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Why Can't People Overcome Their Own Psychology?
I was reading on Science Based Medicine some months ago, and there was an article concerning the influence that gifts from pharmaceutical companies had on doctors. They asked the doctors if they thought gifts had an influence, and a majority said yes. When asked if the gifts had an influence on themselves, effectively none said yes. Even when shown a study that clearly demonstrated a correlation between gifts and increased prescriptions, they still agree that it had an influence, but not on them personally.
Lots of people out there will say that advertisements don't work on them. In fact, I think most people would say that. But if you look at statistics, the only people that ads don't work on are the people who don't see ads.
There was a study awhile ago, which was widely reported on. They took the same exact wine, and put it in different bottles at different prices. People reported that the more expensive wine was clearly superior. The thing is, even if you tell someone about this study, or even tell them that both wines are the same, they still like the more expensive one more.
There was a recent study that showed that telling people they were getting a placebo actually increased the power of the placebo.
People know that MMORPG type games, like World of Warcraft, are just elaborate skinner boxes, but they still get addicted to it anyway.
People know that gambling is addictive, but they still get hooked on it and can't quit.
Personally, once I know about a psychological affect, like the ones mentioned above, I feel as if it no longer affects me. I used to play MUDs and all sorts of MMORPG type games, and got hooked. Now I recognize how they work, and they no longer hook me. I used to use Google Reader and read sites like Digg. I would constantly reload throughout the day. When I realized it was a problematic psychological time wasting activity, I stopped. I stopped immediately. I just removed the bookmark, and never went back. I never had an urge to go back. I just stopped, and that was that.
Though, I'm not entirely immune. I know one psychological trick I always fall for is the relative pricing scheme. Imagine if I sold you just one product, for $10. You may or may not buy it. Now imagine I sell the super deluxe edition for just $1 more. Studies show that everyone buys the super deluxe edition. This is why Adobe sells Photoshop on its own for hundreds of dollars. It's because when you compare it to the price of the suite, you'll buy the suite and they'll make more money. They don't actually want anyone to buy just Photoshop on its own. I fall for this trick all the time, even though I see it plain as day.
You know a magician is trying to use misdirection. You try really hard to keep looking where he doesn't want you to look. Then, no matter how hard you try (if the magician is good), you end up looking exactly where he wants you to look.
Why does this happen? Why can't we overcome these things, even though they are exposed? Is this just evidence that free will is an illusion?
Lots of people out there will say that advertisements don't work on them. In fact, I think most people would say that. But if you look at statistics, the only people that ads don't work on are the people who don't see ads.
There was a study awhile ago, which was widely reported on. They took the same exact wine, and put it in different bottles at different prices. People reported that the more expensive wine was clearly superior. The thing is, even if you tell someone about this study, or even tell them that both wines are the same, they still like the more expensive one more.
There was a recent study that showed that telling people they were getting a placebo actually increased the power of the placebo.
People know that MMORPG type games, like World of Warcraft, are just elaborate skinner boxes, but they still get addicted to it anyway.
People know that gambling is addictive, but they still get hooked on it and can't quit.
Personally, once I know about a psychological affect, like the ones mentioned above, I feel as if it no longer affects me. I used to play MUDs and all sorts of MMORPG type games, and got hooked. Now I recognize how they work, and they no longer hook me. I used to use Google Reader and read sites like Digg. I would constantly reload throughout the day. When I realized it was a problematic psychological time wasting activity, I stopped. I stopped immediately. I just removed the bookmark, and never went back. I never had an urge to go back. I just stopped, and that was that.
Though, I'm not entirely immune. I know one psychological trick I always fall for is the relative pricing scheme. Imagine if I sold you just one product, for $10. You may or may not buy it. Now imagine I sell the super deluxe edition for just $1 more. Studies show that everyone buys the super deluxe edition. This is why Adobe sells Photoshop on its own for hundreds of dollars. It's because when you compare it to the price of the suite, you'll buy the suite and they'll make more money. They don't actually want anyone to buy just Photoshop on its own. I fall for this trick all the time, even though I see it plain as day.
