The Dissonance in Pharma DTC Erodes Credibility — and Limits Its Potential

The future of DTC should foster understanding, trust, and improve clinical conversations.

Prescription-drug commercials have been a recognizable part of American TV for nearly 30 years. Their production values have kept up with the rest of the advertising world, and in the costliest broadcast spaces, they now look almost identical to ads for consumer tech, cars, and sports betting. As The New York Times reported, spending on direct-to-consumer drug advertising is rising again, driven by competition in high-profile therapeutic areas – a reminder that DTC advertising is not fading but growing in scope and influence.

I have been writing about DTC pharmaceutical ads for nearly 20 years, and the dissonance – cavorting cartoon characters or people climbing mountains while vital information is voiced over – has remained remarkably consistent. Patients and clinicians often start the clinical conversation inside a narrative that the advertising has already shaped.

DTC advertising is the biggest untapped resource for public health education in the country. The concern isn't about the presence of risk information; it's whether the overall experience helps people understand what those risks mean and how they should affect treatment choices.

An ad for Vanda Pharmaceuticals’ antipsychotic Fanapt highlights this disconnect: a calm voice lists stroke risk, cardiac complications and sudden death while smiling, anime-style characters move through bright, cheerful scenes. The disclosure follows regulations but trivializes the seriousness of the condition and distracts from the importance of the adverse-event information.

Regulators have started to recognize the gap between mere compliance and actual understanding. The FDA’s letter to Novo Nordisk about a TV commercial for oral Wegovy criticized how the ad implied broader emotional and lifestyle benefits than the evidence supports. In another letter concerning a commercial for argenx’s Vyvgart Hytrulo, the agency noted that “attention-grabbing visuals, frequent scene changes and background music” might hinder understanding of the major risk statement. That language matters because it acknowledges that production techniques influence how risk is perceived. However, it stops short of addressing the core creative decision in most branded campaigns – whether the story enhances the safety message or competes with it.

Direct-to-consumer advertising grew rapidly after the FDA relaxed its broadcast guidance in 1997 and finalized the approach in 1999. Drug names became part of everyday conversation. Awareness increased, but public trust in the industry did not follow the same trajectory. The American Medical Association’s 2015 call for a ban on DTC advertising reflected ongoing concerns that brand narratives can influence the clinical encounter before a diagnosis is made. Physicians interviewed by The Times this week described spending valuable visit time recalibrating expectations created by advertising – explaining why a widely promoted therapy may not be suitable or why its risks and benefits are more complicated than the commercial suggests. That debate is unfolding at a time when trust in health institutions remains fragile.

The conversation still tends to frame DTC as a choice between maintaining the current model and eliminating it. But this overlooks a bigger issue. The pharmaceutical industry now controls some of the most influential health-communication platforms in the country – including television, streaming, social media, search, and digital video. How this multi-channel infrastructure is used has huge implications for how patients understand their health.

That reach is most visible during the Super Bowl. In 2024, Pfizer chose not to promote a specific therapy but to “celebrate science” on its 175th anniversary. Instead, the message was muddled and abstract. Pfizer missed an opportunity – not because its creative execution was weak, but because the platform’s power far exceeded the depth of what it chose to say.

That same media moment has also shown what a different objective looks like. Novartis’ Super Bowl LX screening initiatives and Bayer’s heart-health risk campaign used the industry’s most expensive media real estate to encourage early detection and informed action. They are not simply creative templates for branded advertising; the regulatory environment is different. They demonstrate that when education takes priority, storytelling shifts – and viewers leave with knowledge rather than just an impression.

Branded advertising operates within stricter regulatory constraints, but it still makes choices about tone, pacing, and imagery. These choices determine whether safety information is incorporated into the story or hidden beneath it. The issue is not about fair balance. It's whether the surrounding narrative trivializes the disease and distracts from the risks that should influence treatment decisions.

In many product campaigns, the narrative reassures, while the safety information warns. The viewer receives two emotional signals at the same time and must reconcile them. This split may work well for recall, but it weakens the credibility on which long-term brand success now depends.

Eliminating DTC would remove a source of awareness that has encouraged patients to seek care earlier and discuss stigmatized conditions with their physicians. The opportunity is to use it more effectively. A better approach would replace distraction with decision support – focusing on the moments when a patient and clinician weigh options, reassess progress, and adjust the course if a therapy is not suitable. In this model, safety information is not an interruption; it becomes part of the narrative.

