It's become part of received wisdom that today's patient is
an active partner in his or her medical care. Since we all accept this as fact,
we don't think it's worth questioning.
But perhaps it is: a new research study concludes that most
of today's supposedly empowered patients don't ask the doctor what their
prescriptions are for or about the benefits or risks. Only rarely do they even
answer questions with more than a “yes” or “no.” No dialogue, hence no
And here's another shocker: The standard DTC call to action
of “ask your doctor” doesn't work. There's data to show that 97 out of 100 of
your prospects do no such thing.
Hearing these conclusions caused listeners to sit up in
their chairs in surprise at a Coalition for Healthcare Communication meeting
earlier this year where Joe Gattuso, the director of strategic insight for the
13 CommonHealth agencies, Power-Pointed them.
For years we have relied on studies, such as those by
Prevention magazine, that show that DTC promotion works. And so it does. But
how? What actually goes on in the doctor's office when patients exposed to
these ads see their doctors? Do they say, “doctor, I saw this ad” or do they
ask for, or about, a specific brand? Do they, in fact, give any indication of
having been “empowered?”
CommonHealth set out to answer these questions, Gattuso
reported, and now has a database of more than 2,500 transcriptions of
videotaped doctor/patient encounters. For this particular study, they analyzed
440 office visits, covering 35 therapeutic categories, looking for either
direct or indirect mentions of DTC advertising by either party. In addition,
they identified all direct statements regarding product benefits or risks made
by the physician.
Concentrating on three conditions (allergy, elevated
cholesterol, and hypertension) that were being widely promoted through major ad
campaigns at the time, they then followed up with post-visit interviews with
both the doctors and the patients. Patients were asked, “Were there questions
you felt the doctor didn't answer? Or issues you wanted to know more about? If
so, why didn't you ask?”
“I didn't know whether I should ask that,” they responded.
As for the doctors, reviews of the transcripts showed that 60% of the time they
provided neither risk nor benefit information, and that, for their part, they
felt sure their patients had left the office satisfied.
Clearly, while we have had evidence that DTC works, we
didn't know why or how. Says Gattuso: “What is most significant [about] these
studies is that they point the way to a new and expanded vision for DTC
advertising—one which we believe will encourage and increase the kinds of
dialogues we want [between] physicians and patients, resulting in more
efficient, robust, and appropriate outcomes.”
He cites specific examples of how CommonHealth has applied
its findings. Ads for Topamax, for instance, wind up: Tell your doctor your
story. Other taglines might be: “Be sure to ask your doctor what your Rx is
for,” or “Ask about the risk if I don't take this medicine.” Anything to open
up a dialogue.
That approach could lead to real empowerment—and to better
compliance that will improve both sales and patients' well being.
Warren Ross is editor at large of MM&M