The path to reforming the current state of medicine is proving to be a long journey. However, slowly but surely, we're moving away from the reflexive practice of throwing needless drugs and procedures at a symptom (and hoping for a "cure"), and toward getting at the real cause of a problem and treating it without surgeries or drugs.

I've been seeing many encouraging signs that movement away from drugs is growing more popular.

Pfizer slashing its sales force, despite generating billions merely from owning the rights to the world's best-selling drug, is one such sign. Pfizer's sales force of 11,000 was at one time considered untouchable, being one of the prime means they use to put newer, more expensive drugs -- that are just as useless as the older ones they replaced -- in the hands of your physician.

Still, the battle is far from over. Drug companies are spending about $15 billion a year just to market to physicians -- this is marketing that most of you never see, above and beyond the television ads that have become so familiar. Even most doctors have no clue that the drug companies are spending (on average) $10,000 on each of them to influence their behaviors. They, of course, do not receive a check, but the perks are quite significant.

One thing these drug companies are not is stupid. There is no way they would spend so much money unless they received a significant return on their investment. The fact of the matter is that the United States alone is spending over $1 trillion for drugs. Folks, that is one thousand billion dollars.

Of course, some of that comes from marketing directly to patients as well as to doctors. The United States is one of only two countries where drug companies are allowed to advertise on television.

Fred from Petersham, Massachusetts comments in Vital Votes that he was one of the people bamboozled by Pfizer's sales force:

"I took Lipitor for about two weeks until I began to get dizzy when I got up from sitting or lying down. I looked for another alternative and stopped taking the Lipitor. My cholesterol is within acceptable limits and I wonder why I was ever talked into taking such a dangerous drug.

My conclusion is that I was bombarded with advertising to a point where I almost believed that the drug companies were in the business of helping me, not making money. There's no fool like an old fool. I'm 72 years old."

Another poster, however, from Sanford, Maine, wonders if this is really a victory, or just a shift in approach:

"I'm willing to bet that this move isn't a 'win' and 'we' aren't making so much as a dent in their sales. They've probably come up with higher tech, less personnel intensive, less expensive techniques to improve sales.

Getting all the 'treatment guidelines' and EBM algorithms in place is one thing I'm seeing more and more of. Of course, there's also their success with DTC advertising and disease awareness groups and medicine by press release ... a well placed magazine article is probably more effective at generating sales than direct cold calls."

You can review other responses to this article at Vital Votes. If you want to add your own comment, you can do so by first registering.