The gatekeepers. It used to be when a new drug or machine came to medicine, the companies would speak to the doctors. They would have meetings and symposia, come to your office, show you the science. The doctors who went through years of premed, medical school, and residency training evaluated it all. Only then would the science get to you, the patient and consumer.
Then things changed. There was an era of aggressive marketing, where the pharmaceutical and device companies would wine and dine the doctors. Lavish dinners, even trips. I am sure those gifts could distort some recommendations. But the current world is different. There are strict guidelines on what pharma comapanies can do, and I can tell you we don’t get anything. (except maybe a free pen now and then). I don’t mind. I think products should be recommended based on their efficacy.
But then came the new era of pharmaceutical marketing.
I think wikipedia states it well: “Marketing changed dramatically in the 1990s, partly because of a new consumerism. The Internet made possible the direct purchase of medicines by drug consumers and of raw materials by drug producers, transforming the nature of business. In the US, Direct-to-consumer advertising proliferated on radio and TV because of new FDA regulations in 1997 that liberalized requirements for the presentation of risks. The new antidepressants, the SSRIs, notably Fluoxetine (Prozac), rapidly became bestsellers and marketed for additional disorders.”
The companies skipped the doctors. They went straight to you.
We all saw this. All the sudden you can’t watch football on a Sunday morning without being bombarded by people enjoying their life more because of lipitor and viagra. You, the consumer, got direct marketing.
What happened next was inevitable. Name and brand recognition drove business. You, the consumer, went to you doctor and said, “I want XX.” Now your doctor might not think XX is the best medication for you. Or it may have an interaction with your blood pressure drug. Or it may not be available as a generic, so YY would work equally well but cost a lot less.
Doctors are no longer the gatekeepers. In many ways, the cart now drives the horse.
What does this is mean in plastic surgery? Ah, tune in tomorrow for my next blog….