Who is the real winner in the latest stoush between pharmacists and doctors?

Last week a state Pharmacy Guild president made a few negative comments about general practice. I thought it was neither here nor there, but what happened next was interesting.

I could not find the original column (admittedly I didn’t look very hard) so I can’t verify his exact words but apparently, he said that increased funding for GPs will only incentivise five-minute ‘turnstile’ medicine.

Most GPs would not have read or been aware of the column until, on the eighth of February, Australian Doctor Magazine, owned by the Australian Doctor Group (ADG), posted an article on their website titled “Pharmacy Guild says GPs working ‘turnstile operations’ filling time-slots with easy patients.”

Then all hell broke loose. There were 170 comments on the article from mostly angry GPs.

A few days later, on the eleventh of February, Pharmacy News published this piece: “Guild takes aim at GPs who favour wealthy, healthy patients”. 

Interestingly, Pharmacy News is also owned by ADG.

Then the response came. On the thirteenth of February a reply penned by the RACGP president was published. And you guessed it, that same day Australian Doctor posted: “Turnstile, cream-skim medicine? RACGP hits back at Pharmacy Guild.”

The ADG publications got hundreds of clicks and views of their website content out of the latest stoush between pharmacists and doctors.

Good on them, one could argue. But hang on, there’s more to it. The ADG website explains how it works:

“We know that GPs are increasingly time-poor and less reliant on [pharmaceutical] sales reps,” says Bryn McGeever, Managing Director of Australian Doctor Group. “They’re looking elsewhere for information.”

“While readership of medical print publications remains strong, digital channels are becoming increasingly popular with almost eight in 10 GPs now reading online medical publications monthly.”

“In recognition of this continuing shift in GP behaviour, Australian Doctor Group last week launched AccessPLUS, a bespoke digital sales channel designed to fill the space left behind as rep engagement continues to fall.”

And the real winner is….

It is sad, but not surprising, that the medical media are fuelling the tensions within primary care. Of course, like other media, ADG is just doing its job. I do wonder how many GPs and pharmacists are aware that they are the product on sale here.

I have had my fair share of altercations with the Pharmacy Guild – but it’s a road to nowhere. I prefer to listen to people like pharmacist Debbie Rigbie, who rightly says, “We must build bridges across our differences to pursue the common good.”

6 warning signs that online health information may be unreliable

If you are using Dr Google to find information about a health problem – like most people do – you will come across unreliable information. Here are 6 warning signs that will help you stay clear from quackery sites.

Information may simply be outdated or incomplete. But sometimes it is deliberately incorrect or manipulated, for example to make you buy something. How to differentiate between the good and the bad? (I admit, this is not always easy).

#1: The site wants to sell something

If a website is trying to sell a product, the information provided may not be objective. Be careful if the site is:

  • Showing lots of advertisements or testimonials, difficult to distinguish from the website content
  • Offering a free trial, money back guarantee or special offer
  • Using phrases or words like: Recommended by doctors, used by professionals, scientifically proven, patented technology, or guaranteed results.

A site may not explain that its main purpose is to sell something. Stay clear if it sounds too good to be true, for example if the website is promising you a miracle or magic cure, amazing results, or a new, quick or easy way to fix your health problem.

#2: It is not clear who makes the claims

Always check if a trustworthy health professional or professional organisation is providing the online information, like the Royal Australian College of General Practitioners or Physicians, the Australian Medical Association, the Consumer Health Forum of Australia or the National Prescribing Service.

Are links to original sources or scientific research provided? Missing or insufficient information may be a clue that a website is not reliable. Websites carrying the HON Code or HealthInsite logos are usually reliable.

#3: The website is out-of-date

Always check how old the information is. Has the website recently been updated? If the information is more than 2-3 years old it’s best to look for a different source of information – or talk to a health professional.

#4: The site has a less reliable domain

Trustworthy health websites contain the domains .gov, .org or .edu, indicating that the information comes from the government, a not for profit organisation or a university.

This doesn’t mean that other websites are always unreliable, but it’s good to find out who is sponsoring or paying for a commercial website (.com or .com.au) before relying on the information. You particularly want to know if the information favors the sponsor.

Websites written by a single person are less reliable than websites run by professional organisations. Yes, that includes this blog (I just shot myself in the foot, didn’t I?)

#5: You have landed on Wikipedia

Wikipedia scores high in search engines so it’s easy to arrive at a Wikipedia page. As much as I like Wikipedia, one study showed that it may contain errors.

#6: The site is requesting your information

Reliable health information is freely available online (at no cost), so there is no need to give a website your details, like your email address. If you must submit personal information, check what will happen with your details first.

Look for the website’s Privacy Policy: this tells you how a website or organisation manages your personal information. You may want to know if your data will be sold or provided to other organisations. A Disclosure Notice informs you if a site receives funding or accepts forms of paid advertising, sponsorship, or paid topic insertions.

