Dr Trevor Mudge, AMA Vice President, Radio 2SM - Discussion about advertisement by press release and the influence of pharmaceutical companies

I hope I've set that up properly. Doctor Trevor Mudge is the Vice President of the Australian Medical Association. Good morning, sir.

TREVOR MUDGE: Good morning, Clive.

CLIVE ROBERTSON: So, is it me or what?

TREVOR MUDGE: Well, I think you've put your finger on something, undoubtedly. The art of advertisement by press release has always been with us, I suspect, and I just wonder whether in part there's a lack of discrimination amongst some journalists reporting such things.

CLIVE ROBERTSON: Well, that's always true, yes.

TREVOR MUDGE: I mean you always have to look, don't you, at what's behind a press release, and many press releases are appearing with expert names and they're from organisations that, as I think you intimated, are not obvious to the casual eye and so I think, in many ways, we have to be careful as to the source.

CLIVE ROBERTSON: So, what is in it for these well known specialists endorsing this not as a generic cure which is the old way, which is acceptable as you must admit, a new sort of drug and they say it can be sold in these different brands, but now this new drug by a specific name.

What are they getting out of it? Why would they sell themselves out which is what I see it as doing?

TREVOR MUDGE: I doubt that they would consider that they're selling themselves out. I think that…

CLIVE ROBERTSON: They wouldn't do it for nothing.

TREVOR MUDGE: I suspect they are, Clive, by and large. I mean…

CLIVE ROBERTSON: Really, more fool them.

TREVOR MUDGE: Well, maybe so, but society is changing, isn't it. Commercial interests seem to be crossing everything. Medicine is increasingly being seen as a corporate exercise out of which people want to make money.

Pharmaceutical companies, Kerry Packer's organisation. You know, the world is changing, the new Trade Practices rules say that doctors should advertise, doctors are not very keen on that idea, but…

CLIVE ROBERTSON: But, sir, the conclusion you can draw and by the way I'm not reflecting on anyone who endorses, but in a principle, not only do you wonder what's in it for them, but you question their objectivity.

If some well-known person in a hospital endorses a commercial pill, one brand of it, not a generic one, you wonder how objective they are. You want to talk to someone else and say is this pill good and are there other brands.

This is the problem I now have.

TREVOR MUDGE: I think it's a real problem, but it's probably not confined to medicine, is it? The problem of conflict of interest and its identification in the press is a very important one and certainly one that you would strike in lots of areas.

I suspect that some of the new drugs don't have generics. Remember that a pharmaceutical company has to invest billions, in many cases, in dollars in bringing a new drug to market.

In return, they get a patent on it for a period of a number of years, 10 or 15, in which time they don't have opposition and during that time they have to recoup their investment.

Now, the investment cost is higher because we as a society want guarantees of safety of that new drug.

Now, that means we have to pay for it. It's a complex set of arguments, Clive.

CLIVE ROBERTSON: But, unfortunately, it produces some adverse reactions because we feel we don't know the truth. Even though that might be the truth, we don't know it's the truth. You understand that?

TREVOR MUDGE: I understand that entirely and I think probably we all need to look more carefully at the bottom line behind the press release.

CLIVE ROBERTSON: So, what do we then do if we look at that, when we see only a commercial name is mentioned? Do we get the chemical makeup of that thing and refer to it by its chemical name and not by its commercial name? Isn't that the way to go then, people go to their GP.

TREVOR MUDGE: It's certainly the way to go. I mean, the other thing is to consult a body that's known to be independent, and the Australian Medical Association, you've rightly identified as an independent body, Clive.

CLIVE ROBERTSON: Yes, anyway, it just really got to me. It's interesting, it really got to me. This week we got one and I looked at it, there's a certain look about these press releases. You see the name and you look at these specialists and you keep looking and the PR people don't say who they're the PR people for.

It gives them a great commercial. I mean, they can't pay for these sorts of ads and it's, unfortunately as you say, even if it isn't the only brand, it appears it's the only brand there is because it's the only one that's being promoted.

I don't know how you people cope. I mean, in private practice how do you people cope when people come around and offer you all these pills all the time?

I mean, there must be an enormous amount of pressure. How do you remain objective as a GP, tell me?

TREVOR MUDGE: Well, I think the medical profession does have a 6,000 year tradition of fiduciary duty to the patient being their primary concern.

And, I mean, you can't legislate for that and that's one of the problems. It's something that doctors do by training and obeying inclination, I think, Clive.

CLIVE ROBERTSON: So, if you're sitting in a GP's thing and the bloke, Mr Smith from so and so pharmaceutical company is coming to see you, and he promotes this as the new wonder drug, this is the way to go, better than the others and what have you, who is your referee then, when he's gone, to find out what you need to confirm the truth about that product?

Have you got a book? If it's new, what do you do as a GP?

TREVOR MUDGE: Well, you go to the literature, what's published in medical journals, which are independently refereed. You can't get something published in a reputable medical journal without it being submitted to a panel of independent umpires, if you like, to verify that it's scientifically accurate.

CLIVE ROBERTSON: So, you're not…

TREVOR MUDGE: So, I guess, that's the major safety net.

CLIVE ROBERTSON: Otherwise, you would be on your own, you wouldn't know where you were going, would you?

TREVOR MUDGE: No, you wouldn't and one of the problems, though, is that increasingly in society, research - and not just medical research - is no longer funded by the public purse, it's funded by corporations.

CLIVE ROBERTSON: And that's the confusion.

TREVOR MUDGE: One of the big problems society now faces is you may think where does a doctor go to independent correlation, but where does the Government go to get independent research and an independent opinion on, say, genetically modified food when billion dollar companies are the ones funding research.

It's a very difficult area.

CLIVE ROBERTSON: Now, you're a medical man, you're meant to make me feel better. I don't feel any better, I just want you to know.

TREVOR MUDGE: Take two aspirins, Clive, and call me tomorrow morning.

CLIVE ROBERTSON: Thank you, sir. Well, as you say, we should read the fine print, is that right?

TREVOR MUDGE: I think that's right.

CLIVE ROBERTSON: Thank you very much.

TREVOR MUDGE: Thank you.

CLIVE ROBERTSON: Doctor Trevor Mudge, Vice President of the Australian Medical Association. If you saw the press releases, dear listener, you'd understand. We look at this and we think what you don't want to be is conned. And PR people, that's their job. But when you see a pill by its name and you see well known specialists and what have you, you think what is going on here?

But as Doctor Mudge said, sometimes there's only the one brand. But, even so, you feel uneasy. Ultimately, you don't want to feel a fool by publishing something just because the PR people send it to you.

We get all sorts of stuff. I'm not saying the PR people are doing the wrong thing, or whether things are worth promoting, sometimes they're good, but we want to make that choice on your behalf.

We want to be the final filter, in terms of censorship, but we say, ah, this is worth doing for this reason.

Anyway, so, Doctor Mudge has made me feel worse now because I didn't think about the bigger picture. It's worse than I thought.

Well, there you go and, as I say, I'm not casting any doubts on those who do endorse it, it just creates this question mark within my mind. That's all.

Ends.