The first lawsuits are coming against Merck in wake of the Vioxx recall:

Nevels says her 34-year-old daughter, Shelly South, took Vioxx for 21/2 years before dying of a heart attack in November 2002. She claims Merck knew of the risks of Vioxx long before its announcement Thursday.

Also named in the suit is Dr. Waclaw Alex Dymek, the Carrollton physician who prescribed the drug to South. Nevels claims Dymek failed to diagnose the severity of her daughter’s heart condition and prescribed Vioxx despite her medical history.

Tough spot for the physician to be in. Today’s analysis in the Washington Post explains the pressure that physicians have to prescribe the latest medications – after all, medicine is becoming more of a customer service business:

. . . in a survey of 2,300 physicians that IMS conducted in 2001. It found that 52 percent of doctors were willing to write prescriptions for COX-2 inhibitors if patients requested them and needed painkillers.

“When a patient comes in and wants something, there is a desire to serve them,” said Wofsy, of the American College of Rheumatology. “There is a desire on the part of physicians, as there is on anyone else who provides service, to keep the customer happy.”

A large part of the blame can be placed on direct-to-consumer advertising:

Vioxx’s downfall is likely to spur other changes as well, experts said.

It may lead doctors and patients to take a fresh look at the consequences of direct-to-consumer advertising, the root of much of Vioxx’s enormous popularity in a field full of competing pain relievers.

Banning direct-to-consumer advertising would go a long way in preventing another debacle like Vioxx.