American College of Physicians: Internal Medicine — Doctors for Adults ®

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From the June 2000 ACP-ASIM Observer, copyright © 2000 by the American College of Physicians-American Society of Internal Medicine.

Professional satisfaction

I found the commentary by S. Spence Meighan, FACP, on regaining professional satisfaction refreshing. ("Steps we can take to regain professional satisfaction," March ACP—ASIM Observer, page 2.) I was especially drawn to his advice, "Don't limit your choices in the pursuit of wealth."

The willingness of many physicians to point the finger at others, including their peers, for their financial woes and their failure to look beyond to the big picture of health care is disconcerting. One well-to-do specialist recently told me he was "starving." Other physicians I know have stated that their pay is not fair compared to other specialties. The source of health care funding is not their concern, nor are the uninsured.

We must remind ourselves of Dr. Meighan's advice. We must work together. We must develop perspective. We must remember, as my doctor recently put it, that the practice of medicine is a privilege.

Steven J. Brown, ACP—ASIM Member
Media, Pa.

Direct-to-consumer advertising

As a practicing physician, I have fallen victim to direct-to-consumer advertising over the last several years. ("Consumer ads: How should you handle the pressure?" March ACP—ASIM Observer, page 4.)

Direct-to-consumer advertising does not enhance the doctor-patient relationship, but it instead impedes the practice of effective medicine. My feeling is that the goal of drug makers is not to educate the public, as they might suggest, but simply to increase sales of their newest therapies.

I would like to propose an alternative form of direct-to-consumer advertising that could benefit drug makers, patients and public health. If companies producing similar therapies combined their resources, they could produce public health advertising that could increase sales of their products while improving the management of chronic illnesses.

As a practicing nephrologist, I immediately think of hypertension. Researchers estimate that only 25% of hypertensive patients in the United States have their condition under control. If drug makers pooled their resources and created advertising that urged patients to have their blood pressure checked and to see their physicians on a timely and frequent basis, all parties would benefit. More patients in this country would be treated for their hypertension, patients would see their physicians for other appropriate medical screening and the pharmaceutical companies would enrich their coffers by increasing the total number of prescriptions for hypertension medications. Such an approach could be extrapolated to other illnesses as well.

Instead of pharmaceutical companies fighting over their piece of the pie, all could benefit by enlarging the pie.

Lloyd H. Alterman, FACP
Summit, N.J.

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