Pushing Drugs How medical marketing influences doctors and patients

[Celebration]

http://www.sciencenews.org/articles/20050730/bob10.asp

The researchers recruited 152 family physicians and general internists practicing in San Francisco, Sacramento, Calif., or Rochester, N.Y. Each participating doctor was told that he or she would be sent two standardized patients during the next year. But the doctors weren't told the study's purpose or how to identify the fake patients.

The actors then scheduled appointments with the physicians. Once in a participating doctor's office, some of the fake patients described symptoms of major depression, a long-lasting mood disorder that's often treated with antidepressant medications. Other standardized patients complained of symptoms of a less serious psychiatric ailment, which is called adjustment disorder with depressed mood. This condition generally disappears within months without medication.

When standardized patients faking major depression didn't specifically request an antidepressant, 31 percent received a drug prescription. However, when others claimed that a television show about depression had encouraged them to seek drug treatment, 76 percent received a prescription of some kind.

The whole article is interesting and has a lot more in it than I quoted.

[SteppingRazor]

1. So if I want drugs, I should ask for them?

Shoot. NOW they tell me. I coulda had scrips for uppers, downers, screamers, oxy, vic, black beautys, dems, and whathaveyou... months ago!

Boy, why even bother doctor shopping? Just get in there, plant your fist on the counter, and demand your narcotics! :evilgrin:

[Celebration]

10. Practice your acting skills

Maybe it helps to add a little drama to your presentation. You could practice a script first.

I think it could particularly help for people without insurance. They either have to pay the exhorbitant non insurance rate for doctor visits, or if the acting is good enough, they might be able to negotiate something as low as a Medicare rate. The strategy might be to practice going to the flea market and bargaining for clothes. That would serve two purposes:1.looking sufficiently ragged to appear destitute, and 2. honing the bargaining skills.

Some of the pharmaceutical ads are quite entertaining. There was one with an elderly woman sliding down a bannister. That had something to do with urination I think. It made me laugh every time I saw it. Clever music too.

[dwckabal]

28. Dilbert

[Ian David]

2. Problems with medical marketing

If you go to a doctor and say, "Doc, my arm hurts when I go like this, and I think I need a pill," then the doc might say, "Well, I hear you saying it's bad enough that you feel you need a pill..."

It looks like in this study, the doctors were more inclined to give drugs to less-sick patients because the less-sick ones asked for pills.

Either:

1) The doctor was practicing "Customer Service Medicine." The patient wants, pills, the doctor wants the patient's business, so give the customer what they want.

or

2) The doctor was relying upon the patient's own assessment of their needs rather than the doctor's personal evaluation.

Imagine going to the doctor with a broken arm and he says, "Aw, that doesn't look too bad. You don't need pain pills..."

In any case, problems arise when:

1) Patients see a commercial and ask for a drug they don't need, and the doctor gives it to them.

2) Patients do need a drug, and the doctor gives the patient the one from the TV commercial (because the patient asked for it) despite the doctor knowing there are better choices.

3) Doctors giving patients drugs based on advertising or "lobbying" from pharmaceutical companies.

These same problems are endemic in both conventional and "alternative" medicine which both rely on the same tactics and methods of marketing.

This is Bob...



is when physicians choose one drug over another

[beam me up scottie]

3. Exactly.

The drug companies have their ads pulled when they make fraudulent claims.

No such regulation exists for snake oil salesmen, they can claim their drugs are miracle cures and the consumer has no way to know if the products are safe, let alone effective.

Bottom line, you need to be aware of your choices and be willing to ask questions.

Buyer beware.

An intelligent consumer already knows this.

[Celebration]

7. Please note

Fraud statutes apply to ALL advertisers!! This isn't about fraud. This is about promoting pharmaceuticals. Of course this is self evident. The pharmaceutical companies are not dumb enough to spend money for advertising that doesn't work.

One huge problem with pharmaceutical advertising as opposed to say, glucosamine sulfate, is that WE ALL BEAR THE COST OF PHARMACEUTICAL ADVERTISING-- through higher taxes (Medicare, Medicaid) or through higher insurance premiums. Only the person buying the glucosamine sulfate (or whatever) suffers financially. And yes, buyer beware applies to them as well. At least it doesn't have the social cost in dollars that the pharmaceutical ads have.

