Pharma’s 6 Billion Dollars
Our Superior Results
While chiropractors have enjoyed a recent surge of research supporting spinal manipulation over pharmaceutical options, not all medical physicians have heard that news – in no small part because big pharma’s collective marketing voice is far louder than ours. A January 2019 JAMA study detailed pharmaceutical spending trends:
- “From 1997 to 2016, medical marketing expenditures nearly doubled to 30 billion dollars.”
- “Direct-to-consumer prescription drug advertising increased from $1.3 billion in 1997 (79,000 ads) to $6 billion (4.6 million ads [including 663,000 TV commercials]) in 2016”
- “Marketing to health care professionals by pharmaceutical companies accounted for most promotional spending and increased from $15.6 billion to $20.3 billion, including $5.6 billion for prescriber detailing*, $13.5 billion for free samples, $979 million for direct physician payments (i.e. speaking fees, meals) related to specific drugs.” (1)
*Prescriber Detailing– a vendor purchases prescription data from large pharmacies then re-associates the prescribers name with the DEA numbers. They analyze specific physician prescription patterns and sell provider-specific data to pharmaceutical companies. Drug reps then perform evidence-informed, direct-to-physician advertising to influence prescribing behaviors.
Check out the following video of 3 simple steps to help level the playing field.
The Recommendations Are Clear
In the past two years, we have seen numerous published medical studies endorsing spinal manipulation over pharmaceutical alternatives. Evidence-based chiropractors are delighted by the recognition from so many trusted medical establishments including the FDA (2), CDC (3), Joint Commission (4,5), JAMA (6), Annals of Internal Medicine/ The American College of Physicians (7), and The Lancet (8). This certainly means that we have all seen a dramatic escalation of medical referrals – right?
Why No Change?
Medical providers prescribing patterns are influenced by several factors including financial and managed care considerations, pharmaceutical representatives and drug samples, direct-to-consumer advertising, and peer influence. (9)
Unfortunately, medical referral patterns are shaped and changed more slowly – primarily by personal experience. To break through, chiropractors must provide overwhelming evidence that we are indeed the best option for a given diagnosis. Check out the following short video from a prior blog that outlines three things that you can implement right now to help change medical attitudes and referral patterns.
Regardless of our professional degree, MD’s and DC’s all have failed cases mixed into our many clinical successes. Unfortunately, since the successes don’t need to seek additional care, we primarily see each other’s failures. We must not lose sight of each other’s proven value. If we judge each other by our successes rather than our failures, we will work toward an integrated model where the patient wins. Together, our professions will help more patients than either working alone.
Consistently sending quality communication is one simple way to cultivate better relationships with our medical peers. If you’re not taking full advantage of the ChiroUp MD Connect functionality, what are you doing?! Check out our tutorial videos for creating initial reports or release reports to see how you can start generating better relationships (and patient referrals) from other medical providers in your community, today!
How Can We Improve This Process?
We are currently in the process of coding ChiroUp 2.0; a dramatically enhanced version of ChiroUp with new functionality that will take your practice to the next level – and we are pumped! We hope you’ll take a couple of minutes to share your input as to how we can make ChiroUp the best possible program for you. Click here for the 3-question survey. Thank you in advance!
- Schwartz LM, Woloshin S. Medical Marketing in the United States, 1997-2016. JAMA. 2019;321(1):80–96. doi:10.1001/jama.2018.19320
- FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017
- Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.
- The Official Newsletter of The Joint Commission. Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. July 2017 Volume 37 Number 7. Ahead of print in 2018 Comprehensive Accreditation Manual for Hospitals.
- Joint Commission Online. Revision to Pain Management Standards. http://www.jointcommission.org/assets/1/23/jconline_november_12_14.pdf
- Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain; Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451-1460.
- Qaseem A, et al. for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
- Foster, Nadine EBuchbinder, Rachelle et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, Volume 0, Issue 0. Accessed online 4/10/18: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30489-6/abstract
- Gallan, Andrew. (2011). Factors That Influence Physicians’ Prescribing of Pharmaceuticals: A Literature Review. Journal of Pharmaceutical Marketing & Management. 16. 3-46. 10.1300/J058v16n04_02.
About the Author
Dr. Tim Bertelsman
DC, CCSP, DACO
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