Not so subtle subliminal messaging is a common advertising and political foil with which we are all familiar. Inundated by messaging “below the surface” of the proffered material, we find it mostly harmless, sometimes comical and occasionally wildly satirical.  I have often wondered why, when drinking expensive Tequila, I don’t seem suave and debonair like the guy in the commercial… but I digress.

When used in other arenas, it can very effectively sway public opinion, influence the course of debate and even shape governmental policy. In that vein, I share with you a New York Times blog that appeared earlier this week related to the relationship between pharmaceutical companies and physicians. The article states that even the casual relationship is viewed as beneficial by the pharmaceutical and device industry, each encounter subliminally altering our behavior. This is without question true, irrefutable education and social sciences research serving as proof, demonstrating unequivocally such an effect exists. You see, it’s not the pen with the name on it that induces a particular product usage; it’s the smile, the brief friendly chat and the bagels that engender positive feelings and subtly influence behavior.

In a similar way, albeit perhaps unintended, articles such as this have a subliminal effect on legislators, on patients and on the public. The “below the surface” message is not positive but sinister; one of greed, of excess, of influence peddling. And with each, we lose just a bit of our most powerful weapon, the non-medical world’s overwhelmingly positive impression of our trustworthiness and altruism. For you see, each time we lose a bit of that positive impression, with each little chink in the armor,  it becomes easier for those outside medicine to paint us with a broad brush, to convince others we all stent phantom lesions, to imply “inappropriate” really means “did it for the money” and to have that messaging believed.

As health care payment reform convulses forward, as value moves to center stage, as our David faces the hospital and payer Goliath, we can ill afford to dull the polished shield of trustworthiness or blunt the sharpened sword of altruism.

I would like to hear your thoughts.

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