Patients as Consumers: The Influence of DTCA and "Becoming Little Doctors."

Direct to consumer advertising of prescription drugs (DTCA) accounts for approximately $5 billion in advertising spending in the US. Critics of this controversial practice cite confusing and misleading information negative effects on the physician-patient relationship as reasons to restrict or even ban DTCA, while proponents claim it empowers patients and facilitates discussions between physicians and patients that may improve overall health.

An ethnography of consumers in the most prominent target market for DTCA initially seeks to understand the meaning of DTCA among middle age adults in the US with chronic conditions. Participants in the study are skeptical about this category of advertising, and describe DTCA as being “good and bad.” They see ads as being helpful reminders about conditions, however, they rarely remember the brand names represented. For them, the downside is that the ads are pervasive and don‟t provide enough useful information. Discussion of their interactions with DTCA acts as a keyhole into the life world of patients with chronic conditions as consumers, whose information search efforts amount to “becoming little doctors.” Through emergent design, exploring an expanded set of research questions yields a description of patients as consumers. The process of adjusting to a chronic condition among participants occurs in stages and involves diagnosis, learning and management phases. Information search and social networks play a large part in the adjustment process, as patients consume health care services, information and often, prescription drugs. Implications for marketers, health care professionals and public policy makers are discussed.