This isn't a call for longer risk language or more data on the screen. It's a call for creative alignment. When tone, imagery, and narrative support the medical reality instead of competing with it, the advertising sets the stage for the clinical conversation rather than pre-empting it.

That shift has business implications. The industry has long argued that informed patients achieve better outcomes. In a crowded and scrutinized market, credibility remains one of the few durable advantages for brands. Creative work that distracts from risk might boost short-term recall, but creative approaches that aid decision-making builds trust with patients, clinicians, and regulators.

Direct-to-consumer advertising has become a permanent feature of American culture. Its future credibility will rely more on whether it bridges the gap between marketing and medicine than on disclosure adherence. In a medium where a 30-second story can reach tens of millions, aligning the message with medical truth is no longer optional; it is essential for understanding.

The Fools of April

I remember looking forward to April Fools’ Day – the gags, the puns, and the harmless pranks that sparked laughter or, at least, a good groan. This year? It felt like April Fools just disappeared. Hardly anyone I know made the slightest attempt to lighten the day. The world felt too heavy. The jokes, if they existed, weren’t funny anymore.

Years ago, some stories we see now might have given us pause: Wait, that can’t be real… is this an April Fools’ joke? But today, there’s no punchline – just policy. April isn’t over yet, but let’s review a few.

Universities Defunded

The Trump Administration intensified its campaign against higher education institutions, citing antisemitism as the justification for funding cuts and other punitive measures. 

It’s offensive. It’s manipulative. 

Let’s not forget the 2017 “Unite the Right Rally” in Charlottesville, Virginia, where clashes between white nationalists, neo-Nazis, and other far-right groups resulted in the death of a counter-protester and injuries to others. Donald Trump commented, "You had some very bad people in that group, but you also had very fine people on both sides." 

This isn’t policy; it’s political retribution dressed up as civil rights enforcement. Antisemitism must be addressed in the strongest terms. But suppressing academic freedom while harboring white nationalist sympathizers exposes the Administration's contradictory and hypocritical approach to addressing discrimination and protecting civil liberties.

Cutting Science at the Knees

What began as a Silicon Valley mantra – “move fast and break things” – has been embraced by this Administration as its governing philosophy. The problem? Government is not a start-up; it is the infrastructure that binds society together. It is being dismantled in the name of speed, spite, and spectacle.

The U.S. National Institutes of Health (NIH) terminated nearly 800 research projects with lightning speed, reclaiming more than $2.3 billion allocated to researchers. This could mean potential cancer treatments, rare disease therapies, and mental health innovations – all gone.

Dr. Peter Hotez, from the Baylor College of Medicine, warned, “Anti-science has become a dangerous social force that threatens both our national security and global stature as a nation renowned for its research institutions and universities.” NYU Bioethicist Dr. Arthur Caplan put it more bluntly: “Trump's anti-science, dangerous HHS head and their oddball gang of misinformers are now firmly in charge of federal biomedical policy.”

Those concerns deepened this month when Dr. Peter Marks, the highly respected head of the FDA's vaccine division, was forced to resign. Vaccine expert Dr. Paul Offit at the Children’s Hospital of Philadelphia put it bluntly: “RFK Jr. is now the wolf guarding the hen house.”

Healthcare isn’t the only scientific discipline on the irrational chopping block. The Trump Administration has proposed significant budget cuts to the National Oceanic and Atmospheric Administration (NOAA), including plans to eliminate its climate research division, the Office of Oceanic and Atmospheric Research, and several other NOAA offices. These cuts could devastate weather and climate research, potentially crippling industries like agriculture that rely on accurate weather and climate data. The reductions may also hinder research on severe weather events that affect virtually everyone, such as storms and tornadoes.

All of this uncertainty, combined with the hostility toward science and higher education, could have a generational impact on U.S. research and competitiveness: more than 75% of respondents to an informal Nature poll of readers who are scientists said that they were considering leaving the country.

We’re witnesses to the dismantling of the innovation engines that have powered American progress for more than a century.

Due Process, Discarded

The Department of Homeland Security proposed new rules allowing expedited deportations without a court hearing for certain noncitizens. According to the Migration Policy Institute, similar fast-track removal programs in the past have raised serious due process concerns, particularly regarding access to legal representation and the risk of wrongful deportations.

The dangers are not theoretical. A federal judge in Maryland issued strong reprimands to the Trump Administration for failing to comply with a Supreme Court order requiring the release of Kilmar Armando Abrego Garcia, who had been wrongfully deported to a notorious supermax prison in El Salvador. “To date nothing has been done,” said Judge Paula Xinis. “Nothing.” 