You know a magician is trying to use misdirection. You try really hard to keep looking where he doesn't want you to look. Then, no matter how hard you try (if the magician is good), you end up looking exactly where he wants you to look.
Why does this happen? Why can't we overcome these things, even though they are exposed? Is this just evidence that free will is an illusion?
Comments
We're made of biology. At our core, we are a complex system of stimulus/response interactions. That's it. Granted, things get very complicated, and we need to use the tools in psychology (and the hard sciences as well) in order to understand those things.
I would also make an argument that you are not as able to rid yourself of psychological effects as you might think. I mean, after all, "District 9" addressed this same point, really. Nobody ever thinks that they're "that guy," but in reality, we're all "that guy" to some extent at various times. The challenge is not to stop yourself from being "that guy," but rather to recognize when it is occurring and to do something to mitigate it. You might not be able to stop it, but you can take steps to minimize the effects it can have.
It's like having an irrational emotional response. Most of the time, I'm pretty good at dealing with my emotions rationally, and examining them and understanding why they're occurring. Sometimes, however, you just feel a certain way for a reason that you can't explain. When you hit an irrational response like that, you have to admit that it's irrational and take steps to manage it. You can't stop it (though you can try and cause yourself some deep-seated emotional issues if you'd like), but you can try to manage it.
Why can I recognize when I'm falling into the serotonin trap and consciously break out of the cycle? What allowed me to see WoW for what it was when, in my younger days, I was unable to do so with The Realm?
Study the breaks, not the rule. That's how you find the answers.
You're probably not as good as breaking out of the serotonin trap as you think. As I said, nobody thinks they're "that guy."
As for doctor prescribing drugs, I always ask for the generic form of a drug (if it is available). I had a doctor that would not prescribe a generic prescription for my inhaler in college, claiming that the generic was not as effective (though I had used it in the past with great success). I refused the prescription and changed my GP.
EDIT: Rym's questions seem to relate strongly to recognition and the basis for behavior modification therapies.
Generally, the doctors prescribed the medicines for which they had received compensation more often than the ones for which they did not, irrespective of their claims to being unaffected by said compensation.
Without having read the study, I'm thinking there might be quite a few variables here.
However, I'd say that 99% of the time, the generic is just as safe.
- swayed by advertising, though normally in the "I see the use of x, so I might buy one" but then I'll check out other sources of x.
- happy to try something which may be just a placebo, but only if it costs nothing.
- happy to get addicted to something when I know I have the time or money to spend on it, but know I can give up anything quite easily (except chocolate).
- normally inclined to NOT go for the slightly more expensive but more inclusive option, though I often find this costs me money as I find I want of need the more costly option and upgrade.
I'll give out a few examples how other things take advantage of us.
Doctors giving out prescriptions to certain medicines was mentioned, namely ones that the doctors receive compensation for. This plays on greed mostly, which usually stems from a person feeling the pain of not having what he or she wants. Greed also shows up in other areas, especially when it comes to companies and stores having sales, giving away free things, or having reduced prices for bigger packages. This isn't all bad since sales and free things are good, but they're often for things people don't really need, or even want, they just get it because they can. Also, if it involves going to a brick-and-mortar store, consider the costs of getting there, plus the cost of time which could have been spent doing other things.
Advertising in general is also based on trying to alleviate pain of some kind. "Drugs can help you feel better." "Why go through the pain of doing this when you can do it easier and better with our services?" Even products that are strictly for entertainment purposes do their best to give people things to do because being bored sucks.
Now, it is easy for us to say that we don't get influenced as much, but that's because we are educated. Not only educated, but we want to strive to make ourselves better. So we may be suckered into something once (it happens to everyone at some point), but the next time it comes around, we know better. Given enough time and experience, we could potentially be able to resist all forms of temptation without even having to think about it. People who know better, but get sucked into it anyway, still lack something, or they don't understand themselves as well as they think they do.
And yes, this is my first post on the forum in almost a year. Hi.
