Direct-to-consumer advertising: physicians' views of its effects on quality of care and the doctor-patient relationship

J Am Board Fam Pract. Nov-Dec 2003;16(6):513-24. doi: 10.3122/jabfm.16.6.513.

Abstract

Background: The objective of the study was to determine physicians' views of the effects of Direct-to-Consumer Advertising (DTCA) on health service utilization, quality of care, and the doctor-patient relationship.

Methods: Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship.

Results: Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted.

Conclusions: DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians' communication and negotiation skills; and encouraging patients to respect physicians' clinical expertise.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advertising*
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Information Services / statistics & numerical data*
  • Internet
  • Male
  • Middle Aged
  • Patient Education as Topic / trends*
  • Patient Participation*
  • Physician-Patient Relations*
  • Quality of Health Care*
  • Surveys and Questionnaires