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Healthy Skepticism Library item: 16133

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Murray E, Lo B, Pollack L, Donelan K, Lee K.
Direct-to-consumer advertising: physicians' views of its effects on quality of care and the doctor-patient relationship.
J Am Board Fam Pract. 2003 Nov-Dec; 16:(6):513-24
http://www.jabfm.org/cgi/content/full/16/6/513


Abstract:

BACKGROUND: The objective of the study was to determine physicians’ views of the effects of Direct-to-Consumer Advertising (DTCA) on health service utilization, quality of care, and the doctor-patient relationship. METHODS: Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship. RESULTS: Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted. CONCLUSIONS: DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians’ communication and negotiation skills; and encouraging patients to respect physicians’ clinical expertise.

Keywords:
Adult Advertising as Topic* Attitude of Health Personnel* Cross-Sectional Studies Female Health Knowledge, Attitudes, Practice Health Services Needs and Demand Humans Information Services/utilization* Internet Male Middle Aged Patient Education as Topic/trends* Patient Participation* Physician-Patient Relations* Quality of Health Care* Questionnaire

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909