I see and feel the passion you have towards a very strong argument towards the relationship of physician and pharmaceutical companies. I believe what you are posing is indeed happening in the world we live today. It is the result of the human nature to be greedy and selfish. With that being said I as Biomedical Engineer will not fed into this physician-drug designer game but, it comes done to ethics and if you are willing to whistle blow such claims. Its easier said then done as the expression goes. You have to be fearless with what you want to do but in a professional manner. Will I find myself in this position one day? I hope not and if I find out by word of mouth I hope to be bold in that day. This scenario of what you have talked about is exactly like CTE and the NFL. The NFL is a huge money making business and for them to stop would probably bring down investments and would hurt the economy. The love of money is what has held people in their actions.

I used to ponder about the relationship between physician and drugs designer as well, so I completely understand where you are coming from. However, I believe eradicating or improve this relationship which is truly toxic to the patient will never fully be accomplished. It all boils down to the nature of humanity as a whole. We tend to make profits from others, not by lack of sympathy for them but by greed for ourselves. Especially in the case of the USA, where costumer attraction tends to overcrowd quality of service. I am going to reference other medical routes different from the common allopathic medicine. I am originally from a very nature-driven country in Africa. I have seen people being treated for cancer with nothing but herbal medicines. The goal of "Traditional medicine", as it is commonly called, is to completely eradicate a problem whereas allopathic medicine tends to eliminate the symptoms prompting patients to ultimate return back or future hospitalization when they symptom resurface. Take, for instance, this addiction that we, Americans, have with painkillers. By relying so much on them, under the suggestion of our dear physicians, we essentially ignore the root of the problem which might eventually worsen if left untreated for too long. Another medical route, I am interested in is the osteopathic medicine, D.O., These physicians, although highly underrated, have figured the best approach to cure human ailments. Their holistic approach to patient treatments, which include the musculoskeletal system, ensure that not only avoidance of surplus of pharmaceutic drugs which are loaded with side effects, but also a " natural" and direct way to address the problem.
However, I wouldn't be so fast as to blame allopathic physicians so rapidly. We, as future engineers, share parts of that blame. Engineers in the Industry tend to be highly driven by profit, as opposed to their counterpart in the Academia. I understand why Industry engineers try to prioritize the development and commercialization of their products for a disease that perhaps a '' natural'' form of remedy might exist. Nobody wants to see their years of education result in no check. Sadly, it is life.

Each illness and remedy needs to be examined individually in order to substantiate your claim. Many illnesses don't have a cure yet, so the remedy that physicians prescribe or treat patients with cannot cure them and the patient knows that. The aim of these "remedies" that are made by pharmaceuticals is to ease the patients pain or discomfort. Sure, you may believe that the cure for any disease is somewhere in our bodies or in the environment naturally, and I don't disagree with you, but those cures need to be discovered and tested. The age of moving away from pharmaceutical drugs and towards natural components for rehabilitation is now, but there's definitely not a cure for everything right now. For the people with incurable diseases, their best option right now is to get relief from their discomfort that pharmaceutical companies and physicians work together to provide.

I believe the case to be true, it can be seen most of the places that the relationship between physician and drug dealer are mostly on the profit side rather than to actually cure the root problem. I think to rectify the solution it would require quite a bit of research.

Now this is something that has bothered me for a long time. I have always said that, while physicians and big pharma are here to assess and relieve our ailments, at the end of the day it's all about money. Cash rules everything. There will never be cures to ailments because once its cured, there is no more money to come out of the disease, or more specifically, there is no more money coming from the person themself. I, personally, don't think this is something that will ever change and that has to do will the statement I made earlier. Once people get a taste of millions, their only focus will be on the millions of dollars they can make and not the millions of people the can save. As Americans, they know the power of the dollar and will try to grab that power by any means. Even if those means are preying on the ill. It's something that genuinely upsets and frustrates me. If the physicians and the drug companies really cared about the people and couldn't find a cure, at least make that drug more affordable. For example, no one asks for Type I diabetes, however there's nothing a person can do to prevent getting it and it will come for anyone no matter their race, gender or financial status. Seeing this fact, why should a lower class citizen who gets Type I diabetes have to pay thousands of dollars for insulin. They never asked to be diabetic and they couldn't prevent it but now they have a lifetime fine for something they absolutely need (insulin) to survive. It's because drug companies see the people as statistics, numbers, and not as a living breathing human. I read a story once told by a physician about a man going to the doctor and asking "Doc, which kills you faster? Blood pressure you don't control or blood sugar you don't control?" He was asking this because he was unable to afford both medications for ailments that he never asked for. That broke my heart and I don't even know the man personally. This is one case of something that happens all across America. So many people struggle with this but at the end of the day, the people who are able to make change don't care as long as they are getting paid. 

