title: Direct-to-consumer print ads for drugs: do they undermine the physician-patient relationship?
abstract: BACKGROUND
  Critics of direct-to-consumer print advertising for drugs (DTCA) contend it alters physician-patient communication by promoting greater patient participation and control. We assessed the nature of messages in print DTCA to identify potential guidelines they may provide to consumers for communicating with physicians.
  
  
  METHODS
  We analyzed all unique advertisements (ie, excluded ads repeated across issues or magazines) in 18 popular magazines (684 issues) from January 1998 to December 1999 (n=225). We identified every statement that referred to physicians, and within that set, statements that focused on physician-patient communication. Each communication-related statement was coded as a message to consumers about communication in terms of cues suggesting who should initiate communication, who should be in relational control, and appropriate interaction topic(s).
  
  
  RESULTS
  More than three-quarters (83.8%) of the advertisements' statements referring to physicians focused on physician-patient communication (M=2.6 per ad; SD=1.8). Most (76.1%) of these messages explicitly or implicitly promoted consumers initiating communication, but cast the physician in relational control (54.5%). The most frequently suggested interaction topics were clinical judgments of the product's appropriateness (41.8%) and information about the product (32.1%).
  
  
  CONCLUSIONS
  Typical direct-to-consumer print ads contain multiple messages about communicating with physicians. The patterned nature of these messages appears to promote social norms for consumers' communication behavior by repeatedly implying the appropriateness of consumers initiating interaction, physicians maintaining relational control, and avoiding negative consequences of advertised drugs as conversational topics.
authors.affiliation: Barbara Ann Karmanos Cancer Institute/Wayne State University, Detroit, MI. USA. cliner@karmanos.org
authors.forename: Rebecca J Welch
authors.initials: RJ
authors.lastname: Cline
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Young
mesh_terms: D000329:Advertising / Q000145:classification*; D003142:Communication; D004345:Drug Industry; D006801:Humans; D010506:Periodicals as Topic; D010817:Physician-Patient Relations