Research Article Open Access Singer et al., Anthropol 2013, 1:1 http://dx.doi.org/10.4172/2332-0915.1000101 Review Article Open Access Anthropology Volume 1 • Issue 1 • 1000101 Anthropol ISSN: 2332-0915 ANTP, an open access journal Keywords: Patient role; Pharmaceutical advertising; Direct-to- consumer advertising; Rising cost of health care; Discursive regime Introduction Changing conception of patienthood Social science understanding of the making of the patient as a social process dates to the development of role theory and to speciic discussions of the cultural construction of patienthood [1]. In its classic expression, the sick role involves four components (varying by illness severity and duration): 1) sick people are expected to give up some of their everyday activities and responsibilities, however, 2) they must want to recover as quickly as possible; and, as a result, 3) must seek care [2]. In the case of chronic diseases, patients must manage their condition by adhering to their treatment regime. As a consequence of care-seeking, an important aspect of sickness is the experience of being a patient, making the factors that inluence the social construction of patienthood items of research concern [3-5]. Historic analyses stress that the making of the modern patient as an individualized, internally focused, and generally science-conident being awaited the ability of biomedicine to provide eicacious treatment [6]. Overtime, argue Herzlich and Pierret [7], “sickness was transformed from a collective to an individual afair, from a way of dying [e.g., sweeping lethal epidemics] into a way of living [e.g., the rise of chronic disease].” More recently, discussion has shited from a focus on a silent and trusting patient enfeebled by a paternalistic doctor- patient relationship to a distrustful and demanding consumerist patient demanding personal rights in the medical encounter [8,9]. In recent decades, the pharmaceutical industry has played an ever expanding role in deining patienthood as part of a wider pattern involving the pharmaceuticalization of illness [10,11]. Commodity advertisement, a practice the pharmaceutical industry helped to create, plays a critical part in this process. While modern pharmaceutical advertising through the mid-1990s primarily communicated understandings of patienthood to physicians, today advertisement on television, radio and in other electronic and print media also is pitched directly to the patient. What is a patient as communicated through these ads? What are the messages about how patients should feel and act embedded in DTC commercials? In this paper, we seek to answer these questions about what might be called the construction of pharmapatienthood based on an analysis of DTC advertisements in the electronic media. Our approach is informed by Foucault’s concept of the “discursive regime,” which maintains that a discourse or codiied body of meaning about a topic (which is propagated through language, media images and other communication channels) is intimately related to power. In the health arena, the enactment of power can be seen in the worldwide development of a pharmaceutically-centered neoliberal model of public health that stresses access to medications over disease prevention or even clinical care [12]. he ability of pharmaceutical discourse to rise to dominance and masquerade as “truth” is rooted in the power of a $800 billion global industry to frame particular social understandings, expectations, and practices regarding patienthood. Pharmaceutical discourse, in short, seeks to shape the way that people know and act in the world [13]. As Park and Grow [14] found in their study of DTC antidepressant advertising, this mode of communication “may play a role in constructing [the] social reality of diseases and medicine.” Moreover, we argue here, the scripting of patienthood in DTC pharmaceutical advertising forms part of a discourse regime that can be read as containing meanings, communicated through sights and sounds that produce a subject, namely the modern patient. he making of a discourse regime On Oct. 10, 1962, the Kefauver Harris Amendments to the Food, Drug, and Cosmetic Act required pharmaceutical companies to provide detailed information about drug side efects, contradictions, and eicacy in their advertisements, as well as present a “fair balance” between beneits and risks, and avoid false or misleading claims. In 1985, a year in which new drug approvals reached a 20-year high, *Corresponding author: Merrill Singer, Department of Anthropology, University of Connecticut, Storrs, CT 06269, USA, E-mail: merrill.singer@uconn.edu Received May 09, 2013; Accepted May 13, 2013; Published May 20, 2013 Citation: Singer M, Ostrachm B, Evans J (2013) “Pharmapatienthood”: The Patient Constructed in Direct-to-Consumer Drug Advertising. Anthropol 1: 101. doi:10.4172/2332-0915.1000101 Copyright: © 2013 Singer M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Over the last 15 years there has been a large body of research and considerable public debate on direct- to-consumer (DTC) advertising for prescription pharmaceuticals. Concerns include the accuracy, fairness, consequences, and gender messages of these advertisements. Less attention has been paid to the role of DTC advertisement in the social construction of patienthood in American society. Based on a content analysis of a sample of 40 broadcast DTC ads, this paper addresses two questions: What is a patient as constructed through this communication channel? What are the messages about what how patients should feel and act embedded in DTC advertising? In short, we seek to understand what might be called the construction of pharmapatienthood. Moreover, we argue that the scripting of patienthood in DTC pharmaceutical advertising forms part of a discourse regime that can be read as containing meanings, communicated through sights and sounds, that produce a subject, namely the modern patient. “Pharmapatienthood”: The Patient Constructed in Direct-to-Consumer Drug Advertising Merrill Singer*, Bayla Ostrach M and Jacqueline Evans Department of Anthropology, University of Connecticut, Storrs, CT 06269, USA