Friday, February 29, 2008

From Australia, A Gem of an Analogy

Roy Moynihan, the Australian journalist best known for his investigations of "disease mongering" by the drug industry marketers, recently did an interview show Down Under:

The theme of that program was how Australian GPs are tricked into attending continuing education conferences put on by companies that claim the programs are independent from commercial influence, when at the same time those companies are marketing their wares to drug firms by promising them a hand in choosing the speakers and topics so long as the drug firms fork over enough dollars.

That of course is old news, so what was in fact the high point of this interview, for me, came from Dr. Peter Mansfield of Healthy Skepticism, in this "Dang! I wish I had thought of that" analogy:

Peter Mansfield: I think the situation that we are in now is similar to in the 1840s, doctors didn't believe that we needed to wash our hands before we did surgery. We couldn't believe that we could be infected by something invisible that could cause harm to our patient. Bias that comes from promotion is like a bacteria in that it is invisible, and at the moment, if you suggest to a doctor that they could have become biased, many of us will take that as a personal insult, in the same way that doctors in the 1840s felt insulted by the suggestion that they could be carrying infections.

This great quote has it all--how a point of view can absolutely permeate the medical culture, and yet still be dead wrong; how physicians can unwittingly be a source of harm to their patients; and how the first natural, human reaction of physicians, when this is pointed out, is to be angry and insulted.

Dang! I wish I had thought of that.


Bernard Carroll said...

Sounds like a description of Thomas Stossel. See

Jim Sabin said...

We forgive you for not thinking of this metaphor. Thanks for posting it! The metaphor meshes with the widely used concept of "viral spread" for internet dissemination. Hooked is an important part of the "viral spread" of counter-detailing!