I would only add to be careful when talking to doctors. There are still doctors that talk in terms of good and bad cholesterol rather than taking a lipid panel and getting a graph of small dense to large buoyant particles within the cholesterol. To make matters worse many of them in the USA have been corrupted by financial incentives to push statins and that is another deep and endless topic all in and of itself.
> many of them in the USA have been corrupted by financial incentives to push statins
The pharma companies don't have to do anything more than get a steering committee to say "we recommend lowering blood cholesterol" when there's really only one very effective way to do so in the absence of major dietary changes - and that is statins. Once the American College of Cardiology says you need to do that, exactly how is a family doctor in a small town supposed to defend him or herself from charges of malpractice for not prescribing them?
Imagine the courtroom scene. "Doctor, where did you go to medical school?" "At the Directional State University College of Medicine." "And where did you do your residency?" "At Second State University College of Medicine." "And are you board-certified in cardiology?" "No." "Prior to their visit, did the deceased patient ever have a documented reaction to a cholesterol-lowering drug?" "Not to my knowledge." "So, doctor, why did you not follow the recommendations of the highest-level association of cardiologists in the country? [mic drop]"
There are financial incentives, but they are all stick, no carrot. I'm an anesthesiologist, so I pick the drugs I use - but unless I use the cheapest option, the hospital pharmacy is going to freak out. And I don't have many patented drugs available to me (I can think of three, of which we really only use two; there are probably a couple of others that are out there that I'm not thinking of, but they won't be commonly used). One of those, however, is absolutely amazing magic; nothing else works in the same way, it fixed a problem dating back about 80 years, and it's so useful that a lot of hospitals don't use anything else for the purpose. And I get lunch about twice a year. Big deal: I can get free food from the hospital cafeteria every meal if I want. It's better than hospital food, but it's not a steak-and-wine dinner, let alone a free vacation for "consulting".
This method is cheaper for pharma companies than the old way, which is why the PhRMA "code" prevents them from giving me even a pen. Device companies have no such agreement.
Which is to say: we don't get free trips to St Barts with all-you-can-snort coke bars.
Very fair point. I am disenfranchised from medical institutions in the USA and sometimes forget to look at the time. Edited my comment to clarify my location.