I also agree that this game - unfortunately - exists in  the world, and as it have been said, it is human nature. I do not think there is any cure for this situation, humans have different personality. You have made a 2 generic assumption, all pharmaceutical company are bad and all engineers are good and I can not agree on that.

From my point of view, this situation has no end, it is between those individual and there God, no rules can change any of the outcome, it is all about morality.

The mindset that physicians and drug makers will never create cures because that will not gain them money is a very dangerous view to hold. While I cannot say that every doctor and pharmaceutical company is free from corruption, I think there are enough people in Industry and Academia who are actively working towards treatments and cures that it cannot be claimed that we must seek out holistic treatments since they're the only, "apparently ethical" ones out there. 

Vaccines are a great example of this. They prevent the spread of specific diseases and can even be used to eliminate them. There are plenty of laboratories and companies around the world that continue to make vaccines even though that is completely counterintuitive to your claim. 

The kind of belief that you hold also assumes that scientists are perfectly capable of curing illnesses and just do not do such because it doesn't get them any money. Medical research takes time.Sometimes cures take over 100 years to even be made. I mean, for example, people have only really been culturing cells effectively since the 1950s. Plenty of vaccines and treatments have been created from what is around only seventy years of research but to assume that scientists have gone so far as to cure every modern disease and then hide these cures so they can keep making half-functioning treatments is ludicrous.

In reality, we aren't as advanced as we'd like to think. It is important that we, as biomedical engineers and researchers, continue to design, research, and help expand the current knowledge base so that hopefully in the future cures will be accessible.

For now, though, treatments work. There may be bigger issues in the fact that there is less funding going into cures, but to assume that people aren't actively looking for cures over treatments is not justified. 

I do agree there is a game being played between physicians and drug companies- you go to the doctor, tell them what's wrong, they prescribe you some pills and you hopefully feel better soon. Well, if that weren't the case, did the doctor really do anything? Although I previously agreed with the existence of the game, I am unsure if it is deliberate on both specified sides. Patients will go see a doctor in search of a remedy for their illness. And since the development of pharmaceutical drugs, patients regard this as the most immediate remedy. I would like to propose the thought that it is not the physicians per say, but instead the supply and demand of an "instant cure" from patients. 

Regardless of who is in on it, the question at hand is how do we, as Biomedical Engineers, stop this cycle? Well, I would like to believe that we are acting as an aid in the search for the most effective and efficient remedies, and pharmaceuticals should be used as one of the many tools to do so. By finding other remedies to illness, through medical devices or biologics for example, patients have an alternative cure that is as fast-acting and noninvasive as taking a pill. It is then the job of bioengineers to find such alternatives, the physicians to inform the patient of their possible treatment methods, and the patient's to deicide for themselves without the pressure or influence that a pharmaceutical drug is the only instant cure. 

I believe the "vicious game" talked about here cannot be stopped for as long as the American culture relies more on curative medicine rather than preventative medicine. If the patient is healthy, then the doctor wouldn't prescribe drugs, however, if the patient is sick, doctors will often prescribe drugs which may or may not help. Curative medicine is very drug-focused, compared to preventative medicine. However, the goal of the physician is to help the patient, regardless of the corporate greed of pharmaceutical companies. Although there are some very suspicious collaborations between physicians and drug companies, I believe most of the drugs prescribed do help the patient rather than harm the patient, and many drugs developed do save lives. There is a larger issue at hand on medical costs in the US, where many people cannot afford to pay for those drugs. Overall, I believe it's a larger systemic issue rather than just the collaboration between physicians and suspicious drug companies. It's not necessarily the drugs themselves, but rather the access to those life-saving drugs which we should be focused on, in addition to creating a system where people don't need to rely on drugs but have an all-around better quality of life (more prevention-focused). 