Garcia, who has no criminal record, entered the U.S. illegally; however, in 2019, an immigration judge granted him “withholding of removal” to El Salvador due to his “well-founded fear of future persecution” from a violent gang known as Barrio 18. 

Now Trump is floating the idea of sending “homegrown criminals” – U.S. citizens – to the same prison.

Rolling Out the Propaganda Welcome Mat

Also this month, Secretary of State Marco Rubio announced the closure of the office that tracks disinformation from China, Russia, Iran, and other foreign actors. This office had been monitoring disinformation campaigns by rival powers and terrorist groups while also publishing relevant reports. James P. Rubin, a former State Department official who led the precursor to the office during the Biden administration, stated, “This amounts to a form of unilateral disarmament in the information warfare Russia and China are conducting all over the world.”

The Trump Administration has also dismantled efforts to monitor U.S. elections for foreign interference. The New York Times reported, “Those employees tried to combat false content online and worked on broader safeguards to protect elections from cyberattacks or other attempts to disrupt voting systems.”

We are blinding ourselves as our adversaries continue to become much more aggressive in spreading disinformation, creating division, and inciting violent acts. 

A Trade War on Ourselves

Then came the tariffs.

Trump reimposed a 10 percent baseline tariff on nearly all imported goods this month, marking one of the most sweeping trade policy shifts in modern U.S. history. Select countries, particularly China, were hit with much steeper penalties, with total tariffs on Chinese imports reaching as high as 145 percent. Mexico and the European Union faced additional levies ranging from 20 to 25 percent.

Is this to rebalance trade? Reshore manufacturing? Let’s be clear: there is no endgame. The world is left to guess. Nobel Prize-winning economist Paul Krugman said, “Uncertainty created by ever-changing tariff plans is arguably a bigger problem than the tariffs themselves."

But Trump boasted, “These countries are calling us up, kissing my ass” to negotiate deals. “We need to teach these countries a lesson – they’ve been laughing at us for years,” he said. 

The markets showed no signs of laughter. The Dow plunged by more than 4,000 points in just two days. 

Financial titans are no longer able to stay quiet. Jamie Dimon, CEO of JPMorgan Chase, said in his annual shareholder letter, "Trump's tariffs will likely increase inflation and are causing many to consider a greater probability of a recession.” Larry Fink, CEO of BlackRock, stated: "Most business leaders from our portfolio companies say we are probably in a recession right now." And Ken Fisher, Chairman of Fisher Investments, criticized the tariffs as: "Stupid, wrong, arrogantly extreme."

So... Where’s the Joke?

These aren’t mistakes; they’re not even misguided policies. They are intentional. In many cases, the Administration and millions of supporters and enablers take pride in that.

What’s chilling is not only the content of the decisions; it’s the logic (or lack thereof) behind them: reverse what my predecessor did, punish ideological opponents, and provoke simply for provocation’s sake.

The cruelty isn’t a byproduct. It’s the point.

A Call to Sanity and Humanity

April was once a time for pranks, laughter, joy, curiosity, and creativity. But here’s the thing: it’s still possible to reclaim that spirit. We can resist the normalization of chaos and reject leaders who govern through vendetta. 

We can demand compassion in immigration policy, invest in education, showcase scientific evidence, and demonstrate humility in power.

Let’s revive the best parts of ourselves and our institutions. Let us be a nation where absurdity is confined to comedy, not policy.

Let’s stop the fools of April from writing our future.

Informed Dissent

H1N1 Vaccine is Here With Too Few Takers

Parents want the best for their children – happiness, success and good health. But nearly two-thirds plan on delaying or denying vaccinations against the H1N1 flu to their kids. It’s more than ironic to me, especially when so many complain about the lack of access to preventative care in this country.

Two similar polls just came out – one from the Associated Press-GfK and the other from Consumer Reports – that demonstrate that only about half of the U.S. population will be vaccinated. It’s not big news, though. This sort of result has been the unfortunate norm.

Why haven’t the numbers improved? Why are people so wary? Why are there so many who actively oppose vaccination? Is this just a case of people not being adequately informed? And, is this the government’s fault? The report published by the AP said that “The survey raises questions about government efforts to stem illnesses already spreading widely across the country.” I’m not quite sure what this statement is based on but my view is that the public-private partnership that has made millions of doses available is an impressive achievement.

So, allow me to briefly address some of the suspicions and concerns:

Flu isn’t all that serious. Influenza and pneumonia are the eighth leading cause of death in the U.S. (over 56 thousand annually).

