Healthy Skepticism Library item: 5916
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: news
Priest A.
A look inside a doctor's mailbox
Shared Vision 2006 Aug 19
http://www.shared-vision.com/2006/sv1908/PostTraumatic.html
Full text:
A look inside a doctor’s mailbox
by ALICIA PRIEST
Most of us are familiar with what was once a doctor’s constant companion -that little black bag packed with mysterious tools of the trade. But what about the contents of a typical doctor’s mailbox? That material, I contend, reveals more about modern medical practices than anything found in any MD’s carryall.
Recently, I examined two separate stacks of mail, gathered over two months by Dr. Warren Bell, a Salmon Arm, B.C., family physician. One stack contains a collection of plain, understated, and professionally penned letters, brochures, and notices. The material includes invitations to medical education courses sponsored by drug companies; and offers on how to make money by learning vanity procedures such as skin tightening, cellulite reduction, and hair removal.
Bell, however, is not a typical doctor so there’s a lot that’s not in this pile. Absent are the reams of pseudo-medical journals, drug “information,” and other advertising mailed free and unsolicited to almost every doctor in the country.
Bell estimates he gets about 10 per cent of the mail a conventional doctor does. That’s because 30 years ago, soon after graduating from medical school, he wrote a firm but polite take-my-name-off-your-list-or-else letter to the Canadian Direct Marketing Agency, the company hired by the drug industry and others to mail material to doctors.
“I was astonished and amazed at how much of it there was,” Bell recalls. “I was inherently suspicious of it . . . If you’re not careful, your mail will be full of enormous amounts of public relations bumpf from the drug industry.”
University of Victoria drug policy researcher, author, and former letter carrier Alan Cassels agrees. He recalls delivering mail 12 years ago on a route that included a building housing about 10 doctors’ offices. “Each doctor,” Cassels says, “received a six-inch stack of mail. Every day.”
Of course, no doctor can read all the material that comes through their door, let alone keep up with the frenetic pace of medical science research. Consider: From the mid-1960s to mid-1990s, the number of published randomized clinical trials increased from 100 to 10,000 articles; in fact, nearly half of all medical literature ever published has appeared in the past five years.
But, says Bell, reading is not the point. “The idea is not to read the articles, necessarily. It’s to thumb through them and get the images from the advertisements for various drugs into your subconscious mind.”
Before delving into the second stack of mail, it helps to know a bit more about Bell. While still in training, he began to learn about the intimate relationship between medicine and the drug industry. Unlike the majority of his colleagues, he refused to see pharmaceutical company reps in his office or have any drug company logos on things such as pens, notepads, chart organizers, or calendars in his possession.
Bell has a keen interest in what he calls “non-pharmaceutical approaches” to healing. He is currently president of the Association of Complementary and Integrative Physicians of B.C. That explains the contents of the second stack-a colourful collection of generously illustrated material from sellers of herbal, mineral, vitamin, and other biological remedies. They feature hysterical headlines in colossal type that scream such things as: “Deadly Cancers Vaporized by Harmless Natural Enzymes” and “Fight Diabetes with Three Teaspoons of Red Wine Vinegar.” Also included are several tracts trashing conventional drug therapies.
Bell admits that much of the alternative bumpf is hard to take. Yet he is relatively tolerant of what he calls their “strenuous language.” Why? Are outlandish claims and snake-oil tactics easier to swallow than the calm and ostensibly reasonable material from pharmaceutical companies?
Bell says there is a crucial difference between the two.
“The biological remedies are being sold into the ‘real’ market-like a bazaar in Marrakech,” he says. “So it’s messy, hyperbolic, and loud. Big Pharma, on the other hand, plays a smoothly deceptive game of pseudo-obeisance to doctors, all the while using every trick in the book to persuade us to prescribe: false data, exceptional and unfailingly non-confrontational behaviour, bribes, gifts, you name it. All that I find far more irritating because it is so utterly false.”
Ponder that next time your doctor’s postman cometh.
Alicia Priest is a Victoria-based writer who loves her family doctor despite the contents of his mailbox.
