Ray Moynihan’s investigative journalism book — ‘Selling Sickness’ — was a tour de force – impaling the concept of ‘preventive pharmaceutical therapy’ for healthy individuals. If new to this see ‘disease mongering‘. He continues to raise issues that have major health service and public health ramifications. This paper in the BMJ won’t please those whose livelihood depends on drug sales and company stock prices.
Why is this relevant to sports medicine? Because the focus of drug company marketing is to attribute a very specific [chemical, surprise!] cause to diseases that have many causes. Depression=lack of serotonin. Osteoporosis=insufficient bisphsophonate. The broader sociocultural determinants of disease are marginalized if an unsuspecting patient accepts the pharmaceutical framework. Early childhood development, education, playgrounds, family environment to avoid later mental health problems = too hard, just prescribe Zoloft. Exercise across the lifespan to prevent falls and fractures = too hard, just prescribe Fosamax. 30 minutes of physical activity daily to reduce cancer risk by 50% – ‘impractical’.
Moynihan’s brilliance is to highlight the absurdity of pharmaceutical ‘marketing masquerading as education’ (from Selling Sickness (2005), above). Physical activity is a central platform in prevention of many important diseases. It is likely the most powerful single preventive health measure non-smokers can adopt. But if drug company studies are biased toward suggesting the answer lies in a chemical compound, the naive member of the public will think that physical activity is an optional extra. Realising that Zoloft and Fosamax are not panaceas is an important first step. Once the pharma=preventive solution myth is busted, exercise counselling will have a much greater chance of success.
Share your thoughts in the comments box below or email bjsm to provide a guest blog. Disagree? – let’s hear from you! Personally, I find 4 slots of 15 minutes a day to walk. I’m not relying on a statin for my heart or an anti-cholinesterase to maintain my brain. Follow Ray Moynihan on Twitter @raymoynihan