A patient came to me worried she was going to lose twenty-five pounds in the next month.
Even on tirzepatide, what would make her think that? She'd only lost five pounds in the first two months.
She said the marketing that brought her in had promised her thirty pounds in three months.
So I explained the truth: the body does not save up its losses and then spend them in a lump sum. Thirty was never a guarantee. It was never even a real number. The marketing was just trying to get the sale, but she had taken it literally, made it part of her reality, and now I was handing it back.
And her fear made sense. If someone told me I'd lose thirty pounds and I hadn't, I'd think something was wrong too.
The thirty pounds had not come from a doctor. No physician I know would promise a specific number of pounds by a specific date to a specific person they had never examined. We are trained out of that kind of certainty early, and for good reason; the body keeps humbling the people who make promises about it. It had been written by someone without a medical background. Someone focused and incentivized to make the sale, who had never met her and never would, who would not be on the call when the number she had been sold came due.
Who writes the promises patients believe?
As a physician who also advises on marketing, I have spent a few years now watching where these numbers get made, and I can tell you the room is always full. There are marketers, engineers, and people whose title is some version of "growth," all of them smart, most of them well-meaning, building something quickly. The room is often missing the one person whose name will end up on the chart.
So the team who decides what patients will see, won't know what many will take to heart. They build the intake form and ask the questions a company is comfortable asking, which are not always the questions a patient needs asked. They design the follow-up to treat a frightened patient on a new medication like a subscriber letting their membership lapse. None of these decisions are approached like a clinical decision. We, the physicians, not the marketers, are the ones who will sit on the other side of those words. Marketing creates a debt that will always come due. The question is whether we, physicians, can really pay it back.
As I said, I've been in a lot of these rooms, and I haven't always been on the "right" side. Early on, I took the telemedicine shifts that asked almost nothing of me. I followed the advice I was given. Be licensed in as many states as you can. Log in. Clear the queue. The visits came fast, most of them were a refill and a click, then onto the next one. I told myself I was just the prescriber. The patients could always reach out if they needed something; they rarely did. I was the most expensive and least scalable part of the operation, and it paid well. I knew I was providing a service they'd otherwise wait months for, so I kept doing it.
We are the ones who pay that debt. Which is why "just the prescriber" was never a neutral job: it was me agreeing to let someone else set the expectations I'd spend my day correcting. And it meant the patients who never thought to reach out, most of them, were left alone with whatever the marketing had told them.
How physicians can get into the marketing room
As physicians, we need to get into the marketing room earlier. Here are a few places to start.
1. Ask who writes the marketing claims made by telemedicine companies
Before you sign with a telemedicine company, ask the question: is there a clinician involved in how the marketing gets made? Not approving every line, but close enough to the work to catch the claim that crosses from bold into untrue. If there isn't one, offer to be that person. Most companies do not have one and have never thought to, and many will be glad you asked. The ones that wave you off have told you what kind of company they are.
2. Make the business case, not just the safety case
Business founders hear "compliance" as a wall. Something to get past. Or worse, a speed bump. A clinician who understands medicine uncovers marketing angles a marketer never finds: the real reason a patient hesitates, and the objection that can only be answered with medical knowledge. Honest expectations keep patients from quitting in week three. You are not in their way. You are the reason the honest claim outsells the inflated one, and the reason the advertising still works next quarter.
3. Brush up on the basics of marketing
You do not need an MBA to add value to marketing. You need four things, and you already have the first one.
Marketers call it the funnel. You know it as the path a patient takes: how a stranger first hears about a treatment, what convinces them it's worth trying, the intake form they fill out, the first consult, and whether they come back for the refill. You can advise on every step of it, because you have watched patients walk it. A marketer knows where people drop off. You know why.
The second is the handful of numbers the company lives and dies by: what it costs to get one patient in the door, what that patient is worth over time, how many of the people who reach out actually become patients, and how many are gone by week three. Learn those four and you can tell whether an idea is good or just loud.
The third is what the FTC and FDA actually police, enough to know when a claim has crossed from confident into untrue.
The fourth is translation: saying a clinical worry in language the room rewards. Not "this is misleading," but "this claim will drive refunds." Not "that's too aggressive," but "the honest version converts better." Same objection. One version gets heard.
None of it takes long. The basics can be learned in a few weeks; the rest you pick up on the job. And the fastest way is to ask. In years of doing this, I have never had a marketer snicker at a beginner's question. They are glad to teach, and once you've asked them something basic, they stop being afraid to ask you something basic about the medicine. That trade is the whole relationship. For a head start before the first meeting, read Simple Marketing for Smart People by Billy Broas.
The doctor who can say "conversion" and "compliance" in the same sentence gets invited back to the room. This is the part most of us were never taught, and the part worth learning.
4. Know when to walk away
If a company will not give you a voice in the decisions your license is responsible for, that is the answer, not the start of a negotiation. The willingness to leave is the only real leverage you have. Using it is sometimes the most clinical thing you can do.
The patient who was afraid of twenty-five pounds had a doctor to reach, more by luck than design. It shouldn't be luck. It should be someone in the room early enough that the number she was handed was true the first time.
FAQ: Physicians and marketing
Do physicians need an MBA to contribute to marketing? No. Four learnable basics cover most of it: the patient funnel (which physicians already know as the patient journey), the handful of numbers a company lives by, enough FTC and FDA fluency to spot an untrue claim, and translating clinical concerns into business language. The basics take a few weeks, not years.
What should a physician ask before signing with a telemedicine company? Whether a clinician is involved in how the marketing gets made, close enough to the work to catch claims that cross from bold into untrue. A company's reaction to that question tells you what kind of company it is.
Is being involved in marketing a compliance risk for physicians? The opposite. Physician review reduces regulatory risk: the FTC and FDA police health claims regardless of who writes them, and unsubstantiated outcome promises create legal exposure for the company and clinical fallout for the prescriber whose license sits behind the care.
Why do telehealth companies make exaggerated claims? Usually not malice. The people writing the claims have never met a patient and are paid on conversions. Without a clinician in the room, nobody flags that a "30 pounds in 3 months" promise is a debt the medical team will pay back in the exam room.
Pranay Parikh, MD, is a telemedicine physician licensed in all 50 states and DC and dual-boarded in internal and obesity medicine. He is part of the AIR Physician Academy community, which trains physicians to build fulfilling telemedicine careers and provides a supportive peer network. He also runs Off-Label Advertising, a physician-led marketing advisory for telehealth and health care growth teams.
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By: Pranay Parikh, MD