It may be safe but I worry about side effects. Everything we do carries a risk. One must weigh the risk of injection site swelling and pain against contracting the flu with its potentially serious sequelae.

The vaccine hasn’t been adequately tested. Again, nothing is fool-proof, nothing is risk-free. FDA’s requirements for safety and effectiveness, however, are demanding. Moreover, the methodology for manufacturing the H1N1 vaccine is no different from other flu vaccines – vaccines that have an excellent safety record.

Vaccines can cause autism and other diseases. We may never know with 100 percent certainty but every credible study and review thus far (the most recent having been conducted by the Institute of Medicine) has concluded that there is no causative link.

I don’t think I/my children will get the flu. Sure, you might get lucky but why count on this wishful thinking? It has already been reported in 37 states – a much more rapid spread than in previous years.

I don’t trust it if the government is behind it. Fine, have a healthy skepticism but please don’t take it too far. Don’t undermine your health or the health of your family by listening to the fringe opinions of people like Rush Limbaugh who recently said that “All of this is designed to get people to respond to government orders, not to do things or to do things. It is designed to expand the role and power of governments and schools, and the media, of course, just falls right in line here with amplifying the nature of the crisis.” It's too bad there's no vaccine for paranoia.

If there are such good responses to these concerns, why aren’t people listening? Why aren’t people better informed?

My sense is that people are listening. They listen to and are informed by people that make sense to them. The CDC and NIAID have been all over the news with compelling information. About half of the country will act on what they heard. The other half will not be convinced. The message from anyone employed by or connected to these sources will not be trusted.

This is a barrier that will probably take a long time to breach. The ongoing outreach and education must continue while new efforts must be established to address the reasons why health messages bounce off of so many. Politics and conspiracy theories aside, elevating the public’s health and science literacy may give everyone a common ground from which to make their healthcare choices.

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The Secrecy Bucket is Full of Holes

Get Used to It

The following was published in PRWeek:

The FDA has been under fire for years. Approvals are too slow. No, approvals are too fast. Inspections are not rigorous enough and enforcement is too weak. No, FDA is over-reaching. There's too much interaction with industry. No, there's not enough. This push and pull has been played out in Congress, in the industries that FDA regulates (or hopes to regulate), in advocacy organizations and in the news media.

How do we know so much about some of these sharp divisions and controversies? It's because there have been loads of information leaking out of the FDA -- internal disputes, data allegedly ignored and stories of staffers being pressured to make various decisions. To plug the holes, Acting Commissioner Frank Torti sent an internal memo last month reminding staff about the types of information that must remain proprietary. Want to guess what happened next? Yup, the memo was leaked (and criticized by those who believe such a memo inhibits transparency).

Dr. Torti sent a farewell memo the other week to FDA staff which -- no big surprise -- was leaked, too. (He is returning to Wake Forest University to make room for incoming Commissioner Margaret Hamburg.) Despite the roiling atmosphere, he had some interesting perspectives and high praise to share with the agency: "The FDA is now defined by others. You must speak up and take the FDA back. It's yours, not theirs. You do more good day in and day out than most others, inside or outside of government." He added that, "what's written about the FDA is always from the outside, and I wish there was a way we could communicate what we've done, sometimes under very difficult circumstances."

I see three key points. First, the FDA has, indeed, lost control of its message. Regaining its public relations footing is possible but the agency is in a tough spot: dealing with hugely complex issues that can defy the sound bite, being overseen by elected officials eager to score political points, walking a tightrope trying to balance on the safety and efficacy of new drugs and devices, the list goes on. And when they tried to get some PR help late last year, it backfired. They were taken to task for awarding a no-bid contract.

Second, while transparency is crucial (as I have written here in the past) it cannot be used as a blunt instrument. There really are secrets that must be kept, at least for some period of time. Premature release of information can create a panic among patients in the case of drugs and devices, or among the entire public in the case of food. Or, there may be patent issues or patient information that demand confidentiality.

Third, we need to examine just how much secrecy we should expect these days. Our interest in inclusion means more people are exposed to secrets. More people means more mouths. And with people involved in social issues in addition to work, they often feel forced to choose sides. I can remember working for Roche and getting a call from an HIV/AIDS activist asking me to confirm some data that the company had sent down to the FDA just hours earlier.

The push toward more secret sharing is bound to accelerate. We have a generation growing up on Facebook, MySpace and Twitter, and all the other generations are aching to catch up. The amount of personal information people are willing to share is stunning. Clearly, the need to unleash our inner narcissist has overpowered our interest in keeping information private. A secret isn't what it used to be.