I can see that may of you have favored the initials student's post about the "Evil-Big Pharma", well I can say that I agree to an extent. I can see how the endless circle of treating a disease opposed to curing it can be most profitable for pharma and physicians, but I do not agree with the idea that Doctors would choose to make money over the curing of a patient if there was a choice. Many of the disease that may be inferred in this conversation do not have such cure yet, and patients are forced to find a means to alleviate the symptoms of the disease, because there is no cure. Also, what about terminally ill patients like stage 4 prostate cancer. I do not believe the same can be said about them or any other people with severe cancers. I have worked with many oncologists and have seen first hand how they try to prove the necessity of a drug to insurance companies to extend the life of the patient at least a couple of years so they can enjoy with the families. Is there money in this, well yes for the pharmaceutical company and the physician, but I really do not believe that the motive of keeping a patient alive is to charge them more visits over the fact that they will have more time with their family. 

Now, the other side of the argument is prevalent and does exist when allocating funds to specific therapies over others. In recent time, there has been advancements in immunotherapies that utilize our own immune system to block checkpoints and unleash T cells on cancer cells, or utilize adaptive immunity by selecting for the best T cells, mass producing them, and reinjecting them in patients. These studies have shown efficacy in Phase I, II, and III trials, but have not had enough financial support from the government or cancer institutions to pursue them opposed to a new drug that may target only a specific gene mutation that can alleviate 5% of the population instead of 50% or more that immunotherapy can. I can see this supporting your argument, but I still can not make the same argument and say that Physicians would prolong life to charge more money.

I definitely see your point about flaws in a system that allows physicians to prescribe drugs without the patient's best interest in mind. A good example of your point can be seen when exploring the opioid epidemic. Physicians having relationships and receiving funding from pharmaceutical companies is extremely unethical and has given rise to a dangerous amount of prescriptions given out for opioids. However, as a biomedical engineer, I would personally never think to contribute to this problem. My perspective is focused on contributing to work that benefits the patient and aligning with my morals, which are not financially driven. Although it may be difficult to navigate an environment that does focus on money, I believe that there are still many good people with good intentions in the biomedical field, and not all physicians and drug companies display this behavior.  

I totally understand how jaded you feel about the state of medicine and the treatment vs cure conversation. I get it. Just thinking about diseases like  pancreatic cancer and how much of a death sentence it has become in our society, especially when metastasized to the point of no return. Here’s a glimmer of hope that I would love to share with you and hopefully you can share with your classmates beyond this discussion we’re having. Tell your colleagues about Dr. Jennifer Doudna. Tell them about last year‘s Nobel prize in chemistry winner and how Crispr CAS-9 technology and gene editing will be is the next frontier that will be taught classrooms across this country. Get excited about the fact that we’re talking about cures as opposed to therapies. A course correction in the genome of the individual; a course correction of inheritance, heritable genomic editing. Tell them to get excited about adaptive immunity; how diseases like sickle cell anemia and muscular dystrophy could be things of the past fundamentally reshaping red blood cells in the body allowing individuals with this ailment to be able to absorb more oxygen, a novel therapy whose ramifications can affect generations of individuals. Stimulating endogenous repair of DNA, stimulating from within your own own body the ability to repair itself, mechanisms unfathomable in recent years, direct epigenetic modifications are now a reality.  How will somatic cell genome editing be accomplished? Can these strategies be retrofitted for clinical usage with pinpoint accuracy? I’m excited about to future and hope this can spark the imagination of our most precious commodity, our youths who’s minds are at the forefront of these amazing scientific discoveries of our time.

You make a strong argument, and I certainly can understand your point of view. I also believe that this game happens, but maybe not to the extent that you’ve described. I would like to believe that the majority of physicians entered this field for the sole purpose of helping people. Whether they keep this mindset for the entirety of their career is a different story. After some time of obtaining such high wages, it is common for them to become money hungry.

I believe that without biomedical engineers, advanced equipment would be challenging to produce since physicians focus on interacting with patients. Our role in the medical field is just as important as theirs. We may not personally interact with patients, but our creations certainly do. While this game is played, there is noting we can do to remove ourselves. Think of us as pawns, small pieces focused in one direction that are often not looked to first for power, but eventually some of us will become something much greater. Unfortunately, I do not think this vicious game can be stopped. It is something that we have accepted when we decided to go into this field.

@dyc6 I completely agree with your post that although the "cruel game" as mentioned in the initial post may have some truth to it, there is not just one solution to solve the problem. I do think the overarching goal for big Pharma is to make money and some physician's may take on that sentiment throughout their career as well but not all. I do believe especially in western culture if we focus more on preventative measures instead of corrective measures there might be some relief for patients overall. The drugs do not provide a cure, and although they may aid in some ailments there are many times more prescriptions to aid in the side effects caused by the first medication. I do think this is a cycle that will progress, but I don't believe the sole cause is due to the industry and big players involved such as physicians.