What was your favorite Super Bowl Ad? How about your least favorite ad? Was it “PuppyMonkeyBaby”? Perhaps the Marmot ad, which was actually cute?
You don’t need to be an expert to have an opinion, and at 5 million dollars for a 30 second spot, my guess is that advertisers are happy if the ad sticks in your mind – whether positively or negatively. It’s like the old saying goes – there is no such thing as bad PR. And I am good with all of that, but not with one ad in particular – and ad which I find troubling and even dangerous – even though I found it kind of funny.
Yes, I admit that I occasionally enjoy the ever-childish, poop joke. So, when a one minute -that’s 10 Mil – spot features a guy who is so constipated that he envy’s a dog straddling a fire hydrant, it brings a smile to my face. At least it does until I get that the ad is part of the more than 6 billion dollars spent each year by pharmaceutical companies on direct-to-consumer advertising of prescription drugs in the United States. That’s just wrong, and that is coming from a proudly capitalist, free trade leaning American consumer.
In fact, the United States has the dubious distinction of the being one of only two nations in the world to allow DTC advertising of prescription medications. The other country is New Zealand, with only 4.4 million people, and a government regulated medication reimbursement program which renders the allowable ads virtually irrelevant and virtually non-existent. Then there is us.
6 billion dollars invested toward creating hundreds of millions of largely uneducated consumers, making requests of educated medical professionals regarding the 375 billion dollars Americans spend each year on prescription drugs. And all that, even as the majority of Americans report real concerns about the rising costs of healthcare. You don’t need to be a “lefty” to know that something is really wrong here.
We are getting taken for a ride – and I know that from personal experience. I will never forget waking up from a colonoscopy and discussing with my doctor a minor adjustment he wanted to make in my medication for a relatively minor GI issue – one well-managed by a generic medication with a long record of good success. None of that stopped me from asking him, in all sincerity, if we might not consider a highly advertised, and much more highly priced, name brand alternative.
My doctor looked at me, and smiled. And before he gave me the very patient explanation about why that wasn’t the way to go, I already appreciated the absurdity of the situation. It’s not that patients should not partner with their professionals in working toward better health. We should.
We should also realize that they are the professionals, that we are the patients and that when our desires are driven by ads we see on television, that’s bad. If not, perhaps we should cut out doctors and nurses altogether, make all medicine over-the-counter, and let patients make our own decisions based on guys watching dogs poop on TV. I am thinking not so much.
This is not about stifling information flow, nor is it about shutting down markets. This is about the increasingly important distinction between knowledge and wisdom. What’s the difference? As a friend once pointed out to me in the kitchen: knowledge, is knowing that a tomato is a fruit, and wisdom is knowing not to put tomatoes in a fruit salad.
I imagine that every word of the “poop ad” is true, and that the problem it addresses – OIC (opioid induced constipation) – is real. Those are the facts, but that doesn’t mean that because of a 60 second ad, patients have the wisdom to advocate for a specific treatment. Long-term, we all pay dearly for that.

Listed for many years in Newsweek as one of America’s “50 Most Influential Rabbis” and recognized as one of our nation’s leading “Preachers and Teachers,” by Beliefnet.com, Rabbi Brad Hirschfield serves as the President of Clal–The National Jewish Center for Learning and Leadership, a training institute, think tank, and resource center nurturing religious and intellectual pluralism within the Jewish community, and the wider world, preparing people to meet the biggest challenges we face in our increasingly polarized world.
An ordained Orthodox rabbi who studied for his PhD and taught at The Jewish Theological Seminary, he has also taught the University of Pennsylvania, where he directs an ongoing seminar, and American Jewish University. Rabbi Brad regularly teaches and consults for the US Army and United States Department of Defense, religious organizations — Jewish and Christian — including United Seminary (Methodist), Yeshivat Chovevei Torah (Modern Orthodox) Luther Seminary (Lutheran), and The Jewish Theological Seminary (Conservative) — civic organizations including No Labels, Odyssey Impact, and The Aspen Institute, numerous Jewish Federations, and a variety of communal and family foundations.
Hirschfield is the author and editor of numerous books, including You Don’t Have To Be Wrong For Me To Be Right: Finding Faith Without Fanaticism, writes a column for Religion News Service, and appears regularly on TV and radio in outlets ranging from The Washington Post to Fox News Channel. He is also the founder of the Stand and See Fellowship, which brings hundreds of Christian religious leaders to Israel, preparing them to address the increasing polarization around Middle East issues — and really all currently polarizing issues at home and abroad — with six words, “It’s more complicated than we know.”