There's currently major disagreement over whether prescription drug manufacturers should be allowed to market directly to consumers
- The issue is big, and it isn't limited to drugs. Medical devices, nutritional supplements, and many compounds that have significant effect on bodily function are marketed directly to users--often through media channels like T.V. or internet. Many twitter users are quick to point out that there are stringent requirements on such advertising. However, many question the utility of appealing to an uninformed mass audience on medical prescriptions that require a doctor's approval.
- Pharmabuse recently tweeted that the AMA has publicly stated that they are opposed to such advertising when used for pharmaceuticals or medical devices. The AMA (American Medical Association) is the largest network of doctors in the country, and they have yet to take a stance on this issue until today. Other feeds, like those hosted by Pharma Marketing, argue that patient safety is best handled by the patient, and that doctors shouldn't serve as gatekeepers to medical information.
- All sides are heavily engaged in actively tweeting about this debate. This shouldn't shock anyone. There are vested interests among both medical service providers and pharmaceutical companies, and this makes it particularly difficult to identify trustworthy sources of information. Every side in this debate agrees that patient safety comes first, but they disagree on what practices are safest. Should a patient be as informed as possible? Does a marketing campaign by Pfizer really increase patient awareness, or does it merely bias their opinions? Should doctors serve as the patriarchal gatekeepers who decide what prescriptions or services are appropriate for their patients, or do the patients themselves have a say, too? There's no easy answer, but Twitter is flooded with opinions on the topic.
I also wanted to focus on the niches related to my own research involving patients with diabetes and peripheral neuropathy. After logging into Twitter, I searched for trends in "diabetic foot care," and found:
Podiatrists are currently debating whether total contact casts or ankle orthotics are better at minimizing ulceration risk among diabetic patients
- To be fair, this is a more specialized arena, wither fewer average retweets. However, there's a major question about how to reduce ulceration risk for patients who recently had foot wounds. Total contact casts (TCTs) are known to do the trick quite well, because they keep patients off their feet and allow the wounds to heal. However, the primary way they achieve these benefits is by not allowing the patient to ever take them off: they're a cast! This is seen as somewhat intrusive by some, and the question of how much more effective TCT are is still an open debate.
- Some twitter users favor TCT, while others believe alternative orthotics are nearly as effective and far less intrusive. Some, like the Gulf Diabetic Foot Group, argue that the TCT has proven effective in reducing ulceration risk and improving wound healing time. So, why not use it? At the end of the day, minimizing pressure on the soles is the surest path to wound healing, so forcing the patient to properly offload by using a cast seems like a no-brainer to them. Others have argued that custom orthotics can be 3-D printed to effectively redistribute plantar pressure without such a bulky cast placed on the foot.
- I personally was surprised at some of the hype existing surrounding a fairly niche area within the world of podiatry. There were many recent tweets, and some argued that podiatrists who weren't using TCTs were doing their patients a great disservice. I found these topics particularly interesting because they related directly to what I am working on day in and day out. I even saw several tweets from my PI when I searched twitter for diabetic foot care feeds.
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