The Pharma Shill Gambit Is Stupid

Harriet Hall

I am regularly accused of being a shill for Big Pharma. They are supposedly paying me lavishly to promote their business by writing good things about pharmaceuticals and bad things about alternative medicine. It has become a running joke in our household. My husband keeps asking me where I’m hiding the money, and I keep speculating about who might be stealing the checks from our mailbox.

The term pharma shill gambit was coined by Dr. David Gorski, one of my colleagues on the Science-Based Medicine blog. Everyone who writes for that blog has been repeatedly accused by commenters of being in the pay of Big Pharma. We all joke about it, asking who we should contact to let them know the checks they’re sending everybody aren’t reaching us for some reason. To set the record straight once and for all: we are not paid by Big Pharma or by anyone else. SBM is a pro bono effort, a public service, and a labor of love. No one has ever earned a penny for writing for SBM. I have been writing an article there every Tuesday since the beginning of 2008. That’s over 600 articles so far. Just think how rich I might be if I had been paid by the word at standard rates. It might have added up to as much as two million dollars. Have any of my accusers bothered to notice that the car I am driving is eighteen years old? Have any of them asked to see my income tax return? It would show that I do earn a small income from the magazines I write regular columns for, but I do not receive any money from Big Pharma. SBM bloggers don’t need any financial incentive to keep writing. We write because we love science and truth and because we hate to see people misled, harmed, and sometimes even killed by false information from scamsters and from well-meaning but deluded advocates. And writing serves as my psychotherapy. When I see some egregious pseudoscientific nonsense that particularly angers me, I can let off steam by writing about it.

What’s even more ironic: we are demonstrably not blindly supporting mainstream medicine and have never exempted Big Pharma from our criticisms. We are equal-opportunity skeptics who require the same standards of evidence for every health claim whether it comes from a university or a charlatan. We spend more time talking about alternative medicine than about mainstream medicine because mainstream medicine has a strong culture of self-criticism and self-correction, qualities that have always been glaringly absent from alternative medicine. Mainstream medicine stops doing things when they are tested and proven not to work, such as routine annual chest X-rays and the Medieval practice of bloodletting to “balance the humors.” Complementary and alternative medicine (CAM) never give up anything. Case in point: homeopathy. We have known since the early nineteenth century that there’s no “there” there, but it is still practiced and is even being taught in schools of naturopathy.

The Pharma Shill Gambit is a false accusation that is not only false but downright stupid. Everything about it is stupid. Our accusers are motivated by money, and they are convinced that everyone else must be too. They can’t even imagine that anyone could have any other reason for writing. They know CAM works, so they think anyone who criticizes it must be getting paid to do so. They don’t need evidence; for them, innuendo, speculation, and conspiracy theories are enough to spread doubt and discredit their opponents.

Of course, they never present a shred of evidence. If Big Pharma were funding us, there would be a paper trail. Where is the expense of funding shills documented in Big Pharma’s financial records? Where are the deposits to our bank accounts? Why has no employee of Big Pharma ever talked about it? Where are the whistleblowers? Why have investigative journalists never uncovered any evidence? It’s all just too, too silly.

It is they themselves who are guilty of the tactics they accuse us of. Edzard Ernst’s experience is a prime example. He published scientific evidence evaluating homeopathy and showing that it doesn’t work. German manufacturers of homeopathic products couldn’t answer his criticisms with science, so they resorted to a smear campaign. They paid a journalist €43,000 to run a set of websites with false information in an attempt to discredit Ernst. Their ad hominin campaign was soon exposed in the German press.

Those German companies were afraid that Edzard Ernst’s revelations might hurt their business and reduce their market share. Big Pharma has no reason to fear that accurate scientific information would cut into their profits. In fact, many of the same companies that produce pharmaceuticals also have a division that produces dietary supplements. As the journalist Lynn Stuart Parramore has pointed out:

Increasingly, Big Pharma and Big Herba are indistinguishable… The very same mega-companies with gigantic chemical labs that make drugs are cooking up vitamin and herbal supplements labeled with sunny terms like “natural” and “wholesome.” Pfizer, Unilever, Novartis, GlaxoSmithKline and other big pharmaceutical firms make or sell supplements.

Dietary supplements are a multi-billion-dollar industry and cost the manufacturers far less to produce than pharmaceuticals.

Christopher Hitchens famously said, “That which can be asserted without evidence can be dismissed without evidence.” So critical thinkers will dismiss the Pharma Shill accusations. But the accusations may still do some damage. In a court of law, when an attorney objects to another attorney’s line of questioning and the jury is instructed to disregard what they just heard, they can never entirely erase the ideas from their memories.

The Pharma Shill Gambit says nothing about those who are accused, since it is pure fantasy devoid of facts. On the other hand, it says a great deal about the accusers. It demonstrates their poverty of thought, their malice, and their willingness to substitute innuendo for evidence. It shows that they are guilty of the very bias they imagine they see in others.

Everything about the Pharma Shill Gambit is just too, too silly. Now you know, so you won’t fall for it.

Harriet Hall

Harriet Hall, MD, a retired Air Force physician and flight surgeon, writes and educates about pseudoscientific and so-called alternative medicine. She is a contributing editor and frequent contributor to the Skeptical Inquirer and contributes to the blog Science-Based Medicine. She is author of Women Aren’t Supposed to Fly: Memoirs of a Female Flight Surgeon and coauthor of the 2012 textbook Consumer Health: A Guide to Intelligent Decisions.