Seth Godin has a great post on his blog today about marketing for the here and now. He uses the above pictured National Lampoon cover from 1973 to demonstrate a sense of urgency. Buy this magazine now or we’ll kill this dog will sell a lot more magazines than buy this magazine because if you don’t we won’t be able to keep up our contributions to the SPCA and thousands of dogs might die. The first scenario creates a sense of urgency; the second doesn’t.
In order for marketers – or anyone selling anything, for that matter, to successfully sell, they have to create a sense of urgency in the buying public. It works for all kinds of things. Take diet books, for instance. How many thin people do you know who bought a diet book so they could keep from getting fat? Not many, I would wager. How many people buy books on preventing heart disease? Not many. Those books never make the bestseller list. Books on treating heart disease once you’ve got it sell way more copies. Same with books on diabetes.
In fact, it’s the same with almost all preventative health.
Old Ben said it best:

An ounce of prevention is worth a pound of cure.

Problem is that although everyone understands the wisdom of Ben Franklin’s quote, no one wants to buy the ounce of prevention. However, they will pay through the nose for the pound of cure.
I’ve been in medical practice for a long, long time, and I’ve seen thousands and thousands of patients in my career. Over this many-year span of seeing loads of patients for all kinds of problems, I’ve never had a single one come in to see me and say: Doc, I just feel so damn good I can’t stand it. I want you to tell me what I’ve got to do to keep feeling this way forever.
I doubt that any other doctors have had that kind of conversation with a patient either.
We have all had zillions of patient conversations of the following type: Doc, I feel like crap. I’ve got [fill in the blank with a symptom or seven]. You’ve got to get me fixed up.
Prevention doesn’t sell because the product can’t be consumed until way down the road. Treatment sells because the product is consumed immediately.
But you say: Aha! That’s not true. People are buying statins right and left in order to keep from getting heart disease. It may be misguided, but they’re all buying prevention.
I disagree.
In a stroke of evil brilliance, Big Pharma has managed to create a disease out of a lab value. They’ve managed to make people believe that they suffer from high cholesterol. The elevated cholesterol has become the disease that needs to be treated immediately. Although in rational moments people might realize that what they are really treating when they take statins is the possibility that they might have a heart attack in the future, most of the time they are focused on the elevated cholesterol. Which is there, right now, staring up at them in black and white on their lab result printout.
The sense of urgency has been created, and cash registers at pharmacies are ching–ching-chinging the world over.


  1. I agree! A friend of ours was recently called by her doctor’s office to tell her they wanted to put her on statins. She asked what her numbers were and they told her 220. She said she hardly sees the need for statins because of that number and that she’d work to lower it naturally. The nurse was distressed that she wouldn’t just agree to take the drug. She acted as if my friend would die in a matter of days without it.
    Yep, your friend was suffering from the dreaded minimally elevated cholesterol levels. Got to act fast to treat that one.


  2. Maybe the title for your next book: “Buy This Book Before Your High Blood Sugar Kills You!”
    Or maybe: Buy This Book or We’ll Kill This Kitten.

  3. It’s like you said. Some people buy into big pharma’s crap no matter what. The real sad part is a lot of medical professionals also buy into it.
    I just talked to a friend yesterday that I haven’t seen for about a year. We got talking about medications and he pulled out a list of what he was taking. It was 4 different pills for blood pressure, 2 pills for his heart, 1 pill for cholesterol, an 81mg aspirin twice a day, a multiple vitamin, vitamin B12 and there may have been 1 or 2 more that I missed. He presented this list like he was proud of it. I knew it would be fruitless to talk to him about dropping some of them. Then to top it off he said he is always hungry and gets up in the middle of the night and eats a couple of cookies. He’s not diabetic as far as I can tell but when I mentioned lowering carb intake he just blew it off.
    Welcome to the world of the busy physician.  I can’t tell you how many patients doctors see who don’t want to make any changes, they just want a pill.

    Interesting article in the Guardian today – 1.5 m wrongly told they risk heart disease
    Misdiagnosis has led to massive over-prescribing of drugs – BMJ study
    Of course this is also costing our NHS – and therefore the taxpayer – billions.
    Hi Chris–
    A really interesting article; thanks for sending it.  Just another reason we don’t want an NHS here, but I fear the lure of ‘free’ medical care is going to overcome the rational side of the voter.  We’ll probably ultimately be there ourselves.

  5. Killing kittens?! Really, Dr. Eades! For shame. Yeah, yeah, I would totally buy any book (especially a low carb book) with that sort of cover.
    By the way, does it make me a bad person for laughing at that poor dog?
    Speaking of statins, my cholesterol was 203 (can’t remember the HDL and the LDL’s, but my trigicerides were good) and my doc wanted to put me on Lipitor. I’m 24 years old (Don’t act like it though).
    I love him to death (I’ve been his patient for about 10 years, and he supports low-carbing, so he’s a keeper for the most part) but I flatly told him statins were evil death pills.
    He suppressed a laugh, but disagreed.
    All the best,
    Hi Lyndsey–
    I can’t believe any doc would want to put a 24 year old person on any drug that is supposed to be taken for life for a cholesterol level of 203.  There is enough variation in lab technique to make that 203 a 189 or comparable at another lab – or a 210 at yet a different lab.  Unbelievable!
    The problem is that all doctors are worried about getting sued, and, consequently, they all try to follow the guidelines because as long as they do, they can’t be accused of not following the community standards.

  6. Oh boy do I hear you! My doctor can’t believe that I feel great because several of my numbers are a bit too high. According to him, medications are the only solution – diet and exercise won’t do anything. When I presented some of my research challenging the cholesterol hypothesis, I got this from him, “that’s pure crap!” I then told him that these articles were from JAMA and the Lancet, no comment this time. Arrrggggg!!
    It seems that some physicians do not understand the relationship between proper nutrition/exercise and good health. Sadly, they are not interested in educating themselves about it, either.
    Thank you, Mike for your generosity in giving us the tools with which to improve our health!
    Hi Judy–
    Arrrggggghhh, indeed.  Your numbers are a ‘bit too high’ so Doc wants to put you on meds that you’ll have to stay on the rest of your life.  Unbelievable.
    Glad you didn’t take the bait.

  7. “An ounce of prevention is worth a pound of cure.”
    Wait a minute. If an ounce of prevention is 10 cents, and a pound of cure is 10 cents, wouldn’t that make the cure cheaper?
    Hmmm… Do you work as an economist for the government?

  8. As the friend of a very dedicated and enlightened physician, I hear the stories every week. No matter what the problem is the patient wants a pill:
    “Doc, I don’t have time to ________; just give me a prescription.”
    “But all you have to do to improve your health is cut out the refined carbohydrates.”
    “I’ll be fine; just give me a pill.”
    Noboby has more money than Big Pharma and the insurance industry. It’s just Big Crap.
    Well said!

    The Pirahã take short naps of 15 minutes to two hours through the day and night, and rarely sleep through the night. They often go hungry, not for want of food, but from a desire to be tigisái (hard).
    Interesting.  Must be tough little buggers. 

  10. The marketing of fear. That’s the money maker.
    I understand the comments above. Despite losing 100 lbs and almost doubling my HDL, the RN still suggested I get statins to bring my overall cholesterol level down.
    I told her, I’ve done everything drug-free thus far. I’m not about to start taking them now!

  11. Hi–
    If you are feeling great why are you sitting in some doctor’s waiting room? why are you getting screenings when you are asymptomatic? I cut all that out. Trying to convince doctors that PPLP is the way to go is like trying to convince your family of origin of the same thing. You will make no headway. Why are you spending the money??

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