As the camera zooms in on a man in a blue plaid shirt sitting in a doctor's office, a smooth authoritative voice begins: "Daniel Sorby had no idea that he had high cholesterol, until he suffered a stroke."
A short discussion follows on the difference between "good" and "bad" cholesterol - and their potential role in heart attacks and strokes.
That's the program. Then comes the commercial break.
The spot is for Plavix, "a prescription pill that can help protect you from a heart attack or a stroke if you've recently had one," says a friendly grandmother, as pictures of her playing with her grandkids float across the screen.
Those scenes are from the Patient Channel, a 24-hour network piped free directly into hospital patient and waiting rooms.
General Electric Medical Systems, which began distributing the channel last fall, says the network is a source of "reliable, focused, and easy to understand" information that can help doctors and hospitals educate patients.
But to consumer groups and some doctors, it's nothing more than a marketing tool that delivers manipulative advertisements to a captive audience at a time of vulnerability. They've started a fight to turn off the channel.
"In effect, the Patient Channel turns the hospitals into hucksters for drugs," says Gary Ruskin of Commercial Alert, a nonprofit consumer activist group.
Currently, about 500 of the nation's 4,800 hospitals offer the Patient Channel. GE hopes to have it in 1,000 by the end of 2003.
Company spokesman Patrick Jarvis refutes critics, saying the channel offers "network quality" programs that provides up-to-date, balanced information to help patients learn more about their diagnoses. He notes there are three advisory boards consisting of experts in medicine, patient care, education, and ethics "to ensure the accuracy and appropriateness" of programming.
He initially referred to the advisory boards as "independent" but later acknowledged they were paid by GE. Still, he contends that doesn't alter their judgment. "They have already turned down certain advertisers," he says.
But that does not satisfy critics, who are growing in number as healthcare costs spiral up. A key driver is prescription-drug costs, which are rising even faster than overall medical inflation. And many experts blame that on what's known as direct-to-consumer (DTC) advertising - which the channel depends on for its operating expenses and profits.
Doctors, insurance companies, and health advocates contend it prompts patients to insist on new, costly drugs that may not be any more, or only slightly more, effective than older, less expensive drugs.
Take Plavix. At $3.22 a pill, it's been proved to be only slightly more effective in preventing heart attacks and strokes than regular aspirin, which is 4 cents a dose.
Add to that the notion of pushing the products right in patients' hospital rooms - during programs that doctors may recommend for "educational" purposes - and many in the medical profession think GE has taken commercialism too far.
"Ultimately, it's going to make patients trust doctors less," says Dr. Marcia Angell of Harvard Medical School in Boston.
Paul Wenske's experience with DTC didn't make him trust his doctors any less, but it did taint his view of DTC advertising.
Last fall, the consumer columnist for the Kansas City Star had a heart operation. Afterward, he was given Plavix along with aspirin. On his return home, he started feeling very tired. One morning, he fainted.
It turns out, he was one of a small percentage of people for whom combining Plavix and aspirin is considered potentially lethal. He went back to the hospital for an even longer stay.
"It's what the drug companies don't tell you in the ads that's the most dangerous," says Mr. Wenske.
GE argues that seeing such advertisements in a hospital setting is actually better than at home, because patients have access to doctors and nurses whom they can ask about the drugs.
Wenske sees the opposite problem. "Most people in the hospital don't have any other source of information," he says. "They can't go check the Internet to find out what to ask or how to verify that information."
GE's Jarvis points out that all the ads shown on the channel have gone through a review by the Food and Drug Administration (FDA). Right now, a patient watching the channel will be exposed to only 20 minutes of advertising in a 24-hour period. If advertising slots are fully sold, however, they could be seeing as much as nine minutes an hour.
He also insists the channel is not so much about the advertising, but about the programming - which is designed to help patients better care for themselves.
A study of prostate-cancer patients did find they were better educated about their diagnoses after watching a video about the problem. Mark Schlesinger of the Yale School of Public Health says the information was very problem-specific and did not include advertisements. It was shown in a doctor's office where patients could ask questions.
"Giving patients information that's interactive and problem-specific is very different from having it just randomly broadcast at them," he says. "You can't ask the television questions. That means the relative benefits of the Patient Channel versus its potential benefits goes way down."
The American Hospital Association (AHA) has not taken a stand on the Patient Channel and says it's up to each hospital's administrators to make such a decision.
"There is an enormous need for good, accurate educational information in hospitals," says the AHA's Rick Wade. "Having said that, patients and families come to the hospital in a very vulnerable state. It's extremely important for a hospital to examine whatever they provide to ensure it promotes curing and caring and doesn't upset people."