The “Dr.” in Dr. Phil’s name does not signify an M.D., but rather his Ph.D. in psychology. And yet the good TV doctor is gearing up for a media tour focused on medicine — more specifically, Bydureon, the diabetes drug for which he is now a paid spokesperson.
As Vox’s Julia Belluz reports, Dr. Phil has been taking the medication himself since 2012, and his media appearances will ostensibly be to share what he’s learned since his diagnosis of Type 2 diabetes more than two decades ago. “But be aware: This isn’t an objective and noble effort to raise awareness or destigmatize a condition that millions of Americans face,” Belluz writes. “Instead, Dr. Phil has been hired by the drugmaker AstraZeneca as a paid spokesperson — and this presents all sorts of thorny conflict-of-interest problems.”
This is especially a problem considering the drug itself, which the Food and Drug Administration considers a second-line medication — that is, prescribing doctors should turn to it only when other treatment options have failed. Also of note: The FDA has added a “black box” warning on Bydureon, as the drug may increase the patient’s risk of thyroid cancer. As Steven Woloshin, a professor of medicine at Dartmouth who has studied celebrity health endorsements, tells Belluz, “These campaigns create a blurriness between marketing and public health messages. People tend to view them with less skepticism, particularly when there is a trusted celebrity spokesperson.”
Take a 2013 study, for example, in which Harvard School of Public Health assistant professor Steven J. Hoffman analyzed research in economics, marketing, psychology, and sociology dating back to 1806, and found “that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour.” Hoffman and his co-author, McMaster University med student Charlie Tan, add that “people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not”; thus, they conclude, following medical advice doled out by celebrities is “a deeply-rooted process.” (Note: This study appeared in the Christmas edition of The BMJ, the contents of which are peer-reviewed and held to typical standards for the journal, but tend to cover lighter topics than usual.)
Add to that the fact that the guise of “doctor” is often enough to get people to trust someone without doing much critical thinking about the matter. Consider the “white coat effect,” for example: People tend to rate an actor as more trustworthy when he is simply wearing a white coat. Beyond Dr. Phil’s celebrity status, there is the matter of that “Dr.” in front of his name. “We wonder if [the drug company is] concerned about people assuming ‘Dr.’ means he is a physician,” Woloshin told Vox. Belluz reports that this wouldn’t be the first time a pharmaceutical company has featured a non-medical doctor in its ads:
This tactic has been used before. In 2008, Pfizer ran an ad campaign for Lipitor featuring Dr. Robert Jarvik. The effort spurred New York Times editorials and congressional hearings over the concern that people would assume Jarvik was actually a practicing doctor even though he was not licensed to practice medicine.
Though AstraZeneca appears to have found a handy way to navigate that particular thorniness. “The spokesperson for the campaign explained that Dr. Phil wouldn’t be talking about the drug per se — but he will be accompanied by a medical doctor who will surely fill in any blanks,” Belluz writes. “That doctor happens to be on AztraZeneca’s payroll too.”