribery and brow-beating that occurs, according to Elliott's (Better Than Well) latest. Pharmaceutical companies have overwhelming influence over research studies, grant funding, and the decisions or suggestions that doctors make regarding the care of their patients. As the financial stakes continue to increase, the pharmaceutical industry has an even greater incentive to obfuscate potentially harmful findings about their products. Elliot, a professor of bioethics at the University of Minnesota, methodically exposes every aspect of the connection between Big Pharma and medicine, interviewing experiment subjects, doctors, pharmaceutical sales reps, and others on the frontlines of the issue to give readers a thorough understanding of what lies behind a simple prescription. Employing often shocking stories to reveal larger ethical problems in the industry, Elliott offers no easy answers in an effort that informs and inflames in equal measure.
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From Booklist

*Starred Review* Any physician knows that the careless mingling of certain medical interventions can lead to unwanted—even fatal—consequences for the patient. That explains why physician-philosopher Elliott decided to pen this cautionary book, exposing example after example of the adverse effects of mixing capitalism with the practice of medicine. It leads, he says, to a situation where there is no true advocate for the patient. Patients have become health-care consumers shopping for “the best medical bargains they can find.” In such an atmosphere, neither the pharmaceutical company nor the medical researcher, not even one’s own doctor, can be relied upon to place a patient’s best interests above profits. Besides the obvious perils inherent when a physician accepts “gifts” from pharmaceutical and medical-equipment salespeople, there are risks when authorities trusted with oversight also have conflicts of interest. Many medical journals depend upon corporate advertising, and clinical-trial oversight committees are populated with people who are on a pharmaceutical company’s payroll. Moreover, because medical research has become so proprietary, he notes, no one is sharing basic discoveries, resulting in needless duplication of efforts that can delay or kill advanced scientific developments. Elliott’s dim view ought to be a real eye-opener for health-care patients-cum-consumers. --Donna Chavez
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Product Details

  • Hardcover: 224 pages
  • Publisher: Beacon Press; 1 edition (September 14, 2010)
  • Language: English
  • ISBN-10: 0807061425
  • ISBN-13: 978-0807061428
  • Product Dimensions: 6.2 x 0.8 x 9.3 inches
  • Shipping Weight: 8 ounces
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (45 customer reviews)
  • Amazon Best Sellers Rank: #995,143 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover
As a person who has written about the pharmaceutical industry for years, been a pharmaceutical executive and both a critic and supporter of the industry, I highly recommend this book for its unique perspective on the practice of medicine, the drug business, and the many people (both good and bad) involved. Dr. Carl Elliott has done an excellent job of using his own background in medicine (his father was a physician), his research in philosophy and his own perspective as an MD and professor of bio-ethics, to give a very balanced overview of the many problems besieging the modern pharmaceutical industry. Please don't let all these credentials make you believe this is yet another pedantic study of medicine. The writing is superb and compelling, the stories both often funny, sad and touching and the narrative clear and straight forward. Best of all, while the book maintains a high level of scholarship, it never loses its human touch. As an example of why anyone who has taken a drug should read this book, is Dr. Elliott's examination of the types of facilities and the kinds of people on whom drugs are frequently tested. (It is shocking, but true that drugs released to millions of people are often tested on a limited number of people who are not at all representative of the population as a whole.) Dr. Elliott also does a superb job of helping the reader navigate through what has become a vast, medical-industrial complex: including government regulators, universities, physician groups, medical journals and "continuing medical education" that is sponsored by drug companies. The reader will ask after reading this book just what the difference between marketing and science really is?Read more ›
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Format: Hardcover
I'm an oncologist who likes to think that oncology studies are better controlled and more fastidious than other studies. But as I read this book, I wondered whether I was deluding myself about that. More and more of our studies are pushed by pharm. companies and fewer by nationally run cooperative groups. Also, I was disconcerted and somewhat nauseated to think I may be writing prescriptions that don't do what they're advertised to do. I've always had a healthy skeptism for drug reps - or at least I thought I did - and put up with them so that my staff could get lunch. No more. I will not give them any more of my time.

This is a book that all doctors should read, which won't happen of course. It's an eye opener, quite dismaying. I'm grateful to the author for writing it. We (I) need books like this to maintain a critical eye.
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Format: Hardcover Verified Purchase
I was in medical school in the 60s and saw pharmaceutical research expand and devolve from an NIH--academic project to a business run by large drug companies for profit. This whole idea that a public service should be treated like a commodity is new and not without ethical problems, especially for physicians and those who look to physicians for advice.
Dr. Elliott is a well-known psychiatrist/bioethicist who writes in a conversational tone of the difficult, shocking dilemmas we all face when buying or evaluating medications. He has 7 chapters covering drug reps, clinical drug research, me-too drug development, FDA evaluations, and the ethical challenges even bioethicists face when asked to consult for industry. Nothing new here, but wonderfully and accurately portrayed without hysteria.
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Format: Paperback Verified Purchase
This book discusses important topics that we all should know about;

The nontrivial conflicts-of-interest between pharmaceutical firms and doctors and researchers need to have some more time in the sun so that we all know what they are (and the first step in finding a solution to a problem is to understand that you have a problem and what it is).

The large-scale big-money push by pharmaceutical firms to get their drugs into the market, to get them recommended by medical professionals and researchers and into your prescriptions creates all sorts of conflicts-of-interest that consumers, patients and the general public need to know more about.

The disclosure of the financial (monetary and other) arrangements between pharmaceuticals and doctors and researchers needs to be vastly improved.

The treatment of medical (human) research subjects is, at times, seriously problematic, unethical and dangerous.

The true authorship of medical and research papers "written" by the publicly named authors needs to be disclosed. The true conductors of the research needs to be acknowledged. The financial sponsorship of the research needs to be disclosed and finally the raw data needs be disclosed so that different conclusions can be drawn as data can be cherry-picked to fit a conclusion.

It is not the basic business of pharmaceuticals that is being challenged in this book, it is how some of this business is conducted.

This is an important book because the more people who know about the issues discussed in it then the greater likelihood that appropriate solutions will materialize to the problems discussed. Sunshine (the disclosure of true and complete information) is a powerful disinfectant.

Highly recommended!
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