In the wake of the IOM report last week, I thought it worthy to examine some of the reasons for a disconnect between what is expressed by "the establishment" and what beliefs are formed by the general population. It is no secret that people are losing faith in institutions, whether governmental, church or big business. Several entities within these categories are suffering a diminishment of their credibility. What erodes credibility and what re-establishes it?
Over the past weekend, for instance, it was announced that lawmakers had reached a compromise on a Homeland Security bill that would allow Americans to travel to Canada and return with a 90-day supply of medicine. Internet purchases would still not be allowed. That raises an interesting question that John Public might ask of these policy-makers. If Canadian drugs are safe enough to purchase in person, why aren’t they safe enough to purchase on the Internet, or by an 800 telephone number? It is when policy makers believe that the public is perhaps not bright enough to ask the question, that the public begins to suspend their belief in lawmaker credibility. Of course, this Congress has, for the most part, squandered its credibility on a number of fronts.
Another set of mixed messages comes from the scientific community reporting conflicting health study outcomes. For example, a few weeks ago, the Washington Post ran reports about two interesting sets of studies that talked about benefits of two different naturally growing products whereby studies demonstrated a benefit, even though the agency has said either there is no benefit, or the benefits are unsure.
The first set of studies involved the health benefits of green tea. The Washington Post ran an article that toplined a study of 40,000 Japanese and their consumption of green tea. The headline implied that the study demonstrated a benefit. Then the following Wednesday, the Post ran a follow-up article with more detail on "Green Tea: Mixed Results as a Health AID". The long and short of it, green tea has been studied quite a bit for health benefits related to cancer prevention and cardiac protection. The NIH has done studies and there is an NIH Fact Sheet on Green Tea. The FDA denied an official health claim to green tea. The studies are inconclusive or conflicting. For millions of consumers who are trying to make lifestyle and dietary decisions, such conflicting information results in discounting the source, and making gut decisions, which defeats the purpose of the scientific studies and means that the faith in these institutions is diminished because their direction offers the public little help on this matter. This isn’t true merely of green tea, but of health foods and dietary supplements.
Lastly, there was a study on the marijuana front, and before you get too excited, the research was connected with Hepatitis C and was performed out of the University of California at San Francisco. It looked at the effects of daily marijuana smoking on a small group of patients who were taking therapy for Hepatitis C. Those who used marijuana fared better in adherence and in response to medication (which makes sense if they were more adherent). The theory is the smoking made the side effects of the medication more tolerable. Yet, the government seems very discouraging about marijuana’s medical benefits and that stance seems couched in politics – at least that is what people tend to believe .
What does this have to do with the FDA? The IOM report issued last Friday makes clear the need to regain credibility. The point is that as part of a greater communications plan towards restoring its image, there should be careful dedication to re-connecting with the public on very personal terms and avoiding mis-steps that would erode credibility further. In other words, the establishment of a credibility filter that regularly assesses the agency’s efforts and monitors the situation from policy decisions to press releases. This would be just a part of the machine that the FDA needs to build to restore its image. But it would be better than laying back and letting the chips fall where they may and hoping for the best, which seems to be the status quo.