[beam me up scottie]

8. Sure they do...

Checked your email lately?

Want me to start posting all of the adverts claiming their snake oil cures everything from impotence to cancer ?

I don't think the DU servers could handle all of it.

They are guilty of fraud and worse.

But then, that is self-evident to anyone who reads their spam.

[Celebration]

13. If they are guilty of fraud

They can get prosecuted for it. Fraud applies to EVERYONE.

[Ian David]

9. With minor differences, I'm pretty much agreed on all points

Alt medicine has a cost to society as well.

When people rely on alt medicine until they get dangerously ill, then society has to bear the cost.

Also, some politicians-- such as Kucinich-- want medicare/medicaid to cover alt medicine.

And many HMOs and insurance providers cover it. That means my insurance premiums are paying for someone to wave their hands over people's auras.

No nonsense is without some kind of social cost, even if it is just the damage it does to have people engaging in magical thinking and then turning out at the ballot box thinking that feng shui and "traditional marriage" will save them.

In any case, all marketing intended to deceive and misinform is unethical, dangerous, and does harm to society.

[Celebration]

14. Fundies

Unless they happen to go in for that weird Benny dude on TV they generally avoid the energetic modalities like the plague-- you know, the DEVIL and WITCHCRAFT is in 'em. I heard Tucker Carlson one time saying that acupuncturists all vote Democratic. That may be true. Anecdotally, a friend is an acupuncturist and she is a true radical--not only is she not into traditional marriage, she doesn't believe in marriage at all. Yes she prescribes Chinese herbs. She cannot say the word Republican without choking. Probably feng shui would be the same-- you know those left coasters go in for that (BLUE).

[Desertrose]

4. I've seen this for years....

great article itsjustme.

"The lack of obvious effects from detailing and samples doesn't surprise Kravitz. Drug promotion aimed at doctors, he says, is "a pretty pervasive force. It's really integrated so much into medical practice that it's hard to say what the effects are."

A survey of physicians published in 2001 found that 92 percent had accepted free drug samples. Most doctors had received other freebies, too, including meals, travel, and entertainment tickets. "

My dad was a pharmacist who owned his own drugstore. We lived in a small town and so he knew all the local docs (they played poker together) I saw how the salesmen from the big drug companies would push the newest latest drug...giving the MDs tons of free samples. I worked in the pharmacy so I had a clue what was going on. After the latest round of samples, suddenly it was as if everyone in town was taking the newest drug. Clearly the practice has not decreased.

It was so over the top all the trips & perks these huge companies offered. My parents got trips abroad on a yearly basis. (which was cool for them but....)

As always everything comes down to dollars and marketing is such a big part of that. I have been concerned for a while about the drug ads on TV etc. How curious that an MD has to train for ...how many years to become a doctor and yet if a patient comes in and requests a medication they see advertised, the MD gives it to them...just in case? I wonder if this is what they mean by preventive medicine...


To be fair, I like to think most docs sincerely want to help their patient and they are wooed by the chemical promises of this or that drug, so I suppose it all comes down to educationg and updating them on the newest drug options...it is difficult when patients request a certain drug...

It appears to come back around again to the big Pharma corps who are out to make their billions, regardless of how they do it....

[Ian David]

5. And the alt pharma corps are equally bad

Alt pharma hides behind their "everything natural is good for you" defense, too.

Like we think it's all made by little old ladies on their kitchen tables that only want to selflessly help people.

[beam me up scottie]

6. And worse, they deliberately

cultivate distrust of doctors and other medical professionals, as well as prescription medicines in order to "convert" consumers.

[Ian David]

12. OK, now we're going from science to marketing.

Can we declare this subject exhausted yet?

[Desertrose]

18. Is this your opinion or can you back it up

with sources beyond the skeptic ones?

I know a great many alternative healers who work hand in hand with MD's. Wonder where you get this opinion.

[Ian David]

20. You want me to cite credulous and un-critical sources? To what end?

That's just silly.

"Okay, but why don't you argue against Creationism without using DARWINISM sources..."

