Healthcare is not another market

One study Fugh-Berman and Ahari reference claims that most ‘high-prescribing’ doctors get information on new drugs primarily through drug reps, while another claims, among other things, that most doctors believed this information was at best “somewhat accurate”.  But to what are these doctors appealing to determine the inaccuracy of the drug info?  If biased drug reps are the primary educators on drugs for doctors, then it would seem that the doctors are in poor shape to judge the accuracy of that information.  The doctors know the information is inaccurate, but without having the correct information how are they to know what exactly are its inaccuracies?  This discrepancy emphasizes Elliott’s point that when we seek a doctor’s prescription, we are not simply consulting an expert, but rather participating in a market.

If, as the Elliott article suggests, we should “put our trust in the market,” then we might do well to survey how consumers in other markets resolve product information bias.  However, this only shows  how the healthcare consumer is so unlike consumers in other markets.  When we’re thinking of buying a laptop, we might do some Googling, read some reviews, talk to the salespeople at a few different stores, and eventually we make our choice.  But this seems to be a silly analogy; finding the right prescription is so different from buying the right laptop.  The decision not only carries far more weight, but is also much more involved.  The scientific discourse of drug studies is indecipherable to most people, and getting many consultations from different doctors is either an enormously time-consuming (Canada) or expensive (USA) task made even more difficult – and perhaps unachievable – when we consider that each consulted doctor should first appreciate their patient’s medical history before recommending a prescription. Healthcare is just different from other markets, and its differences are why we must hold it to higher standards.  We need the unique, mediating role the doctors play, and we need them to be true experts.

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