Drug Reps - Helpful or a Pain?
In my Blog about Chaos in the Medical Office, I received a few comments about pharmaceutical representatives that may have an impact on both the daily life of medical providers and patient flow.
Pharmaceutical representatives (hereto called drug reps) have a job. They are required to inform busy medical providers about new medications, new indications for old medications, and provide other educational services.
Yes, they are hocking their wares, but that is their business. Use my drug, not theirs. Mine is better. Mine is less expensive. Their drug causes explosive diarrhea and hair loss. Although they are trained to be respectful of our time, they are also judged by their bosses on how many practices they visit, and how this expensive market effort is working (based on the number of prescriptions that are filled in your local area).
Believe it or not, drug reps do provide some good information, and some excellent patient educational materials. I have some wonderful anatomical posters on my exam room walls, and some great handouts that the patients love. And, I do readily accept samples of my favorite medications. Samples, when properly used, are wonderful. I can give a patient a few days of medications to try it, or give them a day of samples when the pharmacies are closed.
Or, I can provide a full-course of therapy for a struggling family that does not have the resources to pay for their prescriptions. We have a store room filled with expensive infant formula, which I love to give out to needy parents during a well child visit. A can of formula will often save them the cost of their co-pay. Additionally, one pharmaceutical company even provides cases of a wonderful book called Caring for Your Baby - Birth to Year One that we distribute to all new parents, whether they use their formula or not. This is good stuff.
In the old days,drug reps wooed us with many more perks and giveaways that we now receive. Would I prefer an all-expense trip to a resort for a weekend seminar on hypertension, or some more ink pens?
Because of new pharmaceutical guidelines, those trips are now a thing of the past. I have drawers filled with HUNDREDS of ink pens that I do not use - including some cool ones that light up. I have note pads with every drug known to mankind, but yet I write phone numbers down on tongue depressors and paper towels. I have stuffed animals with Zithromax written on them that I give away to kids who have to have a painful procedure. I have a Viagra flower pot with a big 'ol penis-looking cactus poking up out of the soil (I love that). I have worthless paperweights, wind up noses, three-dimensional rectums, and stacks of literature that I do not read. I take some of those things to be nice. I was embarrassed one time when I was caught throwing some things the trash can when the rep returned to give me something else.
I used to work with a family Doc called Dean who absolutely was addicted to ANY pharmaceutical giveaway. Over the years, he collected thousands of eclectic drug rep toys, proudly displayed on his shelf (and now in his home, much to the horror of his wife). One day, I went out over lunch and bought a new blender. I took it out of the box to see if it was made of real stainless steel or not, testing it with one of the many drug advertising magnets that I had lying around. I was pleased to discover that the Augmentin magnet stuck to it.
When Dean returned from lunch, he immediately noticed the blender sitting on my desk WITH the Augmentin magnet. "Where did you get the blender?" Seeing a rare opportunity to jerk him around, I told him that the Augmentin Rep came by and gave us all blenders. Ticked that I didn't get him one, I relished in his efforts the rest of the afternoon trying to call the Rep to get his blender, too.
I can't tell you how difficult it was holding back the laughter when I overheard, "What do you mean you don't what I am talking about. The blenders that you gave the rest of the people!"
I will admit it here. I am a Sushi Whore. Regardless of the topic, I will attend ANY pharmaceutical-sponsored lecture held at my favorite Japanese Restaurant. I can wolf down hundreds of dollars of sashimi, specialty rolls, and sushi without hearing a word. I even sat through an erectile dysfunction lecture - a very important problem that I see in my pediatric practice (right!). I am not happy with myself about doing this, but I do love sushi, and my favorite kind is FREE sushi.
So, I accept nice posters, toys that I can give away to kids, pharmaceutical samples, a few selected ink pens, and yes...sushi, but I do not feel that I am influenced to change my practice style or pharmaceutical choices. If I like a drug, I prescribe it. If I don't, I won't. Simple as that. If I have a busy day with patients waiting, I do not devote even a minute, to spend time with the Reps. They see charts sticking in the doors and on my desk and they see me darting from room to room, and most (not all) while just say hello, and try and catch me next time. And, I will try and talk with them next time, if only for a few minutes. I may learn something.
Related Topics: Drug Industry Pledges New Openness, Heart Drug For Free Could Save Lives, Money
Pharmaceutical representatives (hereto called drug reps) have a job. They are required to inform busy medical providers about new medications, new indications for old medications, and provide other educational services.
Yes, they are hocking their wares, but that is their business. Use my drug, not theirs. Mine is better. Mine is less expensive. Their drug causes explosive diarrhea and hair loss. Although they are trained to be respectful of our time, they are also judged by their bosses on how many practices they visit, and how this expensive market effort is working (based on the number of prescriptions that are filled in your local area).
Believe it or not, drug reps do provide some good information, and some excellent patient educational materials. I have some wonderful anatomical posters on my exam room walls, and some great handouts that the patients love. And, I do readily accept samples of my favorite medications. Samples, when properly used, are wonderful. I can give a patient a few days of medications to try it, or give them a day of samples when the pharmacies are closed.