[Desertrose]

21. so you are saying you know of no others sources beyond the skeptic ones?

well darn, thats just sad.

I'm pretty sure there are many unbiased ones around.

[Ian David]

22. Okay, that's very funny. I thought you were serious for a minute

:rofl:

[Desertrose]

11. Maybe when any company gets big enough or doesn't care more about people

than their profits. I'm sure some alternative companies are only out for the bucks...I just think there may be fewer by percentage, but no have no statistics on that. canonly go by the companies i have dealt with directly and have found them to truly be concerned that their product is helpful and what it claims to be.

I think we certainly need to define just what is "natural" anymore. I have seen lots of mainstream products recently all claiming that they are "natural" and then I read the ingredients....."natural" is a bit of a stretch, hence the need to get a clear definition. Helps when we all speak the same language.


Seriously, I don't really know too many people who believe little old ladies make their natural alternative products at home in a selfless act of helping the world.

[Ian David]

15. Some? n/t

[Desertrose]

16. Well, regardless of what you may think

there are some excellent products made by companies you claim to be alternative, natural, whatever.

Not all alternative products are "fraud". That is one hell of a broad brush statement and I seriously doubt you could back it up with facts, but if you feel the need then to do so go for it.

[Ian David]

17. That wasn't my point. I use some "alternative" products myself.

My point is that all of them are motivated by capitalism.

[Desertrose]

19. I agree with that...all to be sure...probably some

to a greater degree than others.

[dwckabal]

23. And not all "big pharma"

is bad. Seriously, I don't know how you can function under all the doublespeak.

That is one hell of a broad brush statement and I seriously doubt you could back it up with facts, but if you feel the need then to do so go for it.

Yet you do the exact same thing with the pharmaceutical industry. There are drugs out there that do what they claim. Do you still chew willow bark for a headache? Of course not.

Skepticism of only "big pharma" is as bad as skepticism of only "alternative" medicine. Get off your high horse.

[Ian David]

24. Well said. n/t

[Desertrose]

25. Where did I ever say it was?

Please. Find a post where I state that all pharma is bad. I 've never claimed that. Seems as though others here are pretty good at putting words in my mouth I don't say, so maybe thats how you get this "doublespeak" idea. don't worry about me though, I am functioning just fine thanks. :)

Of course I know there are drugs out there that deliver what they promise. I never claimed that there weren't. Do I chew willow bark for a headache...nope, but I do take white willow bark capsules and they really work quite well.


Too bad that just because I have some serious questions about the pharmaceutical/medical industry that you feel I am bashing scientific achievements. I am not so foolish to throw out the baby with the bathwater. One CAN admire the advances science has made and still question some practices and agendas of those institutions, especially growing up & seeing things first hand.


About the high horse thing...how cute.
I wish I still had my horse, but she really wasn't tall...a little under 15 hands. ...evidently not as high as some of the horses that people around here ride on.:evilgrin:

[Name removed]

27. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[HuckleB]

26. A very well done piece.

Thanks for sharing. These issues need to be aired within the medical community and the community as a whole. Beyond this issue, I suspect that most of us have no idea how much marketing actually influences our decision making.

[Name removed]

29. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[Celebration]

30. Replying to my own post

Probably a byproduct of our dualistic nature, but has anyone noticed how people start circling the wagons and create bizarre inferences right here in the science forum?

It seems pretty obvious to me that off topic messages about Vitamin C, alleged fraud by supplement manufacturers and marketers are quite different from the subject of how marketing of prescription medications affects sales, as determined by a study using actors.

It gets to be some sort of "well this is not as bad as" and "look at this too" thing.

Of course, in the science forum I expect better than this. It is kind of like my saying "WHO BOUGHT ALL THOSE PUT OPTIONS ON AIRLINE STOCKS BEFORE 911?" and getting the response "YOU ARE A CRAZY IDIOT TO THINK THAT THE WTC WAS A CONTROLLED DEMOLITION."

WTF? (admittedly this response has a more to do with the NASA post I made and the bizarre response to that than anything here, so I admit to succombing to the same type thing--threads do morph, I know).

So, should our new planet be called Planet X?