Should physicians pitch products?

The ethical ramifications of physicians serving as commercial endorsers was spotlighted recently when Pfizer was pressured into terminating a massive advertising campaign for Lipitor (atorvastatin) featuring Robert Jarvik, MD, in the wake of a US House Energy and Commerce Committee probe. Pfizer ended the campaign after Rep. John Dingell (D, Mich.), chairman of the committee, charged that the ads misled the public because they created the impression that Dr. Jarvik, one of the developers of the Jarvik-7 artificial heart, is a practicing physician. In fact, Dr. Jarvik is not licensed to practice medicine. The committee disclosed that Dr. Jarvik had a 2-year contract to receive $1.35 million for his participation in the campaign, according to American Medical News (3/31/2008). Dr. Jarvik defended his role as a physician spokesman, saying in a statement that his “credibility as a heart expert is fully justified and is fairly represented” in the ads.

American Medical Association (AMA) policy discourages physicians from endorsing drugs or devices in direct-to-consumer advertising. If doctors appear in such ads, according to the AMA, any compensation should be noted in a “clearly visible disclaimer.” Observers have weighed in on the issue with a variety of opinions. For example, Steven Miles, MD, professor of medicine and bioethics at the University of Minnesota Medical School, said “Doctors should not do product endorsements,” that doing so “is either self-dealing or self-enriching.” Stephen Barrett, MD, a consumer advocate and founder of Quackwatch Inc., on the other hand, said he is not against every physician endorsement, noting that what is most important “is whether the product is properly represented and deserves the endorsement.”