Healthy Skepticism Library item: 19924
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
Lundberg GD
Uninvited, Unwelcome Medical Email Message
MedScape 2003 Dec 16; 5:(4):
http://www.medscape.com/viewarticle/465734
Abstract:
If your experiences are anything like mine, you too are now receiving a much greater number of uninvited, unexpected, and sometimes unwelcome email messages than you did even a short time ago. “Junk” mail, largely advertising and marketing messages, has been a fixture of the American postal system for many decades. So, it is natural for people and organizations that want their messages heard or read by others to use this wonderful new medium, the Internet, for similar purposes. Indeed, the creation of email address files has been one of the essential tickets to early successes for many companies operating in this medium. The fact that newer technologies make it possible for electronic messages to be sent simultaneously to vast audiences at virtually no cost (so called spam) makes the approach irresistible to marketers of every ilk.
Fortunately for all of us, the “delete” button/key is very easy to tap repetitively as long as one has a pretty good idea that the message is unimportant. But humans can be very creative; enticing, come-on messages, long the purview and stock-in-trade of the advertising community, are now applied with great trickery by electronic marketers.
Of course, the adage that “for every action, there is an equal and opposite reaction” applies here like everywhere else. Individuals, companies, and now even governments are busy inventing ways to block the penetration of the unwelcome messages into their various domains. Almost invariably, such efforts constitute forms of censorship, albeit some is welcomed self-imposed censorship. In a free society in general, and in this extraordinary medium in particular, censorship in any form is neither desirable nor likely to succeed in any lasting way.
Is the balance of effects of this burgeoning problem really worth all the negative attention it has gained, or is it simply an annoyance, like junk snail mail, advertising on commercial television and in print magazines and newspapers, and unsightly highway billboards, which are all so much a way of life that they are hardly noticed as unusual by most, unless particularly vivid or catchy?
To test this balance, I decided to study one sample of my experiences, a single 24-hour period of emails received, on October 22-23, 2003.
Of the total of some 300 email messages that arrived in my 24-hour queue, approximately 200 were uninvited and unwelcome. Most were in English, but many were in Spanish, some in Greek, a surprising number were in Russian, one was in French, and many were in no recognizable language at all, deliberate gobbledygook, so to speak.
The subject matter of the messages was highly variable, consisting of entreaties to buy cell phones, automobiles, mortgages, support politicians, take out loans, pornography, dating services, universities, business ventures, spam killers (marketed by spam techniques), insurance, search engines, computer security, virus scan CDs, financial newsletters, flowers, computer supplies, haircuts, grass roots lobbying, hair removal, ancestor quests, smiley faces, wine bottles (empty), online surveys, auctions, Christian debt management, stock sales, handbags, coffee, print postage beaters, messages returned as undeliverable that I had never sent, and of course, MANY for various medical and health products and services.
As a physician and medical editor, I found the latter to be of the greatest interest, both because of the nature of our Internet medical journalism business, and the potential to do people harm in ways other than simply taking their money and time.
So I studied those messages in more detail. WebMD Corporation has a very active filter that is intended to block spam and viruses. I only studied those messages received at my WebMD email address, not my personal email address. Indeed, the content of 42 messages intended for my inbox were automatically blocked, I received only the email titles. These “blocked” messages included 15 hawking Vicodin or hydrocodone, 9 offering to sell a wide variety of pharmaceuticals, 3 promoting penis enlargers, 5 marketing sildenafil or Viagra, 3 promoting Cyalus, 3 offering weight loss products, one each selling “sleep pills,” immune system enhancers, and calcium, and one “thanks for your order,” for which, of course, I had placed no order.
Of the 45 uninvited health and medicine messages that came through unblocked by the filter, 15 offered prescription drugs of many kinds, with or without physician services included; 10 advertised penis enlargement products or techniques, all with strong claims backed by promised money-back guarantees; 6 sold HGH, invariably touting the value as reported by The New England Journal of Medicine; 7 offered either Cialis, tadalafil, Viagra, sildenafil, or Apcalis; 3 offered to sell weight loss pills; 2 thanked me for my order for weight loss pills (no such order had been placed) and even stated that my credit card had already been billed (it had not); and one each offered calcium and cosmetic or plastic surgery.
Did I order any of these? No. Was I harmed by any of them? No, although they did waste a small amount of my time. Might someone else be harmed in some way? Yes. How? First off, the unwary or easily persuaded could expend money for products without proven value, many of which would turn out to contain no ingredients likely to improve the condition for which they were bought, and could potentially be harmful. Humans are frail and may be easily persuaded, even intimidated, in medical realms where they may be most psychologically vulnerable, such as size of penis (wanting it bigger), erection/virility (wanting more), size or contour of body (wanting it smaller and prettier), pain (not wishing such and not being managed well by the medical community), and cost of prescription drugs (often thought to be too expensive in the United States at regular pharmacies). In addition, the ingredients in many “nutritional supplements,” when analyzed, turn out to be not at all what the label states, qualitatively or quantitatively, and while most often inert, could be actually toxic. The issue of cross-country border marketing and sale (Internet or other) of chemically valid, properly prescribed and labeled pharmaceutical products is another whole topic, currently very hot politically, and beyond the scope of this editorial.
Typically, the medical and health products on the Internet that one should be truly concerned about are those in which the identity of the purveyor is virtually opaque regarding the origin of company, product, or people in charge. A basic rule in this field for the consumer must be: if you can’t easily find an actual geographic address and real named people who are responsible and accountable for the product or service being offered, DO NOT USE IT.
So where do we go from here? Ethical companies should behave ethically. For example, Medscape uses weekly email distribution to millions of health professionals as a key strategy, but has always done so with the permission of the recipient in advance. No problem, except the potential of getting somehow tainted or mixed up in the medium by the egregious “spammers.” But it is important to always remember that the Internet is simply another medium. The mere fact that JAMA by direct mail arrives mixed in a pile of advertising junk mail, because of the paper and postage tradition, and contains between its covers reams of often uninvited and unwelcome advertising messages, in no way lessens its value. Nor will the spam epidemic lessen the value of Medscape, WebMD, and the other ethical and scientific medical information sources that use the Internet as their medium. But it is true that one might have to search through a whole lot of garbage email to get at the good stuff, and this is annoying, does fill technical space, and can waste time.
In the end, the US Congress, other national governments, the various state and provincial governments, and the technology industry itself will all try hard to eliminate spam, but they will probably fail to be intelligent sustained censors of this medium. The actions and wisdom of ethical companies and people accustomed to freedom of speech, including on the Internet, will prevail. Notably, more than 150,000,000 unique visitors came to our medium, the Internet, in September 2003, an all-time record, 82,000,000 for health information. Those users exercising “caveant lector et viewor” by quickly and painlessly using the power of the delete button/key will prevail.1 Let a thousand flowers bloom, but be alert to distinguish foxglove from garlic and rosemary from poisonous mushrooms.
