A survival guide for direct-to-consumer ads

By Mark Jaben

In the 1970s, a book written about a doctor’s internship experience, The House of God, reached near cult status for its reasonably accurate — if not cynical — portrayal of one intern’s experience surviving medical training.

It was full of somewhat sarcastic but useful rules that enabled him to manage the chaos. In the end, the doctor reached an eternal truth of health care — talking to people was all that really mattered.

Fast forward to 2006. Although we have many more available sources of information now, how helpful is all this information and advice? How well are we talking to each other and communicating our problems?

In a previous article (“Where do you get medical advice?,” SMN, Oct. 18 edition), we looked at what’s a person to do with all the advice we have access to. What about all the TV ads? Can we trust that the purple pill is any better than the other drugs? And do we really believe we can dance all night on one Alleve?

We agree with the ad that it’s good if we can keep our parent with dementia at home longer, but is their drug really capable of doing this? Adding Plavix to your regimen may help protect you, but at what risk and cost? Based on these ads, why isn’t the whole world on Lipitor?

Direct-to-consumer (DTC) advertising was first approved by the FDA in 1987. According to a report in the March 2002 issue of Modern Physician, $791 million was spent on DTC advertising in 1996, while in 2001 the amount spent was $2.5 billion (60 percent being spent on TV ads, up from 13 percent in 1996). No doubt, the amount spent is skyrocketing.

A 1999 study indicates that about half of the respondents to its survey erroneously believed DTC advertising is regulated by the government, and nearly half believed that only “completely safe” prescription drugs could be directly advertised to consumers. DTC marketing had caused 19 percent of the respondents to request a prescription from their physician, 35 percent reported requesting more information from their physician, and 9 percent had called athe number provided in a DTC advertisement.

The drug companies advertise to you and me for one reason — it works. The more it works, the more money they make. Of course there is nothing wrong or immoral about this. Just like the insurance companies and the legal system, the drug companies are just playing by the rules.

The problem is the rules may not work. If our goal is to provide adequate, financially feasible, compassionate health care, then we will have to take a long hard look at how we’ve gotten here and rethink the underpinnings of our system.

We will start doing that next time, looking at how the past 20 years of globalization, legislation, demographics, consumer trends, regulations, and economics have conspired to create what we have. So what’s a person to do?

• Read The House of God.

• If you listen to the commercial, pay close attention to how often they say their product may do something. That’s a buzzword for unproven affects.

• Time how fast they list all the side-effects and note how often that list contains the very symptoms you are trying to address.

• Talk to your doctor. As the intern learned, talking to people was what really mattered.

(Mark Jaben is a physician with Haywood Emergency Physicians and can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..)

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