Patient Empowerment: Consequences for Pharmaceutical Marketing and for the Patient–Physician Relationship - Innovation and Marketing in the Pharmaceutical Industry - page 426

Apart from DTCA regulation, regulation on informed consent is increasing the
power of the patient. Informed consent means that the physician has a duty to pro-
vide information to his or her patients. If a certain medical treatment results in harm,
and the patient is able to show in court that he or she would have opposed that medi-
cal decision, then the doctor runs a high risk of being found negligent (Faden and
Beauchamp 1986 ).
In sum, macro-trends such as modernization and the need for self-expression,
demographic and lifestyle changes, technological evolution and changes in regula-
tion are contributing to the emergence of a new paradigm in medical decision-
making: patient empowerment. In the following sections, I explore the consequences
of this change for therapy promotion and therapy launch and what pharmaceutical
firms are already doing in this regard.

14.3 Patient Empowerment and the Patient-Physician

Relationship

Relationship marketing is widely regarded as a key strategic business mantra
(Palmatier et al. 2006 ). Marketing scholars define relationship marketing (RM) as
strategies geared towards “establishing, developing, and maintaining successful rela-
tional exchanges” (Morgan and Hunt 1994 , p. 22). In healthcare, relationship mar-
keting could mean at least two strategies: (1) strategies initiated by physicians to
improve their relationship with patients and (2) strategies initiated by pharmaceutical
firms to improve their relationship with patients or with physicians. This three-party
interaction between patients, physicians, and pharmaceutical firms makes a relation-
ship approach particularly challenging, but also important, in the healthcare domain.
For instance, medical scholars view the patient-physician relationship as a cor-
nerstone of healthcare (Epstein 2002 ). Thus, it is pivotal to understand how patient
empowerment and pharmaceutical marketing geared towards empowering patients
may interfere with the dynamics of the patient-physician relationship 3 (Charles
et al. 1999 ). The vast majority of medical scholars defend patient empowerment on
the grounds that it brings important relational benefits, such as increasing patient
trust in physicians (Epstein et al. 2004 ) and patient satisfaction with the care they
receive (Flocke et al. 2002 ). Most of these arguments are based on conceptual arti-
cles and are not empirically grounded. However, patient empowerment could also
create tension in the patient-physician relationship. Some patients, for instance,
may expect a more passive role in the medical encounter and react negatively if a
physician tries to share power with them during medical encounters (McNutt 2004 ).

3 In 2003, for example, Johns Hopkins and American Healthways (a Nashville-based company that
provides specialized care and disease management services) dedicated their yearly Outcomes
Summit to defining the patient-physician relationship. To promote dialogue about their evolving
roles, they invited 200 patients and physicians to discuss the ideal patient-physician relationship
for the twenty-first century. See http://www.cardiophonics.com/PatientPhysician.pdf , last accessed
on March 3rd, 2012.