But in this age of patient empowerment, MDs seem to be moving down to second or third choice when it comes to influencing patients. What we see now are drug companies making deals with managed care organizations directly. Take away the choice, and you can better sell the drugs. This approach has its draw backs. What about those people who don't belong to HMOs?
But the drug companies have finally seen the light, and it's called direct marketing! Perhaps you've noticed the numerous advertisements for prescription drugs in popular magazines. With their vast resources, the drug companies are discovering that today's health care consumer is quite capable of reading an advertisement and asking for prescriptions drugs by name.
Who cares if the vast majority of health care consumers aren't going to be reading the ad's fine print disclaimers and morbidity/mortality warnings, or consulting the Physicians' Desk Reference for the precautions and adverse reactions of the drugs they're imbibing.
MDs are bending to the wishes of the "empowered" consumer, but empowerment can have its drawbacks. Without adequate information, such patients become easy prey. This is why the federal government has made such an issue over the advertising practices of cigarette companies. Even with the prominent warning labels on packs of cigarettes, many people are influenced by the advertising to smoke away.
Most everyone knows that smoking is a killer, yet people still smoke. Given this phenomenon, how can the public ever be expected to appreciate the lethal potential of drugs prescribed by their health care providers?
Now let's talk about real empowerment. It has long been known and understood by political advisors and marketing directors that the "highest court in the land is the court of public opinion." As major purchasers of advertising, the drug companies have a significant impact on the content of publications, radio programs, and television shows. Think not? Look back at the October 21, 1996 issue of Dynamic Chiropractic. It featured a front page article about issues of Time and Life magazines. The special issue of Time magazine (Fall, 1996), "Frontiers of Medicine," contained 27 full page advertisements. Drug companies paid for 23 of those; insurance companies paid for two; and one page was given gratis to the Ad Council. There was also an eight page insertion, "Health Tips and Resources Guide," by the largest drug company advertiser.
Want to guess how much control the advertising drug companies had over the editorial content of that "special" issue? While some of the articles told readers about how medicine had advanced into "alternative therapies," it was no surprise that chiropractic received only token mention.
It's easy to see how the advertising budgets of pharmaceutical companies could impact the media:
- You won't be hearing much in the way of pharmaceutical bashing on TV sitcoms, although "illegal" drugs are comedy fodder.
- Articles will be toned down, edited or rejected if they contain content adverse to drug company sales and image.
- Studies proclaiming the dangers of particular drugs will find their way to the back pages or ignored all together.
- Publication of drug company press releases extolling the virtues of their newest "wonder drugs" will become common place.
Look at almost all other chiropractic publications. Notice how much editorial control the advertisers have. While some publications are more blatant than others, many insist on the purchase of a full page ad in return for running their "article." Some are even so bold as to use the term "advertorial" (a euphemism used by publications that have sold their editorial space). According to their advertising rate card, InPractice's "advertorial rate" is a whopping $2,300 per page.
As you can see, selling editorial space is big business even in chiropractic. It has become such common practice, that many advertisers expect it. This publication has lost several advertisers because we refused to print their advertising-oriented press releases.
To better maintain our objectivity, Dynamic Chiropractic separated from the Motion Palpation Institute over a year ago. This eliminated the kind of ties that have potential for editorial conflict. DC feels free to present all sides of every issue without any self-interest.
It may seem hard to imagine, but chiropractors are one of the few sources of honest information about the hazards of pharmaceuticals. Chiropractic may become a lone voice amidst a media which is quickly selling out to the billions in drug dollars.
Keep your patients informed, keep them healthy, and keep them off drugs.
Donald M. Petersen Jr., BS, HCD(hc), FICC(h)
Editor/Publisher Dynamic Chiropractic
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