Once upon a time, doctors were information providers as well as caretakers. Generally the first in line to receive new information
about medical conditions and treatments, physicians' expertise and knowledge gave them authority in all health matters. Patients
had only their doctors to turn to when they had questions about their health, and the only way pharma companies could reach
patients was through their physicians.
All of that has changed. Patients today live in a 24-hour news cycle, in which television broadcasts break news to millions
of people the same day it happens, while the Internet can put people in the know within minutes of an event. DTC advertising
and public health education, along with increased use of the Web to research conditions and remedies, have played pivotal
roles in shaping a more educated patient population. Information is everywhere, and everyone has access to it, including legions
of consumers eager for updates on one of the topics that matter most to them: their health.
Thanks to this round-the-clock access to medical news and information, healthcare providers can no longer stay one step ahead
of the general public. Medical education symposia and journals, while essential tools for keeping medical professionals informed,
are no longer enough. By the time a doctor has caught up with the latest journal articles, some of the content may already
The Time Bind
To make matters worse, physicians' increasingly hectic schedules, beset by the demands of dealing with the various payer systems,
leave them less time than ever to spend with each patient. In a 2001 Journal of the American Board of Family Practice (JABFP) survey, only nine percent of physician respondents said they were not overwhelmed by paperwork and administrative requirements, and that has not changed much in the four years since then.
And yet, increased public access to medical information has led to a more demanding patient population. Some 110 million Americans
logged on to the Internet seeking healthcare information in 2002, up from 97 million people the previous year, according to
a survey of 495 primary care doctors published in JABFP in 2003. With greater access to such information, patients have begun approaching doctors to discuss their full range of
treatment options or even to put forth their own ideas about the best course of treatment.
Although the phenomenon of educated patients taking an active interest in their medical treatments is a generally positive
trend, the issue raises concerns about the role of today's physician and about the best way to distribute medical information.
It's critical that informed consumers have equally informed physicians through whom they can gain perspective, clarity, and
a sense of reassurance about the medications they're prescribed. Physicians need to understand what is driving their patients
to ask for certain medications and how to communicate with patients in a way that will help them put the information they
receive from other channels into the right context.
Caught off Guard
The Regulation Fair Disclosure (Reg FD) rule, passed by the Securities and Exchange Commission in August 2000, prohibits public
companies from disclosing information on a selective basis. That means pharma and other medical products companies can no
longer release advance information to a select group of shareholders and market professionals, such as healthcare providers.
This may create a more level playing field for shareholders, but it forces physicians to scramble to stay ahead of the information
curve, even as patients are walking into their offices with copies of the Wall Street Journal, ready to demand the newest medication or to announce that they've stopped taking a vital medication in response to data
reported through the media.
The events surrounding Merck's recent withdrawal of the COX-2 inhibitor Vioxx (rofecoxib) demonstrate how challenging it can
be for physicians to stay on top of breaking news that is critical to their ability to counsel their patients.