Trust Me, I’m a Colleague by Pat Conrad MD

Do you ever watch the odd-hours infomercials featuring guys or gals calling themselves “doctor”, and then endorsing all manner of miracle cure-it-alls?  I enjoy immensely the various ads for vitamins, shakes, copper bracelets, skin toners, and of course, the plethora of ads for special proprietary, “All Natural!” blends that “enhance that certain special part of the male anatomy”, which hilariously, they never, ever name.

It got me to wondering what others have said about this brave industry, and daydreaming whether I could ever be a paid physician endorser for my favorite beer … anyway, I found an interesting AMA News piece from 2004 titled “Doctors who tout iffy cures will face the critical eye of the FTC.”  Then Pres.-elect Ed Hill said:  “There is an ethical duty in recommending a product that is being used to treat a medical condition.”  Uh-huh.

Then FTC Commissioner Tom Leary said:  “Doctors still have a high level of esteem in the United States.”  He added that doctors should not hold themselves out as experts in areas in which they are not knowledgeable.  He then offered tips for doctors to avoid mal-endorsements:

• “Get scientific proof.”  Doctors should do their own evaluations prior to making an endorsement “to ensure that a product holds up to the claims the manufacturer [is] making.”
• “Do a gut test.  Doctors should be wary of situations in which their own financial gain trumps the interests of the people using the product.”
• “Give full disclosure.”

Those seem like sensible tips.  What if they were applied to more than just infomercials?  Doctors have been endorsing products i.e. selling unproven ideas to policy makers and voters/patients for years now.  Various physicians paid by government, Big Insurance, Big Pharma, the IT industry, or the Ivory Tower have over the past few years endorsed HIPPAA, Medicare Part D, “medical homes”, arbitrary quality standards and pay-for-performance, ACO’s, EHR’s, meaningful use, ICD-10, and of course the latest statin, lipid, and salt guidelines.  When the latest president wanted to sell his health care masterpiece, the White House famously had boxes of fresh white coats for the degreed props to wear for the press conference.  Were they held to any standard other than emotional?  Which CMS physician drones or lobby doc or academic began their sub-committee testimony with “I’m being paid by the taxpayer to recommend these ideas which won’t affect me in the least, because I don’t see patients to pay my mortgage.”?

Actual physicians certainly are feeling an effect in a certain special part of the anatomy, courtesy of their colleagues, but it’s not gender specific and not caused by any late night pill.  We might not want to be too hard on the midnight snake-oil salesmen when the real pros are selling their bullshit in the sunshine.