"for a long period of time, high-prescribing doctors would be invited to trips or annual conferences, that sort of thing"

one of the problems with medical training is that they're not actually training doctors to be critical thinkers but to sort of accept whatever is the wisdom of the day

you think, "Oh, the doctors are probably reading medical journals and looking at the methodology section and the data."  That doesn't happen.  They are lucky if they glanced at the abstracts.  So often the abstracts are spun; they're not actually consistent with what's in the data.

for the longest period of time what they did is they would bring in breakfast, they'd bring in lunches, they'd bring in, you know, some sort of food to eat in the afternoon, and what would happen is you . . . you bring this food in, okay, by the drug reps, who were often are pretty young women. 

what you really see at every step of the way from the beginning of the generation of the evidence base is a story of commerce, a story of creating a story and then disseminating that story that will support a market, support a product, and that's what you see at every step of the way 

The Invasion of False Science Into Medical Schools and Medical Journals.  Thanks to Barbara Loe Fisher for this clip and information.  The speaker's name is Robert Whitaker, author of Anatomy of an Epidemic, 2010.

This is a clip from the movie, Medicating Normal, 2022.

So, unfortunately, I think one of the problems with medical training is that they're not actually training doctors to be critical thinkers but to sort of accept whatever is the wisdom of the day.  So then you want to look at where does the wisdom of the day come from?  And you think, "Oh, the doctors are probably reading medical journals and looking at the methodology section and the data."  That doesn't happen.  They are lucky if they glanced at the abstracts.  So often the abstracts are spun; they're not actually consistent with what's in the data.  But then really, you know, especially for a long time, you ha[d] these free dinners, continuing medical education dinners.  They go out to a nice restaurant, the doctors, or, say, psychiatrists, and there you'd have a famous person, or a fairly famous person, giving a talk about the wonders of the latest drug.  So one thing is freebies, basically free dinners, etc.  That was really big in the '90s and the first parts of the 2000s.  

Then next you have the drug reps they come around and they come to doctors offices and at least for the longest period of time what they did is they would bring in breakfast, they'd bring in lunches, they'd bring in, you know, some sort of food to eat in the afternoon, and what would happen is you . . . you bring this food in, okay, by the drug reps, who were often are pretty young women.  And then they might bring in a speaker to give the talk to the doctor to give but what you have there for is a method of disseminating information to prescribing doctors that involves you know that's where they're getting their information from is from pharmaceutical companies basically, you know, pitching their product, and often they'll leave brief samples.   That sort of thing.  And at least for a long period of time, high-prescribing doctors would be invited to trips or annual conferences, that sort of thing.  So you see money really governing medical education, continuing medical education, what doctors learn at their offices, what young residents learn.  

Money is greasing the story-telling at every step of the way from money greasing what academic psychiatrists say to what the ordinary doctor in his office learns about.  So everywhere what you're seeing is a commercialized presentation of supposed scientific information.  

MEDICAL JOURNALS

And then the other problem you do see of course is where you think "The medical journals!"  Well, the former editors of medical journals like JAMA, and New England Journal of Medicine (NEJM), and the British Medical Journal they've all said that like basically we became vehicles for a sort of story laundering.  In other words, they began where they couldn't even trust what was being published and their own journals because of this corrupt process.  And then you also have the problem that advertisements are going to the medical journals, that's what they rely on to fund their operations.  So if we deconstruct this storytelling process in our society, this information that gets out to the public to prescribing doctors what you really see at every step of the way from the beginning of the generation of the evidence base is a story of commerce, a story of creating a story and then disseminating that story that will support a market, support a product, and that's what you see at every step of the way.  Now supposedly it's getting cleaned up some because it got so out of hand, you know, by 2008 and 2009, but I don't really know how much it's getting cleaned up.  That's sort of still we need you know we need to see.  What we do know is from the mid-1980s to 2010 roughly, in psychiatry, it was the wild wild West with money greasing this storytelling process from A to Z.