title: From Lydia Pinkham to Bob Dole: what the changing face of direct-to-consumer drug advertising reveals about the professionalism of medicine.
abstract: From its founding in 1847, the AMA divided drugs into "ethical" and "unethical" preparations. Those that were ethical had a known composition and were advertised only to the profession. Other, patent medicines (technically proprietary drugs, whose trademarks were protected by copyright), were sold directly to the public. In spite of the AMA's efforts to ban the advertising and sale of those nostrums, proprietary drugs flourished during the nineteenth century. Starting in 1900, however, three major societal trends combined to bolster the AMA's campaign, and by 1920 almost all advertising was directed to physicians, who would then prescribe medications to their patients. This ban on advertising pharmaceuticals directly to the public remained virtually unchanged until approximately 1980. Since then, it has slowly eroded and, as recently as 1997, the FDA created guidelines for pharmaceutical companies to advertise on television. What does this change say about the profession of medicine, the role of the physician in society, and the doctor-patient relationship? Using a comparative historical approach, this paper examines these issues.
authors.affiliation: Center for Bioethics and Health Law, University of Pittsburgh, PA, USA.
authors.forename: Rosa Lynn
authors.initials: RL
authors.lastname: Pinkus
mesh_terms: D000329:Advertising / Q000941:ethics* / Q000266:history / Q000331:legislation & jurisprudence / Q000592:standards*; D000574:American Medical Association; D003256:Community Participation; D000529:Complementary Therapies; D004345:Drug Industry / Q000191:economics* / Q000941:ethics* / Q000266:history / Q000331:legislation & jurisprudence; D004992:Ethics, Medical; D033161:Government Regulation; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007400:Interprofessional Relations; D020452:Journalism; D004364:Pharmaceutical Preparations / Q000191:economics* / Q000266:history; D010819:Physician's Role / Q000266:history; D010817:Physician-Patient Relations; D017009:Professional Autonomy; D011781:Quackery / Q000266:history; D012962:Sociology, Medical / Q000266:history*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D004364:Pharmaceutical Preparations