Or, I can provide a full-course of therapy for a struggling family that does not have the resources to pay for their prescriptions. We have a store room filled with expensive infant formula, which I love to give out to needy parents during a well child visit. A can of formula will often save them the cost of their co-pay. Additionally, one pharmaceutical company even provides cases of a wonderful book called Caring for Your Baby - Birth to Year One that we distribute to all new parents, whether they use their formula or not. This is good stuff.
In the old days,drug reps wooed us with many more perks and giveaways that we now receive. Would I prefer an all-expense trip to a resort for a weekend seminar on hypertension, or some more ink pens?
Because of new pharmaceutical guidelines, those trips are now a thing of the past. I have drawers filled with HUNDREDS of ink pens that I do not use - including some cool ones that light up. I have note pads with every drug known to mankind, but yet I write phone numbers down on tongue depressors and paper towels. I have stuffed animals with Zithromax written on them that I give away to kids who have to have a painful procedure. I have a Viagra flower pot with a big 'ol penis-looking cactus poking up out of the soil (I love that). I have worthless paperweights, wind up noses, three-dimensional rectums, and stacks of literature that I do not read. I take some of those things to be nice. I was embarrassed one time when I was caught throwing some things the trash can when the rep returned to give me something else.
I used to work with a family Doc called Dean who absolutely was addicted to ANY pharmaceutical giveaway. Over the years, he collected thousands of eclectic drug rep toys, proudly displayed on his shelf (and now in his home, much to the horror of his wife). One day, I went out over lunch and bought a new blender. I took it out of the box to see if it was made of real stainless steel or not, testing it with one of the many drug advertising magnets that I had lying around. I was pleased to discover that the Augmentin magnet stuck to it.
When Dean returned from lunch, he immediately noticed the blender sitting on my desk WITH the Augmentin magnet. "Where did you get the blender?" Seeing a rare opportunity to jerk him around, I told him that the Augmentin Rep came by and gave us all blenders. Ticked that I didn't get him one, I relished in his efforts the rest of the afternoon trying to call the Rep to get his blender, too.
I can't tell you how difficult it was holding back the laughter when I overheard, "What do you mean you don't what I am talking about. The blenders that you gave the rest of the people!"
I will admit it here. I am a Sushi Whore. Regardless of the topic, I will attend ANY pharmaceutical-sponsored lecture held at my favorite Japanese Restaurant. I can wolf down hundreds of dollars of sashimi, specialty rolls, and sushi without hearing a word. I even sat through an erectile dysfunction lecture - a very important problem that I see in my pediatric practice (right!). I am not happy with myself about doing this, but I do love sushi, and my favorite kind is FREE sushi.
So, I accept nice posters, toys that I can give away to kids, pharmaceutical samples, a few selected ink pens, and yes...sushi, but I do not feel that I am influenced to change my practice style or pharmaceutical choices. If I like a drug, I prescribe it. If I don't, I won't. Simple as that. If I have a busy day with patients waiting, I do not devote even a minute, to spend time with the Reps. They see charts sticking in the doors and on my desk and they see me darting from room to room, and most (not all) while just say hello, and try and catch me next time. And, I will try and talk with them next time, if only for a few minutes. I may learn something.
Related Topics: Drug Industry Pledges New Openness, Heart Drug For Free Could Save Lives, Money
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4 Comments:
I am a 55y/o female diagnosed with mono 3 weeks ago. I never had a sore throat or swollen glands, nor a high fever.
what I do have is low stamina, and a headache (frontal and occipital) which responds somewhat to ibuprofen.
I am nervous about how long these sx will last, and when I can start to live normally again (cook meals, return to work as an advice nurse).
What can you tell me to encouage me.
Thank you very much
Dear anonymous,
To ask specific medical questions, please visit our General Health message board.
Thank you.
i havae the same thing. it is depressing. i just want to feel normal again. i am a substitute teacher and can't work. thank god i have another income right now, but i need to work too. this is the worst thing i ever had
While the pharmaceutical industry’s image and reputation has suffered, and has been complicated with their declining profits due to a few reasons, these companies still apparently insist on keeping most of their gift- givers on board. Known presently as simply drug reps today, this job has become a vocation void of a sense of accomplishment, which will be described below.
So they may be named at times in different ways, these promoters will be referred to as drug reps, which number close to 100,000 in the U.S. presently, it is believed. The cost to the pharmaceutical industry of these employees is around 5 billion dollars a year. Income for each rep grosses close to or above 100,000 grand a year on average, along with great benefits and a company car, as well as stock options as they gladly work from their homes.
The main function these days of drug reps, I believe, is primarily to offer doctors various types of inducements of a certain value. The drug sampling of doctors may be considered an inducement, and a rather valuable one for the drug rep, as many believe that these samples are what ultimately influence the doctor’s prescribing habits over anything else, including statements from drug reps. This may be why the drug industry spends around 20 billion every year on samples.
