Dear Colleagues ... Wake Up, You Are Being Used

I really don’t like scolds. I have hesitated to write this short piece because it makes me seem like a scold.

But I can’t help myself.

This week I saw on my Facebook feed a picture celebrating the 500th implant of a preventive cardiac device. The picture featured smiling doctors and super-happy industry reps. The writer expressed happiness that they had helped so many people.

The problem: this device has not been shown to help people. It might help people, but there is no conclusive evidence. The regulatory trials were extremely weak.

My Twitter (or X) feed includes many of these similar images—groups of doctors celebrating their first or hundredth implant of some industry product. The image usually has one or two industry reps, a few doctors, and the product’s box or logo.

I am sorry but these are unseemly.

I am not against industry-MD collaboration. Industry has made many great advances. I would not want to return to 1990s technology. I am also not against profit motive in spurring innovation.

But if you are posting on social media with industry products and people, you are being used as advertisement.

And, more times than not, the products promoted have a dubious evidence base.

Professor John Ioannidis has argued that doctors—often inadvertently—become the best advertisers for industry. In the past, industry had to employ key opinion leaders from academia to promote their products.

Now, with social media, industry can make any clinician who uses a lot of their product into influencers.

I believe it best to resist the urge to be used. Through the rise of the managerial state in healthcare, doctors are losing our status as professionals.

These promotional images only accelerate the decline.

JMM

P.S. Many of these images also break the sacred bond of patient confidentiality.