Medical Industrial Complex

It’s quite perplexing and concerning to observe the prevalence of inaccurate information circulating on platforms like Instagram and within political discussions regarding how physicians are compensated for their services and recommendations. This misinformation can lead to misunderstandings about the financial motivations behind medical advice, which is critical to address for the sake of transparency and trust in the healthcare system.

I want to clarify that when it comes to the medications I prescribe (brand name or generic), I earn absolutely $0 dollars for any medication I prescribe. This means that regardless of the number of prescriptions I write or the medications I recommend, there is no financial incentive for me tied to those specific drugs. This is an important distinction that often gets lost in the noise of public discourse.

Five pills in orange, yellow, pink, teal, and green, displayed on a white background, each reflecting light, creating a shiny effect.

I can make $2.87 for each sale of N-Acetylcysteine through FullScript, a platform that allows me to recommend supplements to my patients. While $0 does not add up to anything, the $2.87 can indeed accumulate over time, especially if several patients choose to purchase the recommended supplement. However, this income is not my primary motivation when suggesting these products; rather, it is a secondary benefit that comes from a service I find useful.

Every time I recommend a supplement through FullScript, I make it a point to disclose that I receive additional income from that service. Transparency is crucial in maintaining the trust of my patients. I genuinely appreciate FullScript and often order my own supplements from there, but I want to ensure that my patients never feel pressured or obligated to make purchases from this platform. Their health and comfort are my top priorities.

In practice, what I often find myself doing is sending my supplement recommendations through FullScript, but many patients end up purchasing the exact supplements and dosages I recommend from other sources, whether it be local health stores or online retailers. This is perfectly acceptable, as my main goal is to provide my patients with the best possible advice for their health, regardless of where they choose to buy their supplements.

If I truly wanted to maximize my income, I could aggressively promote various supplements and push for sales, but that approach does not sit well with my ethical standards. Instead, I focus on evidence-based supplements that I have found to be effective in my clinical experience. I believe it is important to prioritize patient welfare over potential financial gain.

Here are some of my go-to supplements that I frequently recommend based on my clinical experience and the existing evidence:

Calcium for PMDD (Premenstrual Dysphoric Disorder)

Magnesium/B6 for PMDD

I do believe that pulse dosing actual medication such as fluoxetine can be more effective for more severe cases of PMDD, but these supplements can certainly help alleviate some of the more mild symptoms associated with the condition.

N-Acetylcysteine (NAC) is probably my favorite supplement to recommend. It has shown remarkable efficacy for conditions such as nail biting, skin picking, and hair pulling. In fact, it often works significantly better than traditional prescription options for these behavioral issues. Additionally, I will recommend NAC to assist with concentration in individuals with ADHD, as well as for those dealing with long COVID, autoimmune disorders, and post-concussion syndrome. Its versatility and effectiveness make it a valuable tool in my practice.

Sometimes, I also recommend fish oil for enhancing concentration. However, it is essential to note that when combined with SSRIs (Selective Serotonin Reuptake Inhibitors), fish oil can increase the risk of bruising and easy bleeding. This is a critical point that I always discuss during the informed consent process when recommending it, as patient safety is paramount.

Saffron is another supplement I frequently recommend, particularly for managing the on/off symptoms associated with ADHD medications and improving concentration. However, I am currently moving away from recommending saffron as I have found that Memantine is a more effective alternative for many patients.

There are various other supplements touted for their potential benefits in treating depression and anxiety. However, I am cautious about recommending too many supplements due to the associated costs and the risk of side effects that can arise from their use. It is essential to strike a balance between providing beneficial recommendations and ensuring that patients do not feel overwhelmed or financially burdened.

So, if you have concerns about the medical industrial complex and the motivations of healthcare providers, rest assured that doctors are not profiting from prescribing medications like sertraline or even zuranolone. The reality is that while supplements can play a role in your healing and recovery journey, they also represent an additional income stream for anyone who recommends them. Importantly, it’s worth noting that anyone can recommend these supplements, which underscores the necessity for patients to conduct their own research and consult with qualified healthcare professionals when considering their options.