Direct to consumer adds are particularly troubling when they are for products that require expert knowledge—like pharmaceutical drugs. When DTC ads are reinforced with pharmaceutical payments to doctors who are pushing them, I believe this is a question of ethics. Unapproved drugs continue to be marketed to consumers, including OTC, and even H1N1 products that have no efficacy whatsoever. These three talking points do demonstrate why we should think about changing DTC ads, or any type of aggressive marketing of pharmaceuticals. All drugs should be approved prior to marketing, and full-disclosure should be made to physician, and consumer alike. I do disagree with ‘off label’ uses, as I think this is a source of ethical compromise. Instead, if there is a legitimate ‘off label’ use, then the drug should be put through the same testing as it was for the primary use of the drug. I was able to visit https://openpaymentsdata.cms.gov and I found out that one of my Grandmother’s doctors has been receiving over 10k every year, except last year, when he received over 17k. This is contrasted to one of my doctors, who received $24.01 for the year of 2016. I would highly recommend everyone use this website to search for their doctor. Getting rid of the ACA would also remove this resource in addition to many others, and this website provides accountability for our doctors. Accountability and information are the first steps we can take as a public health solution. Perhaps in addition to this website, doctors must post how much they have received from pharmaceutical companies right next to their diploma. Finally, I don’t think DTC pharmaceutical ads should be legal, especially when many aren’t approved.