DRUG ADS HELPING THE PATIENT-DOCTOR RELATIONSHIP.

Byline: Lloyd M. Krieger

PATIENTS used to come to me seeking diagnosis of and relief from their ailments. Now they increasingly ask for specific medications by name because they have seen advertisements for them on television or in magazines. Many doctors seem to think this trend is dangerous, but I believe it can benefit both patients and doctors.

In August 1997, the Food and Drug Administration eased regulations on television and radio advertisements for prescription medicines. Previously, the commercials had to include long lists of all possible side effects. Now they can be briefer or simply give a phone number or Web site to consult for further details.

Today the pharmaceutical industry spends $100 million a month advertising prescription drugs to consumers.

Many doctors have protested that you can't sell medicine like detergent. They say that when patients demand specific medicines, doctors have to spend extra time explaining why the drugs might not be appropriate - usually by discussing the side effects.

Many critics of the looser regulations have pointed out that advertisements take advantage of consumers' ignorance and create demand for medications that patients may not need. The result, they say, is ever-increasing health costs, with a growing percentage of the money going to prescription medicines. Managed care companies have threatened to increase consumer copayments for prescription drugs to make up for the extra costs.

But the critics are missing the point. Health care is undergoing an information revolution. Not only are hospitals and doctors learning to track and compare the cost and effectiveness of treatments, but patients are also savvier about their ailments and their doctors. Patients who see me are quoting from medical articles they found on the Internet as often as they are citing commercials for a wonder drug they saw during ``Frasier.''

This is not the first time consumers have been bombarded with grandiose claims. I've found that if I tell patients that a cheaper drug is just as effective, they are usually willing to trust that judgment. If I tell them I think a drug is not right for them, they will usually accept my explanation.

But they are asking the right questions and making sure that we give knowledgeable and reasonable answers. And advertisements are a legitimate, though imperfect, part of that education.

People have access to information that was never available before. Which medical group has the highest rate of performing screening mammograms. Which surgeon has the best record for repairing hernias. And, yes, which is the best prescription medicine to treat baldness. Advertising is just one source of information.

Advertising may lead to new hassles, but it helps to educate patients. The result will be an improved relationship between doctors and patients and, in the end, better health care.