Aaron Gerds, MD, is the deputy director for clinical research at Cleveland Clinic Taussig Cancer Institute and associate professor at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
“Doc, I felt like I just needed some Geritol,” a patient of mine said during a clinic visit, reminiscing on how he felt before he was diagnosed with acute promyelocytic leukemia four years ago. He thought he was simply low on energy and needed a quick boost.
Patient visits like this one are always a welcome change of pace for me during a long, grinding clinic day. They are largely social in nature and reflective, as opposed to the more typical visits filled with the nitty gritty thralls of active treatment, and they serve as a reminder of why I do this work. In this instance, I was struck by the patient’s reference to Geritol. I would expect a Geritol call-back from my in-laws or their octogenarian neighbors, but not from a guy in his early 50s, given the time that has passed since Geritol’s, let’s say, less-than-accurate advertising campaign.
Quiz show “21” host Jack Barry turns toward contestant Charles Van
Doren as fellow contestant Vivienne Nearine looks on / World Telegram
& Sun photo by Orlando Fernandez, 1957. Library of Congress Prints and
Photographs Division Washington, D.C.
https://www.loc.gov/pictures/item/00652124/
Geritol was introduced to the market in August 1950 by Pharmaceuticals Inc. and was first advertised as a tonic that would remedy the ill effects of “tired blood.” Bolstered by celebrity endorsements from Jack Barry and Betty White as well as sponsorships of popular television offerings like “The Lawrence Welk Show,” the iron and B vitamin tonic became a best-selling supplement through the 1970s. Early on, it was touted as a panacea for any illness that may take the wind out of your sails, so customers may have taken it after maladies including colds, sore throats, or the flu. However, the efficacy claims were not backed by data, and in 1963, the Federal Trade Commission ordered the manufacturer to stop advertising the product as a definitive tonic for people with “tired blood.” It took a 13-year court battle to get the makers of Geritol to reform their advertising practices.1,2 By then, Geritol – whose moniker invokes a blend of “geriatric” and “tolerable” – had already been etched into the vernacular as an enduring age-related punchline for sitcoms and comedy routines.
That is the power of advertising. When the right chord is struck, the note can reverberate for decades. Phrases like “When it rains, it pours” (Morton Salt, 1911), “Where’s the beef?” (Wendy’s, 1984), and “Don’t hate me because I’m beautiful” (Pantene, 1986) have been echoing in pop culture for decades, transcending the act of hawking goods to be immortalized in everyday conversations.
With the great power of advertising comes great responsibility, so are we responsible when it comes to advertising in health care? It is common knowledge that health care is not a typical consumer industry that is subject to the same pressures that influence nearly all consumer goods. While over-the-counter remedies like Geritol have long been directly advertised to consumers, direct-to-consumer advertising of prescription drugs took off in the 1990s, driven by medications that targeted the aging baby boomer population as well as changes in the rules that govern it. A survey conducted by the U.S. Food and Drug Administration in 2004 noted that physicians agreed the ads made their patients more involved in their health care but did not convey balanced information about risks and benefits.3 Moreover, the respondents felt pressured to prescribe a medication when suggested by a patient who had viewed the ad.
While it is clear that direct-to-consumer advertising is a double-edged sword, it is less clear what to do about it. Should it be restricted or eliminated, or should we look to reform it to maximize the benefits and minimize the risks? The same can be said for marketing that targets physicians. While I appreciate the nod to the Rabbit of Caerbannog made famous in “Monty Python and the Holy Grail,” I do not agree with the infamous “killer rabbit” ad that was selling a medication for chronic myelogenous leukemia (CML). It noted that after one or two lines of treatment, CML is no longer “the good cancer.” Labeling any cancer as a good one just doesn’t seem right. Not to mention, the image of a fuzzy bunny with a gaping mouth and long fangs is quite off-putting.
While a 30-second television spot may not have the scientific rigor and balance of a peer-reviewed journal article, it nevertheless provides an opportunity to engage patients in the setting of everyday practice. When patients ask about a medication they saw advertised on TV, even if it’s not the best treatment for them, it’s still good that they asked about it. That query can start a healthy discussion about what is the best approach for them going forward. So perhaps Geritol is a panacea, or at least a supplement, for doctor-patient communication.
Aaron Gerds, MD
Editor-in-Chief
References
- The J. B. WILLIAMS COMPANY, Inc., and Parkson Advertising Agency, Inc., Petitioner, v. FEDERAL TRADE COMMISSION, Respondent, 381 F.2d 884 (United States Court of Appeals Sixth Circuit August 11, 1967).
- Geritol’s bitter pill. Time Magazine. February 5, 1973.
- Aikin KJ, Swasy JL, Braman AC. Patient and physician attitudes and behaviors associated with DTC promotion of prescription drugs—summary of FDA survey research results. Washington, D.C: U.S. Department of Health and Human Services. Food and Drug Administration. Center for Drug Evaluation and Research; November 19, 2004.
The content of the Editor’s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.
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