Thursday, June 08, 2006

Direct to Consumer Advertising: Has it gone too far?

I came across this ad while looking at the Yahoo! homepage. The link to their website is here.

Could this be taking direct to consumer advertising (D2C) a bit far? The rather arcane decision making that goes into determining which piece of surgical hardware should go into a given patient is difficult enough for surgeons to make. Can patients really come to informed decisions about such things on the basis of company-produced literature?

While, in principle, I'm all for patient autonomy, in this case I have my reservations. What about a product that is perhaps not as good as those made by its competitors but that has a stellar D2C marketing plan? Is the consumer interest really served by such advertising?

Might an orthopedist, concerned about maintaining his "market share" be unduly influenced by a barrage of patients clamoring to have a particular product implanted? What if the product requires a different (and unfamiliar) technique to put in compared to standard products? What if its construction just doesn't "look right" to the surgeon who has to put it in (and who often has very limited hard efficacy data to rely on)?

What kind of intelligent input can a patient really add to the decision making process in this setting? As an internist, I would be hard-pressed to provide meaningful input into deciding which of the products available that a surgeon should implant in me.

Don't get me wrong. Many consumers are quite savvy and definitely do their homework before committing to a major medical procedure. The medical literature is readily available (and often highly comprehensible by intelligent lay people). I have no problem with this kind of motivated and informed consumer. I myself have had sophisticated patients bring pertinent medical articles to me regarding their own care.

But I think the kind of D2C advertising seen here crosses the line of what is actually in the best interests of the consumer.

Then again, maybe the online degree program advertised below the Stryker ad offers classes in total knee replacement?


Anonymous Anonymous said...

Um ... maybe it comes with a "Do it yourself" kit? ;o)

Seriously, I hate to see that sort of thing ... and that includes the ads for prescription meds on TV.

I wonder what they hope to accomplish ...

June 08, 2006 8:09 PM  
Anonymous Anonymous said...

It is not just the makers of the artificial knees that are getting in on this act. It's also the orthopedic surgeons and their hospitals who are going direct to the public on this subject.

A press release from Pennsylvania Hospital in Philadelphia resulted in the following story on the NBC station in the city: . A similar story also appeared on the ABC station. Last weekend, in the Sunday Edition of the Phila. Inquierer newspaper, on p. A19, the hospital ran a quarter page ad promoting the new knee for women, along with stating the surgeon's name who does the operation.

Guess who's going to be getting a lot of business? It's not just the maker of this new knee joint that's gonna be making money.

As a patient, I'm disgusted when I see something so new being promoted so soon to the public. Doctors and hospitals should know better.

This behavior is not unusual here in Philadelphia. Hospitals routinely advertise new procedures that they have just started performing, and new medical equipment that they have just purchased. Most of these campaigns start with press releases to the local media.

June 10, 2006 7:29 AM  
Blogger Bad Penny said...

If I had let my first doc choose my hip implant, I would have ended up with the plastic kind they put into people who aren't expected to live more than 5 or 10 more years.

Instead, I took an interest in finding out what was available and ended up with a better implant; one that has a much longer life-expectancy than the plastic kind.

I switched to a doc who does the better implants, and who does the anterior approach surgery instead of the old-style big long cut on the posterior. As a result I had a shorter and easier recovery than could be expected with the other surgery, which is important because I still have kids at home and needed to up and around as soon as possible.

I don't think I ever saw any adverts for hip implants, but I did read plenty of manufacturer's web sites. I think that my participation in choosing my implant resulted in me having a better outcome.

Reading about all the different kinds of implants and surgeries made me aware of their benefits and risks, and how there are no guarantees and no perfect solutions. I think this knowledge, plus me taking some responsibility for the decision makes me less likely to sue if something goes wrong.

As a patient, it seems to me that it is my responsibility to educate myself about my condition and its treatments. If I leave all the burden on my doc, and if he accepts that burden, than I am more likely to blame him for any bad result.

You can't have it both ways. You can't say that you are the only one who can make the decisions and then complain when you are held responsible for those decisions. I'm not saying that you have complained about this, as this is the first time I've been to your blog, but I read a lot of med and sci blogs and I see a lot of griping about malpractice cases. I suspect that patients who are well-informed about risks and who participate in decision making are less likely to sue. I wonder if there has ever been a study on this?

July 01, 2006 12:37 AM  
Blogger The Medicine Man said...

Dear Bad Penny,

Check out my response to your cogent observations.


July 01, 2006 11:13 PM  
Anonymous Anonymous said...

Definitely agree with Bad Penny -- too often, walking into a dr's office having read up on one's own medical situation just brings condescending smiles instead of a productive conversation. Given how little time drs spend with patients, personal research and reading is the only way to avoid what for Bad Penny could have been a bad outcome. Good for you, Bad Penny!

July 02, 2006 8:58 AM  

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