Bad Pharma is a book that was written to expose just how the industry of medicine is broken. That phrase alone has the potential to scare people so it was comforting to know Bad Pharma it was written by Ben Goldacre, a doctor with many years experience of critiquing health care practices. Not only is he a doctor, working with real patients, treating their illnesses, Goldacre has been promoting the cause of evidence based medicine. He does this through his Guardian blog “Bad Science” and his work giving free talks to interested parties. Goldacre also wrote another book called Bad Science, which has been very popular and well received.
The premise of the book is this; doctors and their patients need good, solid, scientific information to make decisions with informed consent. What we have instead is an industry which encourages the opposite. Examples that Goldacre gives are companies running their own trials, bad data, hidden data, marketing, lobbying and a whole lot of mess. Goldacre details how after initial medical training health-care professionals are left to their own devices to keep up to date with developments, a vacuum that drug companies have stepped into readily, shiny PR pizza and pens in hand. Goldacre also tackles the controversial issue of patient groups and their industry funding. This $600 billion dollar industry has affected us all in some ways in our lives and Goldacre has set out to try and guide us in how to deal with the current realities of medicine.
For format I chose the audiobook version from audible.com. It is narrated by Jot Davies and comes in two parts totalling 12 hours and 47 minutes. That is a lot of science in one chunk and fans of Goldacre should be delighted with the depth of analysis and detail. The risk is with those who are not so familiar with the area as it had the potential to be dragged out to boredom levels.
I need not have worried. Just like Bad Science, Goldacre crafted the science discussion in a way that was accessible, easy to understand and engaging. When delving into statistics or bundles of trials he made sure to give a heads up to the reader and explained how the information would be framed over the coming pages. Goldacre did not assume a base level of knowledge and thankfully gave clear explanations of things such as peer review, meta-analysis and statical significance.
There were also plenty of real world examples given. Goldacre does discuss medicines that you will recognise. He discusses tragedies and controversies with the right balance of coolness and outrage. Many of these events should not have happened but sadly they did and people lost their lives. Through these examples Goldacre takes us from the academic to the tangible consequences of failures. It was quite sobering and anger inducing.
One element of the book that I was really impressed with was Goldacre’s offering of solutions to problems. Too often I have read books full of facts, outrage and severe real-world consequences but no alternatives or suggestions were offered. I have always found that made me feel a little hopeless. At the end of chapters in Bad Pharma, Goldacre provided solutions for doctors, patients and for drug companies to solve the issues that he had previously been discussing. I cannot say if these suggestions would solve the problems but they seemed sensible enough and it was nice to have them included.
But of course nothing is really that easy. We are all human and can get caught up easily in advertising and marketing spin especially when faces with a brass-necked rep. There is also the lack of data, or misleading information to contend with. Goldacre does empathise with doctors in this position, working in these conditions. He gives plenty of examples of where he made mistakes in his career, or was wooed by tricks. It showed that we are all vulnerable so need to keep out wits about us when looking for information or making decisions.
For those who would like to listen to the book I would recommend the Jot Davies version that I used for this review. This narration was excellent, very clear and concise. His intonation was spot on and he sounded genuinely passionate about the subject. At times it was almost like he had written the book himself and was expressing the outrage that he felt at the state of things. This was done in a way that made the book easy to listen to and understand. There is even a nice bonus at the end where Davies interviews Goldacre. It was a nice feature and gave that extra bit of insight and detail that I am sure you will be looking for at the end of the book.
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