Outside Forces 'Medicalizing' Everyday Problems, Experts Say
Drug ads and other factors are having an impact on clinical practice
THURSDAY, Feb. 22, 2007 (HealthDay News) -- Consumers, often egged on by drug ads they see on television and elsewhere, are "medicalizing" what doctors may have previously not considered full clinical problems, experts write in this week's issue of the journal The Lancet.
The trend has both its upside and downside, experts say.
In the 1970s, the term medicalization "came into being as a critique of the power of doctors, who, in the guise of treatment, were doing things that were bad for people," said Dr. Jonathan Metzl, associate professor of psychiatry and women's studies at the University of Michigan.
"The term has expanded greatly in its use. Today, it is used more in connection with the actions of pharmaceutical companies, and we need to understand its effects better," he said.
Metzl discussed the effects of direct-to-consumer (DTC) drug advertising in one of six essays in the journal, originating from a workshop on medicalization that he helped organize.
"Pharmaceutical advertisements definitely have pushed the boundaries of what is and what is not considered a medical issue," the expert said.
For example, television advertisements for Cialis, Levitra and Viagra have changed the perception of what it is to be a normal, healthy man, Metzl said. In that way, male sexual performance has been "medicalized."
Similarly, DTC antidepressant ads that depict depressed women as unable to fulfill their roles in the family have medicalized that issue, Metzl said.
"It's hard to deal with them, because we are so overwhelmed by these advertisements," he said. "But I don't think we should reject them out of hand. We should think of what they say about illness and health."
On the part of the consumer, such advertisements "can engender useful conversations between doctors and patients," Metzl said. "And they can encourage doctors to look at cultural issues."
Other essays touched on different aspects of the issue. For example, Troy Duster, professor of sociology at New York University, wrote about the medicalization of race -- specifically, about the approval in the United States of medications designed specifically for black Americans.
"The appearance of racialized drugs on pharmacist's shelves only increases the need to attend to the myriad social sources of disparities in morbidity and mortality," Duster wrote. "Although to turn a profit from fighting racial discrimination is difficult, effective medical care requires continued awareness of the complex social dimensions of diseases, such as hypertension and cancer."
Cindy Patton, professor of sociology and anthropology at Simon Fraser University in Vancouver, Canada, wrote of changes that have occurred in the evolution of treatment of HIV/AIDS because of the new accent on medicalization.
Because of the impact of HIV care on other aspects of health -- for example, cardiovascular well-being -- HIV-positive patients and their doctors are increasingly aware of trends across a wide variety of medical specialities. In many cases, these specialities -- such as virology and cardiovascular disease -- used to have little in common, Patton explained.
However, "The distance between biomedical specialties that might once have been bridged mainly by researchers and specialized clinicians now is negotiated mainly by the patients themselves, since their knowledge sets expand and intertwine over time," she wrote.
There's more on DTC drug advertising at the U.S. Food and Drug Administration .