I use my computer a lot, so I see a lot of advertisements. Many of them are for the latest two or three items I’ve priced online (which I find somewhat creepy but fairly easy to ignore). Many of them are generic, casting a wide net. These generic ads frequently talk about “one ridiculously easy trick” to halve your car insurance payments, lose 50 pounds, learn a foreign language, look younger, or drastically reduce your utility bills. Experts in the relevant fields apparently don’t want you to know about these ridiculously easy tricks, and the fact that “local moms” know about them makes the experts “furious.”
The websites promoting these ads either put malware on your computer or make their sites impossible to navigate away from (“are you sure you want to leave this page?” and if you click “yes,” they take you to another page selling the same thing) until you give them your credit card number to subscribe to deliveries in perpetuity of the magic product. They are scams. They are silly. Most people know this and ignore them, but some folks are sucked in.
Those that are sucked in are either looking for an easy way to do something that takes a lot of work or they’re annoyed and fed up with those the ads purport to infuriate. That’s the aspect I want to discuss – the annoyance and fed-up-ness. I can see that people might want to stick-it-to-the-man in situations where they feel like they have been treated less-than-fairly. I suppose there are people who hated their college’s foreign language requirement, resented the homework their professor assigned, and can’t wait to do what “makes language professors livid!” Of course, if you were to take a second to think about it, you’d realize that a language professor wouldn’t be angry if there were an easy way to learn a language – a professor wants her students to learn! But the ad tries to get people to act on an initial feeling of animosity. I find it sad that there is animosity toward teachers (some of my favorite people in the world are teachers).
And as a doctor, it bothers me that people are capitalizing on an impulse to do something that “infuriates doctors.” Again, if you were to think about it for a second, why would a doctor be angry if someone safely and effectively were to lose weight or quit smoking? But the fact that the impulse is there says that there exists among some a perception that doctors want to coerce patients into doing things that somehow benefit the doctors and not the patients. The perception is that the doctor wants his patient to take an expensive medication (which somehow financially benefits the doctor) rather than the mail-order magic berries or green coffee beans or whatever other magic potion the website offers for the bargain price of $69.95 per month – a 70% savings off the retail price!
Doctors need to do a better job in the PR department, specifically by working to partner with their patients to help them feel more engaged and empowered with their own healthcare. Physicians need to do a much better job in the general education department – educating their own patients and doing outreach to help educate the population-at-large on topics like how to evaluate a research study and what websites are trustworthy sources. For example, http://nccam.nih.gov/ is the site for the National Center for Complementary and Alternative Medicine, run by the NIH, which conducts and supports research on and provides information about complementary health practices, including use of supplements/herbs/etc.
What really infuriates the physician writing this blog is unscrupulous people looking to make a buck who try to drive a wedge between people and their doctors. I’ll post this blog later in Chinese, as soon as I finish the program that ticks off language professors, which I paid for with the money I saved on homeowner’s insurance using one ridiculously simple trick.
Hey Doc,
I think part of the problem is that there are docs who’ve not been as ethical as they could be, didn’t take responsibility for outcomes, and what happens is that people capitalize off that mistrust and anger. I think one of the problems you talk about could be addressed a little better. “Big Pharma” or the large pharmaceutical companies, have paid doctors for ads, and the like, and there is suspicion there. They pay for all sorts of little goodies (at least that is starting to get clamped down on) and big goodies and then there are the visits where they get to the see the doc before us patients. On top of that, I read an article that talked about how doctors could word things to get people to vaccinate, a subject that is quite controversial. I’ve been the subject of doctor “do this or else” ultimatums. I think doctors have been less than honest at times about outcomes. On top of that, there’s a new generation of docs that want to work 9 to 5 and make a $300K paycheck. Lots of reasons for distrust.
I think you have hit the nail on the head by trying to get docs to educate. That and addressing the issues above would go a long ways to helping all of us trust each other again.
