Surf At Your Own Risk

Amy Ridenour

1/28/2008 3:22:02 PM - Amy Ridenour

Can trial lawyer advertising put your health at risk?

You wouldn't think so, but a new report by the Center for Medicine in the Public Interest explains how it can happen.

It seems that trial lawyer advertising -- advertising that too often is misleadingly scary -- increasingly is dominating search engine results about the side effects of prescription drugs.

The report, "Insta-Americans: The Empowered (and Imperiled) Health Care Consumer in the Age of Internet Medicine," by Robert Goldberg, Ph.D., Peter Pitts and Caroline Patton, MA, says that eight million Americans search online for health information each day, and when they search online for prescription drug information, the results they get could scare them to death.

Only rarely are health care consumers searching for lawyers, but lawyers are searching for them.

CMPI surveyed the first thirty Google search results for Crestor, a drug treatment for cholesterol and atherosclerosis, and Avandia, a type-2 diabetes drug. "With few exceptions," says co-author Peter Pitts, "the information we found appeared legitimate but had no medical authority whatsoever. In many cases, we found lawyers posing as medical experts."

Pitts adds: "The analysis of search results revealed that online real estate was dominated by Web sites paid for and sponsored by either class action law firms or legal marketing sites searching for plaintiff referrals. Other sites were sponsored by groups or individuals selling 'alternatives.'"

CMPI says public fears about the side effects of antidepressants in teens may have played a role in an increase in youth suicides.

Medical science doesn't yet know what causes autism, but you can't tell that from some trial lawyer websites, which encourage parents of autistic children to call for free "vaccine injury consultations" or claim outright that "the brains of children who have autism have been injured by lead paint, other environmental toxins, medical negligence, and/or other insults."

"Do you want to know what caused your child's autism? For a free consultation about autism and birth injuries with an experienced lawyer...," trumpets a website for a New York law firm.

Some of this hyperbole is medically harmless -- although frivolous lawsuits against doctors raise health care costs and have caused shortages of medical services in some areas -- but exaggerating the link between vaccinations and autism can make parents more afraid of vaccines than the diseases the vaccines prevent, with potentially dangerous consequences.

In 2003, I wrote about state Medicaid programs cutting access to the newer forms of schizophrenia drugs, such as Eli Lily's Zyprexa and Janssen's Risperdal, after trial lawyers filed lawsuits alleging that these valuable drugs may increase a patient's risk of developing diabetes. Never mind that the often crippling, even dangerous, effects of schizophrenia are well-established, and the link to diabetes was merely a theory.

In 2004, during a controversy in Mississippi over whether local TV stations should run trial lawyer ads recruiting plaintiffs for Zyprexa and Risperdal lawsuits, mental health professionals told the Biloxi Sun-Herald that patients had had to be recommitted after not taking their medications.

"People see these ads and they think that [Zyprexa and Risperdal are] bad for them, so they quit taking them," Teri Breister, executive director of the National Alliance for the Mentally Ill in Mississippi, told the Sun-Herald. The paper reported that Breister "said she has heard of at least five people who have been recommitted after stopping the medications. Mental health professionals in Jackson, Hattiesburg and on the Coast have all expressed concerns about the ads, she said."

The paper reported that Michael Maxey, director of the Crisis Stabilization Unit in Gulfport, said he has had two patients be recommitted to mental institutions after not taking their medications, and that Maxey knew of at least nine patients who quit taking their medications after seeing the trial lawyer advertisement.

In 2007, an Eli Lily-funded survey of 402 psychiatrists who treat patients with bipolar disorder or schizophrenia found that, in the words of an Associated Press report, "More than half of the participating psychiatrists said they believed their patients who stopped medication or reduced the dosage did so after seeing lawyers' advertisements about anti-psychotic drugs."

Writing in the Providence Journal, legal reform advocates Sherman Joyce and Victor Schwartz reported that Merrill Lynch analysts say some patients have been frightened away from effective diabetes drugs as a result of lawsuit-fueled news stories and websites.

Many drugs have side effects. That doesn't make them bad drugs.

As Edmund F. Haislmaier has written for the National Center for Public Policy Research, "Class action lawsuits against pharmaceutical companies over prescription drug side effects... distort the public understanding of drug safety. In fact, no drug is ever completely "safe." Even aspirin is harmful if taken in the wrong dose or by the wrong person. A drug is only 'safe' to the extent that it poses less risk of harm than the condition it is used to treat or the risks associated with alternative therapies for the same condition. It is this concept of 'relative' safety, based on scientific data, which the FDA employs in deciding whether a drug is allowed on the market. This relative safety standard means that drugs used to treat minor conditions must have a very clean safety profile to be considered 'safe.' Conversely, drugs used to treat a life threatening condition, such as cancer, can have very serious, or even deadly, potential side effects and still be considered 'safe.'"

Patients evaluating drugs should consider both the pros and cons of their use, but many (though not all) trial lawyer websites and advertising provide only the latter. As such, they are no substitute for objective, science-based information, and an especially poor substitute for consultations with doctors who tailor advice to a patient's specific medical circumstances.

The American Association for Justice (formerly called the Association of Trial Lawyers of America) should sharply reprimand members who refuse to be evenhanded in their websites and advertising about serious diseases and medical disorders. The trial lawyer industry, already scandal prone, has no excuse for not making a serious effort to police itself in this circumstance, in which lives may be at stake.

And it should be said that some trial lawyers make an effort to sponsor responsible websites, either by referring patients to medical sources or by presenting evenhanded information.

Google-using patients beware: Just as you wouldn't hire a doctor to plead your case before a jury, you shouldn't let a lawyer's website determine your medical treatments.