Your Medical Mind_ How to Decide What Is Right for You - Jerome Groopman [9]
Howard Gardner, a professor of education at Harvard University, has written about how the same information can be presented in different ways. One way is numbers, and in the case of medicine, there are numbers about the risk for illness and about the benefits and risks of various therapies. This information can also be presented visually, often via a graph whose lines or bars convey the statistics. Last is stories, the narratives of people who faced these risks and benefits and how they fared. Gardner’s research, along with that of many other educators and psychologists, shows that all of us respond most profoundly to stories; they echo in our minds and become imprinted in our memories. Ultimately, we want numbers and graphs to tell us a story—a story where we can imagine ourselves as the central character.
Advertisements for drugs may include statistics, but fundamentally these ads are designed to communicate a compelling tale. Over the weeks that followed her appointment with her physician, Susan Powell paid particular attention to ads for statins. Once she started looking for them, they seemed to be everywhere. The TV morning shows were punctuated with them; so was the evening news. Her magazines never failed to include at least a page or two that touted these drugs.
We had seen similar ads. And the more we thought about them, the more we realized that pharmaceutical companies understand a great deal about how people decide whether or not to take a medication. Drug advertisements are designed to overcome the psychological barriers to treatment that we witnessed in Susan’s case, particularly loss aversion. They frame information about benefit in the most favorable fashion and exploit the power of availability bias using carefully crafted images and anecdotes.
The most vivid ads run on television. Many of these ads feature an ominous opening scene. In one, an older man is jogging while a voice-over soberly states that an elevated cholesterol level can lead to a heart attack. Next the viewer sees an avuncular physician prescribing a statin medication and the older gentleman nodding with a thankful smile. Then the mood becomes warm and bright, as the man (now presumably on the medication) is surrounded by his family at a birthday party. The camera focuses on the cake and lighted candles and the applause of wife, children, and grandchildren as the man blows out the flames with a strong, healthy breath. The implicit message of this story is that the man’s rich, full life is sustained by the pill. Only when the viewer’s attention is fixed upon the joyful birthday scene does a quiet voice list the drug’s various side effects.
However, Susan focused on the side effects that were mentioned, undistracted by the positive images on the screen. “My daughter and I watched an ad together, and then afterward we just went back and forth with the side effects: muscle pain, stomach upset, liver damage. It’s no wonder they try to distract you.”
Advertising of prescription drugs directly to consumers is often justified as serving an educational purpose. Proponents claim that advertisements raise public awareness about health conditions and encourage patients to participate actively in their own care by learning about useful therapies and asking their physicians about treatments that may help them. In 2009, some $5 billion was spent on such drug ads, more than twice the total budget of the Food and Drug Administration (FDA).
A team of researchers from the University of California Medical Center at Los Angeles and other medical centers studied prescription drug ads broadcast on national networks. They selected commercials that aired during prime-time shows from eight to eleven p.m. as well as the evening news. The researchers found that the average American TV viewer sees