Randy
Thank you for sharing your thoughts. While I personally tend to be a medication minimalist, I think the pharmaceutical industry gets a worse rap than it should. I certainly do NOT like direct-to-consumer ads for drugs on TV or inappropriately huge gifts to doctors (like trips to Hawaii) that used to occur, but the drug companies do a ton of research and develop substances that save lives. And the companies do need to educate doctors about the medications that they’ve developed – that’s why drug reps will bring lunch to an office so that the docs can take a few minutes to scarf down a sandwich as they hear about the new medication, its indications, its effectiveness, its side effects, etc. between patients. It’s the doctors’ responsibility to learn about new medications, and this helps them to do so. And yes, it’s a little complicated, since representatives from the company want to put their medications in the best light because they want to make money, but they’re only allowed to market drugs which have passed FDA muster and they do tend to be quite knowledgeable (and they can contact people/researchers who know answers to questions that they do not). Drug reps also help doctors obtain medications for their patients who have difficulty affording them. It is certainly a responsibility of doctors to be truthful and ethical when serving as a spokesperson for a particular medication or medical device. As far as your other point, I of course do not like “do it this way or else” styles of working with patients – as you know from my posts, I am a very strong proponant of doctors and patients working together as partners, with as much education involved as possible. I also do understand certain policies, such as a doctor’s decision to protect his patients from dangerous, vaccine-preventable communicable diseases – when you have newborns in your waiting room, or people with compromised immunity (cystic fibrosis, leukemia, someone on steroids for severe asthma, someone on immune modulators for rheumatoid arthritis, etc.), allowing people to walk in with measles or pertussis could be lethal to your other patients. And a potential outcome of some proposed policies of rating or paying doctors based on certain health outcomes could certainly be that a doctor might say “if you don’t quit smoking/take your insulin/lose 40 pounds/etc., you’ll have to find another doctor,” which certainly doesn’t promote partnership – it pits doctors against patients. So much to think about. So much to talk about. So many subjects for future blog posts…
Hello Doc,
Gee, per the website ads, you doctors spend a lot of time being furious — perhaps time for some anger management counseling ?
Well, yeah, the ads are absurd. They are appealing to the part of our nature that rejects authority.
But I have to echo, if not the exact words, then the sentiment of Randy’s comments above. Some of the comparisons of prices of comparable pharma products in the U.S. and Canada have left U.S. pharma firms looking greedy, particularly in the eyes of patients who have, over the years, seen pensions disappear, 401K funds go flat, and medical expenses skyrocketing precisely at the time the patients are getting older and in more need of medical attention and prescription drugs. Perhaps unfairly, this anger with the pharma industry reflects upon the medical profession as a whole.
Unfortunately, some doctors also have a really poor way of handling patients. One instance I recall was speaking to an eye doctor about something floating on one of my eyeballs. It is small and transparent, but has been there for years. Not that it causes any real ill-effects, but I thought perhaps it could be removed or at least identified. After unsuccessfully looking for it, the eye doctor suggested that it was perhaps a “hallucination”. Uh, thanks ? Mind you, I can understand the doctor’s difficulty as I have peered into mirrors to see if I could spot whatever it is, and I can’t spot it either — but I think that just means it is quite small and only appears to have some size because it sits on my eyeball. But even so, you probably can understand my frustration with the doctor’s comment.
I have to admit the “furious doctor” ads make me snicker even while I realize they are just amusing con jobs. Unfortunately for doctors in this case, we tend to not recall the times when doctors were absolutely correct in a diagnosis or who had a great beside manner. I will say though that my experience with doctors in Europe has been a lot different — and in many cases less satisfying — than those experiences I had with doctors in the U.S.
Cheers
Thank you for commenting! Re: drug costs – it actually costs billions to develop each new drug (just Google “cost of bringing new drug to market” and read November 2014 study from Tufts University). The high price includes a lot of development costs. Not sure why other countries aren’t doing more of the cost-sharing – I’ll have to look into that more. I would suggest seeing an ophthalmologist regarding your eye floater – it’s a good idea to regularly have an eye exam by an ophthalmologist, and he/she can make sure your “floater” is not caused by something that will harm your sight (the ophthalmologist knows the right questions to ask you and the right things to look for). I would be interested in hearing your perspective on the inter-country differences of your experiences with doctors!