This book is a tour de force investigation into the deeply complicated and corrupt nexus of science, medicine, and money. From barely paid professional human guinea pigs, to feted key opinion leaders, Carl Eliot exposes a medical system that is far from transparent and scientific. Medicine has become a business, driven from the top by pharmaceutical marketing agents on the search for the next blockbuster lifestyle drug. Science, supposed the ultimate arbiter of truth, has been coopted with ghostwritten articles, and company approved presentations. Ironically, precisely because doctors believe they are too intelligent and impartial to be swayed by mere marketing, they are vulnerable to the simplest ploys of free pens and a little gilded prestige.

The key observation of the book is not that this medical system is inherently bad; markets are very good at providing many goods. Rather, people approach medicine half as patients and half as consumers. The traditional role of the doctor is being supplanted by medical technicians and salesmen. To me, it appears that efforts to remove money from medicine are already doomed to failure. Rather than trying to restore a halcyon past, we should instead ask how the strengths of corporate medicine can be used to improve access, care, and outcomes.