The relationship between your physician and manufacturers and vendors of products and services is important. In fact it’s never been more important.
Picture, if you will, a placid lake scene. A healthy looking, late middle-aged white man is rowing. The voice-over announces something about “I’m Dr. Robert Jarvik…” The problem is that isn’t Jarvik in the scene. Jarvik doesn’t row. So, you ask? Well it’s also not clear that Jarvik actually takes lipitor. So? Well he’s only a doctor in name. He holds no medical license. In fact he wasn’t sharp enough to get into an American medical school on the first go. When he did get into an Italian medical school. He dropped out after two years. He does not practice medicine. He’s not a healthcare provider in any realistic sense. In fact he’s only really well known for the 112 days of misery borne by Barney Clark from the Jarvik 7 artificial heart.
Let’s look at the initial deception. Medical school graduates are not physicians until they complete additional training and licensure any more than law school graduates are lawyers until they complete a licensure exam. Is Jarvik smart, probably. He got paid more for those commercials than I make and I know way more medicine. Is he a doctor? Yes. Is he a physician? No. Would I let him treat me- no way.
The real problem is that Jarvik has some name recognition. Most people, even real physicians, can’t place him. It’s like saying you had dinner with Sally Ride last night. There’s just enough name recognition to give that meeting some importance. The vast majority of physicians don’t know that Jarvik is a clinical non-entity. How could we expect better of lay people? Sally Field hawks Boniva. But no one could legitimately expect that Gidget was offering healthcare advice beyond “ask your doctor.”
Even so, every dollar that pharmaceutical companies spend for high-dollar direct-to-consumer advertising is money that can’t be used to defray direct costs to consumers or actually improve products. While high-profile (and even low-profile celebrities like Jarvik) make for interesting advertising the bigger problem is the money spent by pharmaceutical companies to directly influence you physicians judgement. How would you feel knowing that your doctor’s decision to write a particular prescription was influenced by the airfare to a conference provided by the drug rep? Your cost for a long-term, name brand medication, is determined not by efficacy and legitimate medical economics but by the relative value of “freebies” you physician received. How about your surgeon who prescribes a particular a post-operative “pain pump” because the company representative is “cute?”
It’s not enough to demand full-disclosure of conflicts of interest. You must understand them. These conflicts shape your healthcare- and not always to your benefit.
Understand your physician’s relationships and where you fit in. You are not a vehicle for supplemental physician income.