At the end of the day it comes down to the
(lack of education of practitioner)* (greed of practitioner/pharmaceutical company benefits)* (lack of knowledge by client)* (ability to gain client trust) = income to practice
Many drug reps try to book in times to come and show a practice a new product or packaging, they also come in with their gifts and promotional petty crap.
However as a Veterinary clinician I can prescribe but I also dispense, the latter forces a business approach pros and cons of expensive medication versus loosing clientele to clinics who provide cheaper medication.
A rational Veterinary clinic should only need to stock one brand of, lets say an anti-inflammatory of moderate capacity, there are 20+ different formulations with only 3-4 different active chemical constituents. I've worked in sane practices where we just stock the one class and if a client prefers another specifically, we get a special order in for them. Plus the logical is to use the cheapest offer on a bulk buy unless the practice owner/ manager are getting excellent kickbacks on one product over another.
However I've also worked in an irrational practice where we literally had all 20 different formulations because the ordering was done by a practice manager who had no Veterinary training and caved to the owner of the practice who hadn't updated his education in 30 years resulting in responding directly to Veterinary advertising versus educated picks from studies.
Like others on the forum I subscribe to educated choices, I might get it into my head that I want product A but I'm going to compare that to all other comparable products and either pick the one that is a perfect product at the cheapest price.
In that sense the formula is broken.
I don't have a problem with it, either. Most doctors are way too busy with patients and paperwork to have much time to do completely undirected research, so I think drug reps perform an important function. Of course they are going to try to talk up their own drug...that just makes sense. Advertising, aside from promoting a certain name, also lets us know that there are new products available. Some of those products are actually useful. How do you know which new smart phones to go research? You heard of them somewhere to get the idea to research them. Maybe you heard about the iPhone, and you went online to look for alternatives. If you never heard about one of the "new generation" smart phones, you wouldn't have done the search in the first place.
Make the job of finding what I want easier for me, and I am willing to pay a little more for convenience. Just because something is advertised doesn't make it bad. Similarly, just because something is NOT advertised doesn't make it good. If being affected by your surroundings doesn't adversely affect the quality of your life, then why are you worried about it?
Veterinarians both prescribe and dispense plus choose drugs first hand.
A common drug I deal with Amoxycillin Clavulonic Acid -
Retail formulations pushed by different companies: Clavulox, Noroclav, Clavamox, Amoxyclav, Amoxyl
All 5 of these retail formulations deliver exactly the same active constituent in exactly the same concentration tablets. The Pfizer Rep constantly hammers at our door to use Clavulox, the most expensive of the bunch but my managers had a deal with Norbrook where they used a number of other Norbrook drugs so we used Noroclav which was actually the cheapest. there is no difference in effect. However I do know my practice managers also have a golf day every Wednesday because Norbrook got them a premium country club membership each.
Medicine and Pharmaceuticals are a business, you need a reason to exclusively side with a certain company for a drug range especially if there is a lot of competition in the field and they cost almost the same as their competitors. For example - In the case of a Medical Doctor in a hospital, if the hospital director or Hospital manager can push their doctors to prescribe drug X made by Pfizer, they order in a larger load of Drug X from Pfizer for their pharmacy (in addition to Drug X in the form of an injectable formulation for in hospital use), Pfizer gives a big discount to that hospital or a bonus of cash influx to the hospital to use. Pfizer may also perhaps hold a function for the hospital that orders the most of Drug X aswell. That's utter nonsense.
I do as much if not more paperwork and churn through at least twice as many cases as any Medical GP. I have to write reports on everything and don't do the referral shuffle to anything that is mildly difficult.
So being way too busy is an excuse for a doctor to not fully understand what the active constituent of the drugs he/she is prescribing versus what the company rhetoric tells them to tell their patients?
Case in point - at my last practice they used Revolution, made by Pfizer, for the prevention of fleas, and on all the packaging and all the drug reps stated that it prevented all round worms as well. Just from reading the active constituent I was dubious about the claim, however my practice managers were adamant not to change my preferred preventative made by Bayer.
