Are Doctors Blind to Being Influenced?

In the latest Wired, Dan Ariely talks about persuasion in the medical field. This is something we've covered before.

One tactic was to hire doctors to lecture other practitioners about a drug. The reps weren't interested in what the audience took from the talk, but in the effects on the speaker himself. They found that after giving an address about a drug's benefits, the speaker would begin to believe his own speech and prescribe accordingly. Studies show that people quickly start believing what they are saying, even when they are paid to say it. This is cognitive dissonance: doctors reason that if they are telling others about this drug, they must believe in it themselves — and change their beliefs to match their words.

The reps employed other tricks such as switching accents, personalities and political affiliations. They put the doctors at ease, relating to them as working people who should go fishing or play baseball together as friends. They used these shared experiences to develop an understanding that the physicians write prescriptions for their “friends”. The physicians did not think that they were compromising their values when they were out with the drug rep; they were just taking a well-deserved break with a friend with whom they happen to do business.

I was recently at a conference for the American Medical Association, and the topic of my lecture was conflicts of interest. The lecture just before mine was by a representative from a company that created brain implants. He made the case for selling devices in the operating theatre because the doctors may need help learning how to use the device.

What do we do? First, we must realise that doctors have conflicts of interest. Then we need to place barriers that will prevent this kind of schmoozing, and to keep reps from having direct access to doctors or patients. Of course, they have the right to send doctors information and educational material, but this should be all that is permitted.


Dan Ariely is the best-selling author of The Upside of Irrationality: The Unexpected Benefits of Defying Logic at Work and at Home and Predictably Irrational, Revised and Expanded Edition: The Hidden Forces That Shape Our Decisions.