by Raymond J. Voller, DMD, MAGD
Who needs an experienced professional anymore? These days, the average Joe knows more about what “ails” him and what to take or do to remedy the problem than the trained clinician - or so he thinks. Thanks to influences such as TV and magazines, many people are recognizing plights they never knew they had, and just how much distress these problems are causing them. Where do we, as dentists, fit into this trend toward “direct to consumer,” or DTC, marketing as it relates to the medical field?
With regard to medications - prescription and otherwise - our population embraces a “remote control” mentality. To change something, one needs merely to push a button or take a pill to alter an undesirable life situation. It’s no longer an individual’s personal life choices that are responsible for his or her current physical or mental state. We are seeing pharmaceutical companies skip over the medical community and market their products directly to consumers on a day-to-day, or even minute-to-minute basis.
One needs to simply switch on the television to see what new “syndrome” has been identified to satisfy a niche market for a newly approved drug to treat an oftentimes common, benign malady - a “condition” the consumer is being convinced is a “symptom” of something larger that needs to be “fixed.” These so-called symptoms inflict enough people to drive sales and cover the marketing costs. One may say this is just business, but what is intriguing is how the general population - upon which this entire pyramid is built - is affected.
In dentistry, this phenomenon has become transparent as well. The astute dental professional generally can see the hype associated with DTC marketing. However, the truly savvy clinician knows when to hunker down and avoid the pitfalls created with marketing dollars spent to encourage patients to pressure their dental caregivers to prescribe often unproven methodologies or materials. While this is more evident in the medical arena, it’s just over the horizon in the dental world.
The effect of insurance has also intervened with the pharmaceutical industry. No longer can the health practitioner dictate what medication is best for the patient. It is now a decision based on cost vs. efficacy, with effectiveness taking a back seat to what the insurance company feels is most cost-effective for them.
With the advent of patient-driven marketing, we also see in dentistry the shift toward more cosmetic procedures and materials, albeit with sometimes less attention paid to the functional and potentially long-term ill effects of some of these treatment modalities. Dentists who have been “around the horn” and invested the time and money for continuing education often can avoid being persuaded into thinking that just because the lecturer is a good presenter, then of course, the information must be accurate. More important, knowing one’s limitations helps prevent the “one-course wonder” - a dentist who thinks that by attending a one-day or one-weekend course, he or she immediately becomes proficient at a procedure or technique. This is particularly true if the course promotes a particular product, which may or may not be something of merit.
Generally speaking, the dental profession has remained ahead of the DTC bias compared to our medical and pharmaceutical allies. That which prevents the dental profession from entering this black hole is the continual search for new knowledge. The most reputable mentors are those who have sifted through all the information and present it in a nonbiased manner.
Additionally, the clinical procedures that should become commonplace are the ones that are not only highly esthetic, but also function longer than anticipated. What is the definition of “clinical success” in our profession? It could be defined as underpromising and overproducing, along with exceeding patients’ expectations of treatment outcomes.
It’s disappointing to hear how outside influences such as lunches and other perks reward clinicians for prescribing a certain medication, and not necessarily for the benefit of the patient. It’s also disappointing when insurance companies dictate to pharmacists which drug to supply to a patient based on the least cost.
More than likely, because of those who took advantage of the system, a method of checks and balances evolved which has obviously gone overboard. It has turned from policing a system to an out-of-control coup in which the big losers are those who most need these products - oftentimes our patients.
Doctors need to distinguish between heart and hype. True-to-life dental professionals who passionately purport to be successful need to do more than just present a fancy lecture with elaborate slide presentations. Legitimate studies to support their claims of success - as well as failures - of their work must be accompanied by full disclosure, and any personal bias must be put aside and replaced with the truth.
The future of dentistry may depend on our desire to avoid succumbing to patient-centered marketing hype. We need to police ourselves and expose any charlatanism to prevent both insurance and pharmaceutical companies from influencing dentistry as they have medicine.
When it works in your hands and it’s not a result of luck, tell your colleagues. If something or someone’s technique doesn’t live up to its billing in your hands and it’s not a result of improper technique, it’s your responsibility to the profession to speak up. Don’t just stick your tail between your legs and keep quiet. Learning from our own and others’ failures is how we improve. Let’s clean up our own backyard by becoming more vocal on what does and doesn’t work for the sake of dentistry.
