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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 July 7; 335(7609): 48.
PMCID: PMC1910683
From the Frontline

Watch out for the sharks

Des Spence, general practitioner, Glasgow

I jumped as the severed head floated on screen—I was 10 when I saw Jaws. Fifteen years later I tried to learn to surf. Catching a wave is a life enhancing moment. I knew the statistics of shark attacks, but thumping cello chords were often with me in the water. From Sydney to Surfers Paradise and Noosa we travelled in our cliched T shirts and beads. But when a huge finned mass zipped past me in the water off Byron Bay—a dolphin—my Australian surfing odyssey was over. We are not rational beings but prisoners of our emotions and fear.

The European authorities are being urged to relax the rules on drug companies providing information directly to patients. This is a bad idea. It isn't that the industry is a corporate monster with a dark Machiavellian master plan to corrupt health care: the industry is a huge force for good, and all humanity has benefited from its relentless innovation. The issue is one of perspective—they are not selling soap powder.

Health care is different from other markets on many levels. Firstly, it is powerfully emotive. Most normal people have no attachment to a new car or a particular brand of mini chicken Kiev. Nothing matters more to people than their health and that of their loved ones—we would give anything or do anything to ensure it.

Secondly, capitalism and consumerism may be a good thing, for they fuel the global economy and lift nations out of poverty. But consumerism has a dark side, as it depends on greed, so ever more consumption is never sating. Applying unfettered consumerism to health care is folly. The bloated and unhealthy US healthcare system, with its addiction to consumption, is testimony that more medicine should never be confused with better medicine.

Lastly, in these faithless times, medicine is now effectively an organised religion. The population may mistrust other religions, but everyone agrees with “Do as the doctor says.” Medicine controls people's lives like nothing else does.

Why does the industry want more access to the public? Is it benevolence? I fear not. Unbiased information does not exist, and every author has a slant. The industry wants to control the presentation of information, and this is just naked marketing. The industry currently enjoys disproportionate influence—any remarks it makes about North Korean style suppression is absurd posturing. The industry neatly sidesteps current regulations through the use of patients' advocacy groups and uncritical and sensationalised journalism. Health advice must be personalised, delivered by a professional with continuity of care of the patient and ideally someone who has no inducement to intervene. Already half the population wakens to the quickening of cello chords as they reach for their pills every morning—we don't need any more fear.


Competing interest: DS is UK spokesman for No Free Lunch, a US based organisation opposed to the sales tactics of big drug companies.

Articles from The BMJ are provided here courtesy of BMJ Publishing Group