How's business, doc?

Yesterday, a doctor complained to our reporter Sanchita Sen that the Indian Medical Association was making a fortune by endorsing Tropicana and Quaker oats, but wasn't willing to share the royalties with its branches.

Sanchita scented a story and perked up. When she filed her report, we asked ourselves two questions: Is it true that IMA Delhi is greedily keeping all the booty for itself? The second question bothered us more than the first: Is it ethical for India's premier doctors' organisation to suggest that one brand of fruit juice, or one brand of toothpaste, is better than another?

We did some calling up. A representative of the IMA in Delhi justified receiving money saying, "We have our own expenses to worry about." We called back IMA's Bangalore office-bearers with a simple question: Are you objecting to the ethics of endorsement or are you asking for a cut? It turned out they were more interested in the cash, although individual doctors did tell us the system of stamping products with "Recommended by the IMA" disturbed them.

Doctors are considered worthy of the greatest respect because they are believed to have the patient's interest at heart. But consider this: since the 1980s, pharma has transformed itself into the most profitable industry in the world, and has consistently outperformed traditionally more rewarding sectors like commercial banking. It has aggregated so much in profit that it funds thousands of university departments worldwide, and hires the brightest of talent emerging from medical and management schools. And these brilliant minds work towards formulating what a doctor reads, understands and believes.

Jacky Law, a journalist covering pharma, quit in 2004 to write a book on what she had seen of the trade. Her efforts yielded the book Big Pharma, which concludes that modern medicine has lost its way, and that "a relentless pursuit of profit is crowding out the public good".

Law reveals startling facts: Developing drugs is difficult, but once that is done, a company typically spends just $5 to manufacture a product that generates $100 in sales. Pharma spends up to 35 per cent on marketing, and yet delivers unbelievably high profits to its shareholders, sometimes to the extent of over 40 per cent a year.

You have probably seen Amitabh Bachchan endorsing Chyavanprash, and Wasim Akram and Naseeruddin Shah pushing blood glucose meters. Those are straightforward advertisements, but it emerges pharma giants have other insidious ways of raking in their millions (billions, actually).

Law reveals that the football legend Pele gave interviews encouraging men to discuss their sexual problems with their partners as part of a contract with Pfizer, manufacturers of Viagra, that wildly successful pill for erectile dysfunction. Shane Warne similarly received a secret packet to discuss in the media how he had quit smoking, and was furious when a fan took a picture of him clandestinely enjoying a smoke! And who were Warne's benefactors? Manufacturers of Nicorette "stop smoking gum"!

The dirty tricks department employed by pharma is more active than its peers in other industries. Take an example. Over the years, studies have emerged to scare huge new masses of people into taking statins for blood cholesterol levels (the cut-off point has come down from 280 mm per decilitre to 240 to below 100).

I frequently visit an online forum run by followers of a dissident diabetes doctor called Dr Richard Bernstein. He is one determined doctor who has taken on the establishment, and delivered what many believe is an effective, alternative approach to diabetes care. Of course he is unpopular among mainstream doctors. Need you ask?

I have personal reason to be sceptical about prescriptions. Ten years ago, I was told I had to take a pill every day, for as long as I lived, for my blood pressure. I took it for some years, and stopped for some reason I can't now recall. The last couple of times I visited a doctor, I was told my BP was normal!

Doctors are fallible, but they can't all be venal? I fervently wish modern-day healers who stumble on uncomfortable truths would speak out. Our lives are in their hands.