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Are TV Pharmaceutical Ads Damaging?
trivialscene asks: "ABC News is carrying an article about a recently published study in the medical research journal Annals of Family Medicine which examined prime time television ads run by pharmaceutical companies. The researchers concluded that the generally ambiguous ads, which appeal almost entirely to emotion rather than fact, tend to confuse viewers. They also suggest that the ads may be creating problems at the doctor's office, as some people might become convinced they need a particular medication and insist on getting it, rather than leaving the decision to trained medical professionals. What do you think about the presence of drug advertisements on television?"
I identified so much with the little unhappy blob thing on the Zoloft ads, that I finally sought treatment. I am finally free of 20+ years of clinical depression thanks to that ad.
I left pharmaceutical sales because, quite frankly, I was tired of being nothing more than an interruption in a doctor's day. In fact, I left sales entirely as a result of that experience.
The entire purpose of pharmaceutical sales at the doctor, clinic and hospital administration level is this: To abnormally influence the prescribing of drugs beyond what information is public by way of peer-reviewed scientific research. The drugs your doctors prescribe are sometimes influenced by how many pens, pads, lunches, dinners and other free crap are given to the physician and/or his staff. The drugs your insurance company covers are most influenced by what pharmaceutical company wines and dines the formulary administrators the most.
Physicians and administrators who participate in golf junkets, etc., are just as much to blame, but that doesn't remove the culpability of the pharmaceutical companies who know exactly what they're doing and are constantly pushing to be able to intrude even more in the treatment of a patient by way of these methods.
There are examples of egregious behavior at various levels of the pharmaceutical business ranging from minor nuisances to egregious breaches of ethics. One competing company's rep, while I was covering Mayo Clinic, got his company kicked out for six months by following a physician into his office WHILE the physician was seeing a patient... What was the rep's urgent matter? To deliver his canned sales pitch for his product. There have been pharmaceutical companies nailed for including large gifts in honorariums given to physicians for speaking on behalf of their products.
Mayo Clinic is one of the few institutions that has extremely strict rules... No pens, no pads, no papers, samples are signed in through a controlled process giving the rep very limited access to physicians. At the same time, they'll gladly throw up a banner for your product if you'll give them a huge research grant... While that's no guarantee that they'll bias the research in the pharma company's favor, human nature is such that money tends to drive a sense of obligation to the benefactor.
The advertisements have taken the Creationist approach to marketing... by appealing to the opinions and attitudes of the average, uninformed layperson. In doing so, they are still interfering in the process without really contributing anything of value that cannot be obtained by a physician who keeps up by reading the peer-reviewed journals on his or her own time... as a good physician will want to do. Physicians already have a motivation to do this research... it's called avoiding malpractice lawsuits.
Previously reputable pharmaceutical companies have stepped up and started direct advertising to consumers on television... It's getting worse and the cacophony of products being advertised by these companies creates a confusing atmosphere of insufficient information that does what exactly? The commercials don't begin by encouraging patients experiencing certain symptoms to go see their doctor and let them do their educated diagnoses. The ads begin by summarizing symptoms in a manner that creates a sort of confirmation bias, i.e. rattling off a barrage of symptoms, one of which might lead the viewer to suspect they need the drug... while ignoring the specific COMBINATION of symptoms that preclude a specific diagnosis. Then the ads encourage the patient who SUSPECTS they might have this problem not to go to the doctor and find out the proper course of treatment... but to "ask your doctor for".
They know what they're doing and even though I agree, simultaneously, in the principle of customer awareness... The ignorance of the average customer does not change the fact that it was the intention of the company to defraud and profit on the basis of that ignorance and therefore does not make the company any less responsible for doing so.
While I agree that medical science is a luxury and not a public utility, the health of a country's citizens does directly impact the nation's
You know it is funny (in a sad way), but during medical school we were taught that the average physician interrupts the patient within 30 seconds of the start of the conversation and starts asking yes/no questions. Unfortunately we (physicians), tend to miss many of the important bits of information because of that, and the average patient only talks for about 2 minutes if you just sit and listen. Miraculously, I have discovered that if you listen for that extra 1:30, you tend to save yourself a great deal of time ordering tests, drugs, etc. In my experience, patient visits tend to be handled much faster by listening for 2 minutes, asking a few open-ended questions to fill in the blanks, and parting ways with satisfaction rather than misunderstanding and unhappiness.
If I can explain something in 2 minutes rather than spend 5 minutes ordering a drug or test, everyone wins. Of course, this does not always happen, and sometimes the picture is less than clear when I leave a room...but a little extra time spent talking seems to save a lot of time in the end.
Take, for example, the common scenario of the vomiting child. Parents worried, me busy...now I can simply say, "yup, your child is vomiting, we'll give some *insert expensive anti-vomiting medication* and an IV," or I can spend a few minutes explaining the WHO process of giving small amounts (1 tsp or so) of fluid every few minutes so that the child will not vomit, explain how to limit the diet a bit for the next couple of days, and let the parents ask a few questions. In the end, the medication and IV takes an hour+ to accomplish, or the parents spend 1/2 hour giving small amounts of fluid that add up quickly. Either way (usually) the child's mild dehydration gets treated...and with a little more talking up front, I save 1/2 hour down the line.
I am the first to admit physicians get lulled into a "drug for every disease" pattern, but the truth is, a little time, reassurance and education will solve the majority of problems. The trick is knowing which problems that approach won't solve...but that's why I went to med school in the first place (and a topic for another day).