Money Driven Medicine: Tests and Treatments That Don’t Work

In Money-Driven Medicine, published in 2006, Dr. David Cundiff provides a critical analysis of the American healthcare system, arguing that financial incentives—rather than patient outcomes—too often dictate medical care.

Drawing on his experience as an internal medicine physician and a Cochrane researcher, Dr. Cundiff challenges the widespread use of high-cost, high-risk medical interventions that lack proven efficacy.

Key Themes and Arguments

• The Problem of "Standard Practice" Without Proof: Dr. Cundiff argues that many common medical interventions become "standard practice" simply because enough physicians use them, not because they have been proven effective in randomized controlled trials (RCTs).
• The High Cost of Medical "Sacred Cows": The book highlights specific treatments, such as anticoagulation for various indications and invasive cardiac procedures, suggesting they are often over-prescribed despite evidence of potential harm and high costs.
• Conflicts of Interest: Dr. Cundiff details how the pharmaceutical and medical device industries influence clinical research, the FDA's regulatory decisions, and the editorial policies of major medical journals.
• Evidence-Based Alternatives: The book advocates for a shift toward truly evidence-based medicine, where treatments are rigorously tested against placebos or less invasive alternatives before becoming widespread.

Connection to Current Work

This book serves as the intellectual foundation for Dr. Cundiff's current advocacy regarding the systematic review of anticoagulation reviews. It establishes a 30-year history of challenging the "medical-industrial complex" and calling for higher standards of scientific integrity in the evaluation of drug efficacy and safety.