More information

A rule of thumb: Don’t rely on one source. Try to find other reliable websites or sources confirming a message or claim about a product or service. Ask an AHPRA-registered doctor or health professional if you’re not sure.

If you would like to know more about finding reliable health information online, have a look at this 16-minute tutorial by the US National Library of Medicine.

Sources:

3 reasons why marketing to children is unhealthy

“For a young person with creative ambitions, copywriting is one of the coolest jobs around. I got a huge buzz when my ads appeared on TV or in magazines. (…) Who cared if it was all meaningless crap?” ~ Greg Foyster

There is a world between commercial copywriting and my job. A large part of what doctors do everyday, consists of undoing the damage caused by marketing and selling of unhealthy products.

That was the good news. The bad news is: Doctors are not winning.

What the industry says

Marketing to children is a controversial topic. There are people who feel we don’t need more regulation to protect our children from fast food or alcohol advertising.

Instead, parents should make sure their children don’t get exposed to these ads. And if they do – which is hard to avoid – parents must teach their children how to deal with marketing techniques.

The industry states their influence over children isn’t that big anyway, so why worry? Besides, they may say, complaints about advertising are really about the products and companies, and ads in itself are not the issue.

Purchasing power of kids

Although children wield power over their parents’ shopping behaviour, their critical judgement lags behind, and this makes kids vulnerable to marketing strategies.

The American Academy of Pediatrics says:

“Research has shown that young children – younger than eight years – are cognitively and psychologically defenceless against advertising.They do not understand the notion of intent to sell and frequently accept advertising claims at face value.

According to experts it takes until the age of eleven or twelve before children understand the persuasive nature of advertising.

Why advertising is unhealthy

Our kids are overweight, drink too much alcohol, and may not live as long as their parents. Unhealthy habits are often taken into adulthood: Obese children are likely to become obese adults and parents. For a dramatic example, have a look at the video below.

Australian children between the ages of five and twelve are able to correctly match at least one sport with its relevant sponsor, according to a report by the Australian Alcohol Review Board. We know that advertising is effective in getting young people to start drinking, or to drink more if they already use alcohol.

3 reasons

Here are three reasons to stop marketing to children:

  1. Advertising teaches children to want what they don’t need
  2. Advertising encourages kids to make unhealthy purchasing decisions
  3. Advertising promotes materialistic values

Although I’m usually not in favour of more legislation, I feel we urgently need regulatory changes to protect our kids.

Journalist and writer Greg Foyster, whom I quoted above, quit his job in advertising and went on to live a basic and sustainable life. His well-researched book Changing Gears: A Pedal-Powered Detour from the Rat Race is worth a read.

 

We don’t see alcohol as the problem; it’s a solution

Not long ago I attended my first AA meeting. Before you get the wrong idea: The event was organised to give health professionals a better understanding of the important work Alcoholics Anonymous does.

During lunch, one of the organisers said to me: “You doctors keep referring to alcohol as the ‘problem’, but alcoholics see it as a ‘solution’. That’s a major source of misunderstanding.” It was one of the lessons I was hoping to take away from the meeting.

The reason I attended is the number of alcohol related problems I see in my practice. Not a day goes by without hearing personal tragedies caused by booze. And what’s worrying: all ages are affected. The National Drug Strategy Household Survey found that about five million Australians aged 14 or older were victim of an alcohol-related incident in 2013. According to the survey people feel that alcohol is our most concerning drug issue.

Yet, we’re still relying on income derived from alcohol sponsorship.

Industry sponsorship: why?

An article in this month’s edition of Addiction shows that university students who play sport have a higher risk of problem drinking when they or their club or team are sponsored by the alcohol industry. Of course this is nothing new. We know that alcohol advertising and media exposure are effective in getting young people to start drinking or to drink more if they already use alcohol.

But what about older people? The same issue of Addiction features an interesting study suggesting that people aged 50-64 drink less in countries with stricter advertising rules.

One argument for alcohol industry sponsorship is that sport wouldn’t survive without it (It seems like more people feel that alcohol is not a ‘problem’ but a ‘solution’). However, sport has survived the ban on cigarette sponsorship; why wouldn’t it survive an alcohol ban? Interestingly, advertising revenue for TV and radio continued to increase after the ban on cigarette ads in 1976.

A ban doesn’t seem to affect major sporting events either. France is a good example: The country does not allow alcohol sponsorship but hosted the Rugby World Cup in 2007, and will be hosting the UEFA Football Championships in 2016.

What’s the point?

Back to my day-to-day work: The numbers are telling – in the average Australian GP practice about 27 percent of patients are at-risk drinkers. It seems pointless for GPs to counsel people about their alcohol use once or twice a year, when they get hammered with alcohol ads at the sports club every week.

I’m all for a total ban on alcohol sponsorship – what about you?