When an Ethics Company Does Wrong

Lessons From Coast IRB

Some of you know that I've been teaching Research Process & Methodology one night a week this semester at NYU's M.S. program in Public Relations and Corporate Communications. One of the concepts we discuss is confidence - what it means to have confidence in results, how to achieve it, how to measure it, how to determine the amount you actually need. The first thing we started out with, however, was ethics. Indeed, all of the students must pass a test given by NYU's University Committee on Activities Involving Human Subjects - the school's Institutional Review Board (IRB).

Special treatment on the subject of ethics in public relations? Yes, we're serious about this. The fact that some think it oxymoronic is, in fact, a crisis in confidence. With less than solid ethics, we risk creating a false or negative impression of ourselves, our business and our clients.

Ethics and confidence. Everyone knows that they exist in proportional units - the more the ethical behavior, the higher the confidence we have in the message, product, person, whatever. It's all part of the corporate reputation equation. Yet, each day we find new ways to rip ethics and confidence apart.

This is where we come back to the IRB. If there's ever a place where ethics and confidence should be at their most high, it's with research involving human beings. Unfortunately, such was not the case with Coast IRB of Colorado Springs. Federal investigators from the Government Accountability Office (GAO) concocted a fictitious clinical trial for a made-up medical device and attempted to get several IRBs to approve the study. Coast was the one that got out its rubber stamp.

Coast's press release last month said the Company had uncovered a "Congressional 'Sting' Operation." And, in testimony last week to Congress, Coast's CEO, Dan Dueber, complained of "extensive fraud" by the government. But the tune has changed. Now on their web site, Dueber says, "Coast IRB is cooperating fully with the Food and Drug Administration," and that efforts are underway to change "everything" and revamp "every aspect of the company."

Fortunately, no one was harmed although this episode called into question the hundreds of other studies Coast had approved. Those studies are continuing though Coast is banned from approving any new studies or adding patient volunteers to existing studies until the company can be brought into compliance.

Some of the key points I see are:

• Follow through on your promise. Coast IRB says its mission is "to protect the rights and welfare of subjects in clinical trials by providing and ethical and thorough review in a timely and efficient manner." Mr. Dueber, please review.

• Take responsibility. The Company's first reaction was to shift the blame - to the GAO, no less. If you're a company built on ethics, stick to the code.

• We need ongoing monitoring and reporting. Ethical codes stand only as long as there is a commitment to the enforcement of those standards.

• What's best for your audience, your customer, is what's best for you. James Grunig put it succinctly in his Symmetrical Communication model: the organization must consider the public interest to be at least as important as its own.

• Attempt to reassure and apologize. I did not observe any effort to address the hundreds of investigators and thousands of patients participating in Coast-approved trials. Try showing some empathy.

The World's Shortest Diet Book

It's All There in Clear, Concise Messages

I went to my local bookstore the other day to look at the management and leadership books. It was a mission to do a little competitive intelligence, since I'm working on one myself. (Yes, I do think there's room for one more! And if you know of an agent or publisher willing to work with a first time book author let me know.) On the way to my target, though, some catchy titles in the aisle of diet and weight loss books caught my eye. I diverted over there and... yikes. What a mess. How could anyone make heads or tails out of all the claims and contradictions?

Could this be an opportunity to work on a second book? Could I retrieve some of my long ago training in nutritional biochemistry, and meld it with my career in communications and passion for health and science literacy?

There's a huge need to be sure. The National Institute of Diabetes and Digestive and Kidney Diseases reports that two-thirds of U.S. adults are overweight or obese and nearly one-third are obese. Attempting to meet this vast market are the hundreds of fat-burning, colon-cleansing miracle products seen in advertisements and infomercials, and the thousands of books that claim to be the solitary answer to such a vexing and pervasive problem. (Message to the FTC and FDA: please help protect a desperate public from these purveyors of junk science.)

So, I got serious for a moment but then realized that I couldn't put an entire book together. I couldn't even think of enough material to fill a page much less a chapter. Why? Because it would be the world's shortest book. In my view, it all boils down to four words:

Eat less. Exercise more.

As communicators, we're taught to make the messages few, simple and memorable. I think I aced that test with my book title and book in one.

