I recently debated Steve DiFillippo, owner of Davio’s and Avila’s restaurants, on the WGBH program Greater Boston, hosted by Emily Rooney. The topic? The effect of the Massachusetts Gift Ban law on area restaurants.
On one level, it was a friendly debate on the economic impact of the law on those restaurants that depend on drug company sponsored dinners for a chunk of their income.
But on another level, this is a larger and more worrisome issue, which is the trickle-down effect of deceptive marketing practices on the economy, such that very good people unwittingly help to perpetrate deceptive marketing practices.
When you do these news shows you arrive a half hour early and are greeted by the producer, who brings you to a waiting room where all the other guests are sweating it out in preparation for their five minutes of fame. For example, I got to meet House Speaker Robert DeLeo, who was there to talk up his proposal to legalize casino gambling in Massachusetts. I then had a pre-debate chat with Steve DiFillippo. He has created some amazing restaurants, one of which I have a personal connection with. My wife and I had our wedding rehearsal dinner at Davio’s when it was in its former location on the Charles River in Cambridge.
Steve is a completely ethical person, does great community work, and was just given the Torch of Liberty award by the Anti Defamation League. Yet, here he was arguing that drug companies should be allowed to wine and dine doctors in order to sell them on their newest drugs. From his perspective, doctors, with all their training, should be smart enough to separate the hype from the truth.
But unfortunately our extensive training does nothing to immunize us from the effects of marketing, as many companies have discovered. Merck, for example, found that hiring doctors to pitch other doctors at restaurants and other venues led to four times more Vioxx prescriptions. It didn’t matter how much they spent on restaurants, they knew they would get a handsome return on their investment. Unfortunately, a bunch of people who took that Vioxx died of heart disease, and the drug was eventually taken off the market. As patients, we deserve to have our treatment decisions based on the medical literature, and not on the pitches of salesmen who have softened up their clients with cabernet and filet mignon.
I think if Steve and the other restaurateurs didn’t have a dog in this race, they would agree with this. But they do have a dog in the race. And when your income stream depends on believing something, it’s highly likely that you will believe it.
Steve, like thousands of other business owners, is a victim of “trickle-down deception.” It begins with the drug companies, and spreads and expands where the money goes. Other victims include advertising companies, medical education communication companies, publishers, lunch caterers, and celebrity spokespeople. In each of these industries, there are ethical people who believe they are just making an honest buck. But they are unwittingly participating in a system that depends on a basic deception: trying to dress up advertising in the guise of education.
The solution is to simply do what we are doing — keeping a close eye on the industry and reporting their most deceptive practices. Unfortunately, when they just can’t behave themselves, we have to expend a lot time and effort to pass laws regulating them. The ensuing trickle down effect of honesty is something we can all support.
Daniel Carlat is a psychiatrist who blogs at The Carlat Psychiatry Blog and is the author of Unhinged: The trouble with psychiatry – a doctor’s revelations about a profession in crisis.
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