Sunday, March 30, 2008

Voices From the Past: Consumer Reports, 1961

First I'll offer some quotes from a volume called The Medicine Show: Some Plain Truths about Popular Remedies for Common Ailments, by the editors of Consumer Reports, published by Simon and Schuster in 1961. Next I'll make some comments.

The volume begins with an "Introduction" by Dexter Masters, Director, Consumers Union:

A good many of the ailments which the subtitle of this book refers to as common...are more annoying than dangerous, more a bother than a threat. They are part of the occupational hazard of living, and it is likely that, left to our own devices, we would be quite capable of getting along with them during their comings and goings. But we are not left to our own devices. Indeed, we are all but overwhelmed with the devices of others, the popular products which have occupied the drugstores, which stare at us from advertisements in the newspapers and magazines, and which give us our instructions from the television screens they now command. Our peace is endangered if not our health, and at least the economic threat has become real.
...[O]ne of the plain truths which emerge from the chapters of this book is that we are here in the presence of something irrational.
For the popular products in their bottles and jars and tubes have become a major reliance of a considerable part of this country's population, and the sellers have become the prime source of medical education for ther buyers. It is demonstrable that the contents of the bottles and jars and tubes are most often a good deal less than represented and that many are worthless. But none of this is to be learned from the representation, which therefore cannot be said to represent very well. ...[V]irtually all of them proceed in the same pattern, inducing alarms so that they can offer assurances, and stating at best no more than is in the sellers' interest, since selling is their first function. But selling is not a function which rationally can be associated with education, at least not with good education, and most decidedly not with anything so complex as medical education.

Most of the rest of the book deals with over-the-counter remedies, but a short section deals with prescription drugs. The introduction to that section is titled "A Perspective on Medical 'Miracles'". The editors there begin by defining an "ethical" drug as ones sold only by prescription, hence suggesting a "dignity and seriousness of purpose" not shared with over-the-counter nostrums. They then list the various ways that "ethical" medicines are marketed to physicians--direct mailings of glossy brochures; medical journal ads; throwaway journals that exist almost solely as adverising vehicles; exhibits and social events at medical conventions; and the ubiquitous "detail men":

Thus the spirit, the values, and the tactics of of patent medicine promoter now hold sway over the "ethical" drug. We who listen hours a day to the conflicting claims made for various brands of deodorants, cold remedies, toothpastes, weight reducers, hair dyes, headache remedies, and laxatives cannot help but feel a sympathetic uneasiness for our physicians, now subject to so intensive and extravagant a hard sell on behalf of the drugs they prescribe. And the uneasiness is heightened by the fact that, in many instances, the very same companies making exaggerated claims to sell patent remedies to us are also sellers and promoters of prescription drugs to the doctors.

Comments: I discovered this volume through an excellent recent historical study by Nancy Tomes (see below). As we near the half-century point since the publication of this book, it is worth being reminded of just how far back the marketing practices and the inappropriately cozy relationships between medicine and Pharma actually go. Reading such materials, I am always struck by how few changes would be necessary to transpose these passages into a publication of last week's vintage.

Tomes N. The great American medicine show revisited. Bull Hist Med 79:627-63, 2005.

1 comment:

Daniel Goldberg said...

Dr. Brody,

I had the exact same thought in reading the article referenced here:

http://hcrenewal.blogspot.com/2008/03/article-ties-together-pogo-and-anechoic.html