Computers changing dynamic of medical consultation

From today’s edition of 6 minutes:
What the computer says about the GP

By Michael Woodhead

Like Charles and Di’s marriage, the doctor-patient relationship is looking a little crowded these days with the computer screen vying for attention, GP researchers have found.

In fact, the way a GP orients his or her computer  – and the screen in particular – says a lot about whether they have an patient-inclusive or patient-exclusive approach, says Dr Christopher Pearce from the Melbourne East General Practice Network.

In a study of 20 general practitioners’ room layouts Dr Pearce and colleagues found that most had adopted a patient-inclusive seating approach, and yet many still excluded the patient from full access to the computer screen.

While most GPs arranged their computers so that patients could see the screens, the patients often had to turn round to view it adequately, or were too far away to see the screen content and had to pull their chair forward, they found.

GPs were also reluctant to share use of the computer keyboard and mouse, they found, and sometimes even the computer printer could be a barrier between the doctor and patient.

Their study, published in the journal Primary Care Informatics (6, 111-117) does not imply that a  patient-excluding computer layout is bad, only that it results in different consultation behaviour patterns, they say.

“The screen now represents a third “face” in the consultation, one that is the object of regard of both the doctor and the patient. The keyboard and mouse are symbols of control over the computer, much in the same way that ownership of the stethoscope indicates status in the relationship,” they conclude.

See the full article here.


‘GPs rely on drug reps for info’ – is anyone surprised?

Choice has just published a survey saying that Australian general practitioners are reliant on pharmaceutical reps for much of the information they learn about new treatments, the Sydney Morning Herald reports.

“Even though only 24 per cent of doctors trusted the information as much as an independent source, most (81 per cent) would rather receive it because it was often the only way to get timely information on new drugs,” the SMH reports.

“The survey of 180 doctors found that 73 per cent referred to pharmaceutical companies or their representatives for drug information. This made the companies the second-most important source for doctors after clinical evidence.

“Drug companies are the main source of information for 16 per cent of doctors when deciding whether to prescribe a new drug, the survey said.

“‘[Drug company marketing is] often the only way you get information about new drugs in a timely fashion,'” one doctor said.”

Unlike most media reports, which paint pharma companies as worse than tobacco companies, this report stresses that the main reason GPs rely so heavily on pharma companies is the lack of independent information available. Although there may be a difference between “lack of information” and “lack of knowledge of information”, as half of the GPs surveyed said they were not aware of the government-funded National Prescribing Service (NPS). Hmmm, maybe the government needs a national field force armed with brochures, pens and Post-it notes…

Diabetes sites rank top among pharma product web properties

Maureen Malloy, strategic marketing and corporate communications manager from Manhattan Research and one of my news sources, has sent me some preliminary data on Manhattan’s most recent physician marketing research. She writes:

Manhattan Research just released its annual Top Pharma Product Site list from the ePharma Physician® study.  Overview: Diabetes treatment brand sites from Januvia, Actos, Byetta, and Avandia are among the top pharmaceutical product websites in terms of primary care physician visitation

Top 10 Product Sites Visited by Physicians in 2008

Ranked by Number of U.S. Primary Care Physician Visitors

Position               Product  

    1.                          Januvia

    2.                          Actos

    3.                          Chantix

    4.                          Gardasil

    5.                          Actonel

    6.                          Vytorin

    7.                          Amitiza

    8.                          Byetta

    9.                          Avandia

   10.                         Aciphex


Quote: “This year’s rankings show that market events, rather than just advertising alone, can be critical drivers to brand websites,” points out Meredith Abreu Ressi, VP of Research at Manhattan Research. “Pharmaceutical companies need to ensure that brand websites contain the latest, most accurate content possible and can be found relatively easily by physicians using search engines to research pharmaceutical information.”

Source: ePharma Physician® v8.0 (2008)

More info is available at

Save the trees – send an email

Al DiGuido writes in ClickZ this week about how traditional businesses could benefit from thinking about how ned media technologies can be used in their day-to-day business. DiGuido commutes into New York from the suburbs ad describes how, when there are train delays in the morning, the transit authority prints explanations of the delay and places them on train seats for the afternoon return. As DiGuido writes: “Here we are, in the media capital of the world. The year is 2008, not 1878. And the mass transit organization hasn’t figured out how to send breaking news alerts and apology notifications via e-mail? Can you imagine how many hours it took the department to format this printed notification, then put it on the seats in every car of every train leaving Grand Central Station during rush hour? It’s absurd! Especially in light of the fact that all this work was done for one day’s train delay.

“Trains are delayed all the time. This practice gets replayed hundreds of times a year. What part of the e-mail and Internet movement has the transit authority missed? If it started looking at the technology that its customers use each day, it would figure out that the best way to communicate – the essential way to communicate with customers – is real-time e-mail.”

This is a really practical example of how online technology can save serious money every day. Mind you, he doesn’t talk about the cost of obtaining email addresses for those thousands of commuters…

Relevance, timeliness and accuracy will always have an audience

Amy Gahran has produced a very articulate opinion piece in the continuing debate about the future of journalism. Responding to a question posted on the Public Journalism Network blog asking whether, if people aren’t prepared to pay for quality journalism, perhaps journalists should just stop writing, Gahran argues that the question contains a number of fallacies. She points out that it is advertisers, not consumers, who pay the lion’s share of journalist salaries.

She goes on to write: “(However,) just because people aren’t willing to directly pay cash for something does not necessarily mean they don’t ‘find value’ in it. For instance, when’s the last time you personally chipped in for a clinical trial? And how are you paying for that air you’re breathing right now?

“Some benefits are assumed to be part of the environment in which we exist. That’s what it means to have an environment. If a benefit grows scarce to the point that people feel they must directly pay cash from their pocket to keep getting it, there’s probably a far more dire calamity at hand than that single point of scarcity. Most people will almost always seek other free sources of a benefit first.

“I think it’s important to bear in mind that people value benefits, not necessarily forms. The key benefit that journalists and news organizations have provided has been relevant, timely, accurate information that helps people make decisions, take action, and form opinions. For over a century we’ve established an ad-supported business model around packaging that benefit in a form known as “journalism.” But that’s not the only form this benefit can take, and many parts of the “American public” (and the advertising industry) are figuring that out.

“…Therefore, I think the real question isn’t whether we should “stop doing journalism” if people won’t pay for it, but rather: How can society continue to receive the benefits of journalism, given the current media environment? Also, which players might provide those benefits, and how?

“Probably that solution (or more likely, set of solutions) won’t look or work like traditional journalism. It might not be done by ‘professional journalists’ or ‘news organizations.’ It may have different values and standards. It might not even be ‘a business.’ And yes, the big risk is that society could experience harm during this transition. But society also can participate in finding new solutions.”

Visit Gahran’s article (on the site) to see the lively debate this posting has already created.