I had a kitten that was bought by one of my clients for lethargy, loss of condition and diarrhoea, a few days after it arrived from another state. It had been on Revolution since 4 weeks of age and was also on a supplemental tapeworm product, since the Revolution protected it from roundworms according to the package, we didn't have to worry about it. I took a faecal sample, stained it and found what looked like round worm eggs. I sent it to the lab to confirm and they identified it as a specific roundworm, it should protect against Toxascaris and Toxacara species to claim that it prevents all round worms, it had not.
I went through the entire Medical text supplied with the Revolution package in text that was about size 5 font and finally under the round worm section it stated it protected against Toxacara but did not mention Toxascaris. When I finally presented this to my practice managers with back up of the efficacy of the active constituents according to the most recent studies and compared it with the Bayer product which explicitly stated efficacy against both Toxascaris and Toxacara they finally sent back all the Revolution to Pfizer and ordered in Bayer.
The advertising bombards me in every journal I get, Pfizer still runs ads that say it protects against all round worms when I know from a personal clinical point of view that it does not. Just like with the drugs I prescribe I make sure I look at a few well balanced reviews.
With Veterinary medicine, its my profession to know what specific active constituents do so I already know. Drug reps with new products usual present bias articles, I usually only order in a trial batch and see its clinical efficacy if the studies have been proven to be good or if I personally know the writers of the trials. No it doesn't but it can be misleading and misleading can lead to me being sued. However almost everything is advertised to some extend, if something isn't advertised its often something that is already in broad use or is a cheaper version of a big brand pharmaceutical drug. If it's bad it usually gets recalled and an alert is sent out by the Veterinary Associations internationally.
Nowhere in my posts have I said that advertising is a bad thing, just that I'm leary of drug reps who often crack under pressure when questioned.
I said I don't expect doctors to do undirected research. I did not advocate a complete lack of any research, whatsoever. The reason I don't have a problem with advocacy in the medical field is that while it does put the name in a person's mind, if the person is educated then it usually leads to research. Good god, of course I don't think a doctor should prescribe medicine based only on a rep's testimony. Nowhere in my post did I say or imply anything of the sort. Any practice that does so is negligent in their duty of care to their patients. However, there is a difference between prescribing something you were told works but aren't completely familiar with and prescribing something you were told about and investigated on your own. I worked as the ONLY administrative assistant for my mother's practice for a summer. I know full well how much work she had to do. I still expect her to know about the drugs she is prescribing, but I do not expect her to know about all drugs that are presently in the marketplace or in development at any given time.
Similarly, I read a book fully before recommending it to someone. However, I do not have a working knowledge of all books on the market. If I had never heard of the Prince of Nothing books, I would have absolutely no impetus to read them and evaluate them. I have not decided whether they are good enough to recommend to others yet, but I now know they exist and can find out if they are worth my recommendation. Consider that the FRC was the equivalent of the drug reps in this scenario. Sure, they tell me these books are good, but I still do not tell other people to read them without doing my own research first.
I wasn't trying to form any rebuttals, just furthering a conversation which at the time felt like it was directed at me. I've been eating at dinners held by pharmaceutical companies way back since the last 2 years of university - free food at good restaurants plus free well branded alcohol. However often these occur when generics aren't out yet and the drug is exclusive to one pharmaceutical company, as soon as others make their own, I too jump off to the generics. Some companies can still get away with this however what they do is also make a conference out of it. During the early part of the year there is always a "Winter Australian Veterinary Conference" where for a minimal amount you get business class tickets to Japan, and stay at a ski resort for 2 weeks, all food and activities paid for by a drug distributor active in Sydney and Melbourne.
You also get a bunch of continuing education points (we get audited every 3 years to make sure we attend continuing education events or activities); Even if you don't turn up to the meager 5 or so lectures, half of which is taken up by a specific drug company doing a lecture about their own product.
It's also tax deductable.
I'm not sure of the different legalities between the US and Australia surrounding the situation and I'm pretty sure the event is held out of Australia for a reason.
One nagging thing you still don't understand about yourself.
Here are some relevant bits. Also, it's interesting to note how many of these psychologists are atheists.