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How do Physicians Decide Which Medication to Use

It is hard to know what to believe with all the sensationalism in reporting news today. Some months ago, I was having a conversation with some fellow physicians and the topic we were talking about was, what can we believe anymore? We were talking about the field of medicine. Wouldn’t you think that would be a safe field where honesty is always reported? But we physicians know that when it comes to new drugs arriving on the market, in which a company may have spent hundreds of millions of dollars to bring it to market, they are gong to do everything possible to make sure it is a success.

Let me give you an example. Suppose, Pharmacy company A does 100 different studies on a particular medicine and 0.1% of the 100 studies show the new medicine has one bad side effect that may lead to death. The other 99.9% of the studies did not find that problem side effect and suggested it was safe. Should the bad effect be discounted being it was only 0.1% of the studies? Remember, the drug company may already have $900,000,000.00 invested in this drug. Their new drug, they feel, will save thousands of lives every year in spite of that small percentage of patients that may die, that would not have had to. Is it worth it? Certainly not for the one who got the side effect and died, even if it did save the neighbor.

For us the consumer, it is not much of a problem. Of course, we do not have nearly $1B invested in the new drug. But would we be willing to take a medication, if you had a 0.1% chance of dying from it, even if it would save the other 99.9%? Probably not. Drug companies will try to find all kinds of ways to spin this. They are trying to salvage most of their investment without really hurting people, but remember, they have bean counters that can spin the arithmetic a million different ways to make the medication look safe. We poor doctors, that do not have calculators for brains, often believe the cute little drug reps that come in with their short skirts and pom poms, genuinely making us know that their new drug is the greatest medication in the world and the only side effect they have found so far is poverty.

When I started practicing medicine in 1969 all the drug reps were middle-aged greying men with a paunch that were pushing new drugs. Over the next 15 to 20 years, that all changed dramatically. Suddenly, all the drug reps were beautiful women that looked like they were off the front page of Vogue. Whoever thought that beautiful young women might do a better job of pushing meds to a profession that was at that time over 90% male, was probably not taking much of a leap in faith with their new sales approach.

I am going to let all of you read between the lines so you can decide if your doctor is picking the best medication for you, or is that medication being presented by the girl off the cover of Vogue when your doctors defenses were down? Don’t take me too seriously today. This is a lighthearted post. Is it true, or all fake news? I love all the American people. Let’s fight for our president and our country.

God bless all of you. Rick Redalen, MD, Maverick Doctor

Pick up a copy of my book “God’s Tiniest Angel and the Last Unicorn,” available on Amazon.

Dr. Rick is a retired American physician, entrepreneur, and philanthropist who has done mission work around the country and the world. He is now on a mission to improve healthcare in America. Visit or email him at

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