Column: Beware of the ‘Madmen’ of medical marketing


Have you seen an iridescent green moth floating across your television screen?

The ad for Lunesta, a sedative, is designed to grab your attention. The first step of one neuromarketing technique pulls you in with an image that pours happy-chemistry into your bloodstream. It prepares you to take the hook.

Decades ago, Madison Avenue’s “Madmen” guessed at what catchphrase would sell products and they pitched ideas to businessmen.

That approach evolved into measuring markets and opinions, but interviews have produced unreliable information.

The business of selling cures has relied on anecdotes since the days of the traveling snake oil salesmen. In fact, it was practiced widely in Athens, at the time of Hippocrates. Healers hawked their wares from house to house.

In my previous article, I demonstrated that our eyes deceive us. What we think we see is actually the construct of an image, modified by memory and charged with emotion.

We are imperfect in many ways. We can be very defensive about mistakes even when we recognize them. We make some of our riskiest errors when we buy into skillfully designed marketing for medical treatments.

Whether the message comes from a well-known hospital or a fringe operation, it was created to sell a product or an idea.

Motivations of the advertisers may be complex, but the business of medicine vies for a massive income that amounts to more than 17 percent of the U.S. gross national product.

An important result of competition is direct-to-consumer advertising. Only two countries allow it — the U.S. and New Zealand.

The power of the pharmaceutical industry and equipment manufacturers is evident in the dollars they commit and the effects on the public.

I became aware of the impact in my own practice and through a well-documented lecture at the University of Washington. A lot of patients come to their doctor with an expectation of leaving with a prescription for a specific drug or treatment.

One report suggested that 10 percent are willing to change physicians to get what they saw in an advertisement.

If you are the doctor and you have other patients waiting, would you go beyond a brief explanation of a complex subject? You have the prescription pad and the solution in hand. Your institution, your harassed receptionist, and your patient may be happiest if you just write for — what was that thing you want?

Big Pharma has access to the newest discoveries of neuromarketing. Some of the ways they dazzle and amaze you include old tricks, learned from entertainers and carnies.

Misdirection, the status of the presenter and feeding us what we want to believe is the beginning of a long list of techniques.

As a preteen, I worked in a carnival that traveled around Pittsburgh and its suburbs. I enjoyed learning the ways to trick men into emptying their wallets. It took a few years before morality challenged the pleasure of feeling myself to be a terribly clever devil.

Misdirection and simple science allowed me to trick professors on a college campus. The game required the player to pitch a pingpong ball into a 3-foot-high beer bottle that had once perched on the roof of a delivery truck. The rim of the opening was cut on an angle so that any ball that touched it bounced off.

Students and teachers alike pointed to the bevel, with an “Aha!” and pride in discovering what I was trying to fool them with.

None of them recognized the angle of the edge was a bit of misdirection. The real trick was in the intensity of the lighting.

A light bulb in the bottle created a current of warm air that made most of the balls drift to the side, before it bounced off the irrelevant rim.

I watch TV and see claims in favor of treatments that are sometimes inaccurate because negative studies have been suppressed by the manufacturer.

I see misdirection, diverting attention to issues that don’t predict outcomes.

In previous articles, I’ve suggested that screening breasts and prostates for cancer are important only to the extent that they provably improve survival or the quality of life.

Ads for breast screening promote increased accuracy. The question is whether the resulting biopsy will accurately diagnose cancer and whether it will result in longer survival. The answer is in doubt.

Expensive prostate treatments cause some severe side effects. Advertisers point out treatments, like protons, have less complication risks, but that doesn’t mean much, if none of the therapies prevent death from cancer.

There are many such examples. As a consumer, you need to ask the right questions and avoid misdirection.

For the past two years, I’ve titled my series “POV Science.” The scientific POV, point of view, is neither easily definable nor perfect. It does try to adjust to new information.

It’s now time for me to put the column on the shelf, as Judy and I are still expanding our travel plans for our big year and I’m also committed in time and money to promoting my books.

So a final prescription: Ask better questions. Enjoy digging into an issue. Accept uncertainty and share thoughts with me on Facebook or on a treadmill at the Y.

My Web page should be running by mid-July and will have segments that promote discussions of my books and, at least one with a scientific POV.

I’ll miss my regular contact with the U-B and its hardworking staff. Thank you for our relationship.

Dr. Larry Mulkerin is a retired clinical professor and oncologist who lives in Walla Walla. A former U.S. Army Green Berets medical officer with experience in the Middle East, he also is the author of the novels “The Ayatollah’s Suitcase” and “The Hospice Conspiracy.” He can be reached at


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