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Direct-to-Consumer Advertising: Physicians’ Views of Its Effects on Quality of Care and the Doctor-Patient Relationship

From the Department of Primary Care and Population Sciences, Royal Free and University College School of Medicine at University College London, United Kingdom (EM), Department of Medicine and Program in Medical Ethics (BL) and Health Survey Research Unit, Center for AIDS Prevention Studies (LP, KL), University of California, San Francisco, and Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts (KD)

Correspondence: Address correspondence to Elizabeth Murray, PhD, MRCGP, Department of Primary Care and Population Sciences, Royal Free and University College School of Medicine at University College London, Archway Campus, Holborn Union Building, Highgate Hill, London N19 5LW, United Kingdom (e-mail: elizabeth.murray{at}pcps.ucl.ac.uk)

Background:The objective of the study was to determine physicians’ views of the effects of Direct-to-Consumer Advertising (DTCA) on health service utilization, quality of care, and the doctor-patient relationship.

Methods:Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship.

Results:Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted.

Conclusions:DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians’ communication and negotiation skills; and encouraging patients to respect physicians’ clinical expertise.

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				E. Murray, B. Lo, L. Pollack, K. Donelan, and K. Lee Direct-to-Consumer Advertising: Public Perceptions of Its Effects on Health Behaviors, Health Care, and the Doctor-Patient Relationship J Am Board Fam Med, January 1, 2004; 17(1): 6 - 18. [Abstract] [Full Text] [PDF]