DTC Double Standard

Apologies to David Williams at the Health Business Blog, (Edit: apologies; it was Dr. RW) where I believe I first saw this mentioned:

Does everyone remember what DTC actually stands for? And that the "D" is not for "drugs."

Why is is that "direct to consumer" pharma advertising is universally vilified (except by Pharma itself, of course) whereas the ubiquitous ads on radio, TV and all variety of print media for hospitals, "health systems" and assorted doctor groups are considered legitimate marketing? That is to say, why is medical marketing kosher at all?

At one time, wasn't self-promotion the height of unethical behavior for professionals? Isn't this why billboard lawyers are deemed to have sunk so low? When did the medical profession join in? Aren't doctors supposed to limit their "advertising" to location, hours and perhaps insurance plan participation? Doesn't anyone else find this kind of self-promotion crass and unprofessional? Just because more and more people are doing it -- offering the excuse that one must join in in order to remain competetive -- doesn't make it right. See the Twelfth Law of the Dinosaur:

A bad idea held by many people for a long time is still a bad idea.

In this case, it's more on the order of everyone else is jumping off a bridge. Going along with the crowd doesn't make it less stupid.

Last week I wanted to write a letter. Not an email; not a phone call; an honest to goodness, pen and paper letter. (Yes, I even wanted to handwrite it. Another post later on the stereotyping of doctors and their handwriting.) I couldn't find any nice stationery anywhere around the house, so I popped out to the mall to find some. Hanging from the magnificent vaulted, stained glass Romanov Egg ceilings were advertising banners. The one outside Nordstrom's flaunted a larger-than-lifesize portrait of a smiling Ryan Howard, the Phillies' slugger. But hanging above the escalator down from the upper level food court was a similar banner touting the Orthopedists at Thomas Jefferson University Hospital. Five Jefferson orthopods stood there, posed and smiling, watching over the shoppers and browsers with the same glint in their eye as Ryan Howard. Each column along the promenade had a smaller poster with one or another of the doctors, all smiling as if they wanted to be your best friend while simultaneously slicing your knee open.

Never mind that if you actually called for an appointment today you'd be told the first one available was in July. Never mind that if your appointment was for 10:00 you'd have to leave your home in the suburbs a good 1-2 hours before that to allow time for rush hour traffic and finding a place to park. Never mind that once you got there (at 10:00) you wouldn't be seen for up to another four hours (true stories from patients of mine braving Jefferson) and then for two minutes by an abrupt ortho resident. Never mind that the exact same "highly specialized and advanced" services are readily available twenty minutes from home at your perfectly good neighborhood hospital, where your perfectly competent orthopedist (who's been doing this for twenty years) sees you within five minutes of your appointment time, and does your surgery himself; no trainees. And never mind that the University of Pennsylvania, Temple University, Lankenau Hospital and any number of other teriary care centers in the same area code all provide essentially identical care.

Medical marketing is bullshit; even more so than direct-to-consumer pharma advertising. Although I am under absolutely no illusions about the extent of my influence, I would like to see it stop.