Editor's Corner

I am swayed by both sides of the argument. I guess the truth is somewhere in the middle. I have benefited from the sample medications left behind and I strongly beleive some medications are pushed because of obligations to the reps representing those companies. Patients just want to be properly cared for and have confidence that the people giving that care really want to see them well.

You are naive if you think that drug prices will decrease just by eliminating inducements, however you may interpret that word, to physicians. The pharmaceutical companies still need to sell their product and will spend the marketing dollar some other way. It will not be invested instead in reduced pricing or R&D for that matter.

As an ex-BMS executive and current consultant to the pharmaceutical industry, I'm aware of the pros and cons of this debate. Recently a pulmonologist in Salt Lake City told me that one of the companies has assigned four salespeople to call on her representing the same drug. She explained that the only reason she puts up with it is to obtain a greater quantity of samples to give to her needy patients.

"Recently a pulmonologist in Salt Lake City told me that one of the companies has assigned four salespeople to call on her representing the same drug."

Big pharma is a victim of its own doing. Providers have been hammered by too many cloned reps who share the same product (pods). Thus, providers with limited time have begged off. Big pharma reps have become faceless chess pieces in a revolving door, which has produced the loss of credibility and rapport.

The pressure on reps to see a quota of docs per day is enormous and often the only way into the office is through an inducement. The ethical docs quickly become apparant as they do not require this bar to entry.
So, we see the ethical docs to get the business (a small number) and need the inducements to see the others, in order to keep the management of our companies happy with our quotas.

The benefit to the pharma industry will be a decrease in costs and an increase in profits. They will get their message out anyway. I am retired now, but I bristle at the thought that free samples left for me to distribute to poor patients, or an office lunch so that a rep might have our ears for 5 minutes, or a pharma sponsored meeting where a trusted colleague could share his or her experience, would influence a doctor to prescribe a medication deemed unworthy of being prescribed. No wonder the best and brightest are no longer going into medicine. They are taking away our income, our prestige, and now accusing us of vulnerability to the point of stupidity. Get off our backs and let us be doctors.

Having been a sales rep in the industry, I see a true benefit to the institution and to the provider by interacting with the sales rep. A LOT of you are set in your ways and are unwilling to shift your paradigm without help and encouragement. I have had multiple customers thank me after the fact because our business relationship enabled them to improve outcomes, save their healthcare system money, be more efficient with Medicaid money, etc. Physicians, PAs, NPs, etc. are like everyone else in that everyone gets into habits and they need help to change and grow.
There are unethical sales reps and unethical HCPs, but they are not the majority of either population. To assume that a sales rep is only in the office/hospital to get what they can from the customer, is just as foolish as assuming that one can change a physician's prescribing habits by handing them a pen or a PDR or buying them dinner. I see the meals, office visits, etc. as a means to an end - to get in front of the provider and present the merits of my case. I make a special effort to bring something new and useful and not bombard offices with 3-4 vists a month. The physician then has an opportunity to interact with the facts, to "throw my words up against the wall and see what sticks", and then make an informed decision.
I also find it ironic that many academic centers want nothing to do with the individual sales rep unless he/she has a grant check in hand. You (Duke, Stanford, MIT, UPMC, etc.) want it both ways where you expect all the benefits of interacting with the representatives of the company, e.g. the sales reps, without actually having to talk with them.
This can and should be viewed as a partnership, not a means to leverage the most out of the other party. We help you (physicians) get published, to get the word out about your issues and concerns, we fund your research (to a staggeringly larger percentage than the NIH or any other public money), we sponsor your conventions in San Francisco and Hilton Head. Why can't you spend a couple minutes with me to hear about the products I represent?
I hope I don't come across as too antagonistic. I respect the medical field greatly, and I have been a patient as well as a sales rep. I have a family to provide for like most of my doctors do. Can we not OVERREACT and OVERCOMPENSATE and find a middle ground?

Why do doctors get the benefit...their are others in the office, nurses, secretaries, lab, etc. It is a poor practice and the rich just get richer!