The Skeptical Professional’s Guide to Rational Prescribing

Book excerpt: The raging COVID-19 pandemic has shaken our trust in science. This volume reviews the evolution of misconduct and fraud in science, the many steps taken to alleviate the problem, and the likelihood that it will continue, given our profit-driven healthcare system. Contents are set in a clinical context, wherein misconduct and fraud affect rational prescribing, a process that depends on balancing the risk–benefit ratio of treatments, whether pharmacologic or psychotherapeutic. The clinical consequences can be significant, in that the efficacy of treatments can be vastly overplayed, adverse effects minimized, and costs to the healthcare system increased if corrective measures are not taken. Key Features • Discusses the various aspects of cheating in publications: spin, protocol changes; failure to publish negative studies, including current data on the publishing industry and its issues, like the menace of predatory journals, poor peer review, coupled with lack of early education in ethics, and its significant impact on rational prescribing. • Assesses the impact of misconduct and fraud on clinicians and healthcare professionals as they attempt to balance the risk–benefit ratio which is supported by multiple contemporary studies. • Presents shocking data on bribes to physicians, journal editors and other key opinion leaders, exposing the ultimate root of the problem which lies in the economics of the healthcare system, badly in need of repair.