OK. Maybe there's a little bit more. There are different body shapes, different rates of metabolism, different personality types as well as economic issues. Unfortunately, when trying to stretch a dollar, junk food can often fill the belly at a lower cost. There are some people who must have a thorough medical examination to search for underlying causes of weight gain, and others who need some intervention to help them get jump-started be it through counseling, pharmaceuticals or surgery.

But the formula is pretty simple, nevertheless. If you don't put enough gas in your car, it dies while you're driving. Put too much in when it doesn't need it, you have an overflowing, dangerous mess. The key, therefore, is balance.

Michael Phelps, the record-shattering swimmer, gives us balance in the extreme. Did you happen to see one of those "up close and personal" vignettes from the Beijing Olympics where he was eating one of his meals? It was like Nathan's hot dog eating contest came to Animal House. Anything and everything was going down his gut. Yet, he's won more medals than anyone in history and hangs in poster form in many a teenager's room. He balances the ingestion of 10,000 calories with 10,000 worth of exercise.

I know my message is simplistic and I know also that the execution is not always so easy. Our bodies and our lifestyles change with age. Keeping in balance gets harder. We all know that we should eat a nutritious, varied, well-balanced diet. So, if one key is balance the other is expectation. We need to take the long view and not hope for or plan on a rapid reduction in weight. The goals must be achievable and bite-sized. With this in mind, I should double the length of my diet book:

Eat a little less. Exercise a little more.

Let’s Not Get Burned and Drowned (By Information)

Right, Wrong; Too Much, Too Little; Too Early, Too Late
If Martha Stewart was in public relations she might say, “Information – it’s a good thing.” Information can educate. It can inspire. But, it can confuse. It can even harm.

We’re exposed – sometimes bombarded – by health information everyday. It comes from our healthcare providers, from the media, from consumer groups, from government institutions and advertisements. Shirley Wang wrote in The Wall Street Journal last week, “Too much information about drug safety – disseminated through media, online alerts from consumer watchdog groups and even by the Food and Drug Administration itself – might overwhelm patients and raise undue alarm, some medical professionals caution." Indeed, also reported in this story was a survey of 300 medical professionals released last March by Pfizer that found nearly all (89 percent) were at least “somewhat concerned that patients might stop their medications if potentially negative safety information was released to the public too early."

The clutter and confusion is an issue not only for patients and caregivers but for physicians, too. The database of clinical guidelines (those standards of care developed by a wide array of medical societies) maintained by the American Medical Association contains over 2,200 entries. Some were not subjected to peer review and some contradict others outright. Dr. Darshak Sanghavi, a pediatric cardiologist at the University of Massachusetts Medical School, wrote in The New York Times recently that in the past year “the American Academy of Pediatrics abruptly reversed its recommendation that healthy infants avoid peanuts and other potential food allergens, without citing any new data. Weeks after the American Heart Association widely publicized the need to perform cardiac testing in children treated with drugs for attention problems, the academy issued a contradictory guideline discouraging such testing.”

These guidelines carry weight in determining if a drug, device or procedure will be reimbursed by insurance, and are supposed to be developed using hard clinical data – so called evidence-based medicine. But here, too, lie a bevy of contradictions. For example, Stephanie Saul wrote in The New York Times last week about the CyberKnife, an FDA approved treatment for the treatment of a variety of tumors made by Accuray. In prostate cancer, the key advantage is that treatments take five days instead of eight weeks for conventional cancer radiation. “As it turns out, Medicare pays for the treatments in 33 states — but not in 17 others. “You can live on one side of the street and get a procedure, but on the other side of the street you can’t,” said Dr. Steven D. Pearson, president of the Institute for Clinical and Economic Review.”

Where does this leave us? Here are a few thoughts:

For consumers: Trust, but verify. We’re told to rely on sources of information that we trust. But be careful. Trust is easily misplaced – just ask those who invested with Bernard Madoff. Look for information that lists its authors. Look for references. Additional comfort can be gained if the information is attached to a major medical institution, or a government agency like the NIH or CDC.

For health information providers: Release information when it’s ready, not when it’s half-baked. Many studies and interim results are made public too early. Clearly, if there’s a serious potential adverse event or public health issue, it’s important to err on the side of safety. But, in other cases, try less for a change. Not everything is news, not everything needs an announcement.

For healthcare decision-makers: Set expectations in advance for what information is needed to render judgment, while leaving room for some flexibility in a dynamic field. We need a clearer understanding of the thresholds of acceptability, when enough information is enough and transparency in the review process.

Positive steps have been taken, to be sure, but we still need to work to ensure that information is of higher quality, delivered at the right time and conveyed in language appropriate to the audience.