While historically drug reps have used their persuasive abilities to influence the prescribing habits of doctors in an honest and ethical manner. However presently, most health care providers now simply refuse to speak with them, or have banned all drug reps permanently from their practices for a number of reasons, including the recommendations from their colleagues. It is possible that this may be due to the following reasons:
1. The doctors lose money. Doctors are normally busy, so their time is valuable. As a drug rep, you are a waste of their time. Yet they will accept your samples still. The credibility you possibly have as a rep is not considered anymore to be present in your vocation due to various controversies associated with the pharmaceutical industry, it is speculated.
2. Most drug reps in the U.S. are hired for their looks and their personality. As a result, many are somewhat ignorant in regards to anything that is clinically relevant to a medical practice, so doctors seem to know this and have responded in such ways. Most drug reps have college degrees that do not correlate with their profession as a drug rep, which is to say that the clinical training of drug reps is limited. In fact, many consider this of such a serious nature that an Act is presently being considered called the SafeRx Act that would certify pharmaceutical reps, and this would be mandatory. One main reason would be to ensure personal accountability for their tactics and statements, I believe, which may improve the quality and safety of their function in the medical community.
3. Many drug reps, it is believed, are void of any ethical considerations due to ignorance of what they are coerced to do or say to prescribers by their employer, and this allows them to embellish the benefits of their promoted products at times in addition to offering inducements to doctors. This is usually due to the rep being unaware of the consequences of their actions at times, yet at other times what reps say is with premeditated intent for potential financial gain for such a drug rep. Worse yet, due to pressure to keep their high-paying jobs, they always are anxious to please their superiors, who require them to offer various types of inducements to physicians that are designated targets of a particular drug company. Such tactics are especially true with the larger drug companies. These reps are in fact coerced to spend these individual promotional budgets assigned to them by their employer. While legally risky, the drug companies continue to dispense to their reps these large budgets reps have been forced to be responsible for dispensing, and are required to spend these budgets. In fact, so much emphasis is placed on this promotional spending, there seems to be an association between the money a rep spends and the progression that occurs with their career working for their pharmaceutical employer. Disclosure laws are being considered presently to mandate the release of all funds dispensed from pharmaceutical companies, which is to say to allow others to see where their money goes and who it goes to, as it is presently very secretive, overall. It is not unusual for a big drug rep to spend 50 thousand dollars a year for clinic lunches alone. In addition, drug reps hire doctors as speakers for certain disease states, and they find many other ways to spend this money they are required to spend.
4. Another issue is what is referred to as data mining. The American Medical Association sells this prescribing data on individual doctors to pharmaceutical companies, which allows them to track the scripts a doctor writes, and the data is free of the patient names. Yet the names the products prescribed are well illustrated and available to the drug reps. This allows reps to tailor their tactical approach with any given doctor, if they see the doctor at all during an office visit. Worse yet, doctors who greatly support the promoted products determined by this data allow reps to reward those doctors who favor the rep’s products that they promote, and this could be considered a form of quid pro quo. Laws are being considered presently to prevent this practice of allowing reps to have this data. Doctors are opposed to the data the reps have as well about them for privacy and deceptive reasons, so they say.
5. Overall, reps can be best described as far as their function goes with their profession is to, whenever possible, manipulate doctors with remuneration or other forms of inducements, as they also continue to sample such doctors along with others their promoted meds. Also, frequent lunches are in fact bought often for doctors’ offices and their staff as a method of access, primarily, as stated earlier with the money reps spend earlier for this type of function. Essentially, because of the income and benefits the drug reps receive that they would likely not be able to obtain with any other job, they are compelled to do such unethical if not illegal tactics mentioned earlier that they perhaps normally would not do in another setting.
Usually these drug reps rarely refuse to implement such tactics encouraged to them by their employers.
6. Samples keep the prescriber from selecting what may be their preferred choice of med due to cost savings from samples left with a medical office by a drug rep. In addition, doctors are now being paid by prescription providers, which are called pharmacy benefit managers (PBMs) that are typically owned by a managed care company to have a doctor switch their patients to generic substitutes, if they exist, and this is often not disclosed to such patients. Apparently, these PBM companies are doing this in response to the activities of the branded drug companies, as they continue pay doctors often for various reasons, which are questionable in themselves.
It is likely that most drug reps are good and intelligent people who unfortunately are coerced to do things that may be considered corruptive to others in order to maintain their employment, ultimately. It seems that external regulation is necessary to prevent the drug companies from allowing the autonomy of drug reps that exists, with their encouragement, which forces the reps to do the wrong thing for the medical community, possibly. Clearly, greed has replaced ethics with this element of the health care system, which is the pharmaceutical industry, as illustrated with what occurs within these companies. However, reversing this misguided focus of drug companies is not impossible if the right action is taken for the benefit of public health. Likely, if there are no drug reps, there is no one to employ such tactics mentioned earlier. Because authentically educating doctors does not appear to be the reason for their vocation. This is far from being the responsibility of a pharmaceutical sales representative.
“What you don’t do can be a destructive force.” --- Eleanor Roosevelt
Dan Abshear
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