The relatively new Diagnostic Statistics Manual 5 (DSM V) came out in 2013 and eliminated Asperger’s and other forms of autism previously specified in the DSM. Attention Deficit Disorder, or ADD, was once linked to the Autism Spectrum. Now they are two separate disorders.
With the system for diagnosis being more liberal, it is easier to get prescriptions, especially since psychiatrists write the DSM. Cory McCleave, a junior bio pre-med major, recently attended the Midwest National Podiatry Conference and described the marketing booths he saw there.
“There were booths of people who did rating systems for doctors,” McCleave said. “Lots of people read reviews.”
McCleave explained that these people offer services that screen bad reviews by having one- or two-star reviews sent to you first before being published on the website. This calls into question the ethical appeal of such marketing practices, as the main advantage would be to censor out unsavory reviews, legitimate or otherwise, to try to get more people to see you.
Commenting on the DSM, McCleave said, “If it had been written by a psychologist, instead of a psychiatrist, it would have definitely been different.”
McCleave uses depression as an example to discuss differences between psychologists and psychiatrists. A psychologist might look at factors such as life at home, work, etc. A psychiatrist following the DSM would ask you how long you have been feeling depressed. According to DSM V, depression lasting longer than two weeks is considered clinical if you have five criteria listed for diagnosis. Listed below are four criteria from the list that are especially subjective:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. •Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Fatigue or loss of energy nearly every day.
Pharmaceutical companies know this when they market to doctors. A company like Shire US holdings, who is responsible for ADD drugs Ritalin and Vivance, often send representatives out meet with doctors and take them out to lunch. When asked if he thought that this practice might violate the do-no-harm oath, McCleave replied “I would say no. A lot of the marketing I have seen is for practices and for drugs.”
At Dyson Wellness Center, marketing to doctors isn’t a huge issue. Tatiana Sifri, director of Dyson Wellness Center, said, “Dyson Wellness Center doesn’t experience a lot of that.”
Dr. Sanjeeb Khatua, who is employed at both Dyson and Edwards Hospital, doesn’t experience much marketing through Dyson, but life at Edwards Hospital is a different story. In 2013, Khatua received more than $300 in “food/beverage” transactions from various pharmaceutical companies (22 total food/beverage transactions), some of which are listed as an informational meal. This is not uncommon, especially at a large hospital. It would be difficult to locate a doctor who didn’t have any trace of influence from pharmaceutical companies.
McCleave noted that the future of advertising to doctors will be on social media. He suggested that doctors, especially in urban areas, might hire marketing professionals to manage their social media presence. McCleave wants patients to be aware of their options. Doctors nowadays are more likely to present options instead of a specific treatment.
“Drugs don’t cure everything,” McCleave said. “Often, they will make another symptom more pertinent.”
Another suggestion is to know the side effects of the drugs you are prescribed, so that if you experience abnormalities, you are aware of them and can report them to your medical professional.
