This reprised from a post by Kathy Dettwyler in 1995.

More to support the idea of the marriage of hospitals and physicians'
groups with the formula "mob." Akin to the old close ties between the
AMA and the tobacco interests. Kathleen

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of katherine a. dettwyler
Sent: Tuesday, August 15, 1995 8:29 AM
Subject: Re: doctors, formula companies, and greed


Well, since Rachael posted her note about me "joking" to LactNet, guess
I need to post my response.


>> Sorry folks, I have to pipe in.  I don't know *any* pediatricians or
>> family physicians who actually want children to get sick so they can
>> make more money!! <snip>
>> --
>
>No offense to anyone, but I understood Katherine Dettwyler to be joking

>when she wrote that pediatricians were happy to benefit from the
>additional illnesses caused by formula.  You were joking, weren't you,
>Katherine?


No, Rachael, I WASN"T joking.  Of course they will never say this to the
patient's face, but the history of collusion between the doctors and the
infant formula industry is well documented, and doctors have "known" for
years of the effects of formula use.  They come up with all sorts of
reasons/justifications why they still advocate formula: not wanting
mothers to feel guilty, not believing the scientific research, leaving
it up to the parent's choice, etc.  But the bottom line is, it is
well-known among medical researchers that breastfed babies are
healthier.  Think about who benefits financially when kids get sick.
The doctors and the drug companies.  Doren Fredrickson (M.D., Ph.D. in
epidemiology) wrote a wonderful "Commentary" for the book on
breastfeeding that I just finished co-editing, in which he analyses the
economic impact of formula use and talks about how managed-care (HMOs,
capitated care systems) should realize how much more money they will
make when women breastfeed and really start promoting breastfeeding to
their patients.  As opposed to doctors in private practice,
HMO/capitated-care system doctors make money by keeping patients healthy
and preventing the necessity of care, so they should be highly motivated
to encourage breastfeeding.  It used to be that HMOs were really into
quit-smoking campaigns because it saved them money if they could prevent
cancer, heart disease, emphysema, etc.  Then their big customers started
hopping HMOs from year to year to get the best deal (this year Kaiser,
next year Blue Cross, etc.) and the HMOs realized that all the money
they spent on quit-smoking programs would end up benefitting some other
HMO
-- whichever one the patient belonged to when she or he was older and
either got sick if they were still smoking or didn't get sick if they
had quit. SO, the HMOs stopped funding quit-smoking campaigns because
they weren't cost-effective.  They started them to realize savings for
themselves, not out of concern for their patients, and they stopped them
as soon as they realized their patients would be someone else's patient
when it came time to realize the savings from better health.  On the
other hand, as Dr. Fredrickson points out, programs to encourage
breastfeeding will probably generate their biggest savings in the year
following birth, when the baby doesn't have to come into the HMO for
multiple ear infections, allergies, rashes, upper respiratory and
gastrointestinal infections, etc.  So HMOs should be highly motivated to
do these programs as the savings are more tangible and immediate (before
the family has switched to another HMO). Anyone who thinks doctors are
not in business to make money is extremely naive.  Why do they think
plastic surgeons encourage women to think that their perfectly normal
breasts are "too small."  Why have there been such huge scandals over
doctors who invest in independent laboratories, and then require all
sorts of unnecessary lab tests for their patients.  Sorry to burst
anyone's bubble, and again, of course there are many doctors out there
who are noble and altruistic and put the patients' welfare above all
else, but many do not.  Doctors in private practice win both ways by
pushing formula -- they get direct benefits from the formula companies
and they get more business.  Likewise, the U.S. hospital lobby has
argued against the "Baby Friendly Hospital Initiative" because it
requires no free giveaways of formula to new mothers.  Why do the
hospitals care one way or the other? Because the formula companies not
only give the hospital all the free formula they can use, plus cases to
send home with each mother, they ALSO give the hospitals money for new
wings, money for continuing education classes, money for supplies and
equipment.  This is BIG BUSINESS folks.  We have a hospital locally that
continued to give out a particular pacifier to every new mom even though
they knew very well that it interefered with breastfeeding even more
than the other brands of pacifiers.  Who supplies these particular
pacifiers to the hospital to give away?  The infant formula company (NOT
the pacifier company).  The infant formula company knows very well that
this particular pacifier is their ally.  I will stop now.


Rachael's partner in rabble-rousing,
Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology, Texas A&M University e-mail to
[log in to unmask]

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