What’s Missing In Our Office?

 

Remember the last few times you went to see your

doctor? Did you happen to notice one or more

nicely dressed people with a black rolling suitcase

waiting to see the doctor, but were not there as

patients?  Well, this is your friendly local pharmaceutical

representative.  He or she is there to see the doctor, but usually without an appointment.  Yet, like you, they only want a “few minutes” of your doctor’s time, not to request his medical advice, but, according to them, to impart the “latest information and updates” on their company’s products, which the doctor just can’t do without. As a nice perk, they usually bring along “gifts”, or pharmaceutical paraphernalia along with free trial size samples that the doctor can dispense to his patients. They also leave behind nice color pamphlets or brochures for you to read.  Marketing studies have shown that the more patients read and hear about a medication the more likely patients are to ask about these medications from their doctors.

 

Like most doctor’s offices, we used to welcome these “drug reps” to our office, mostly so that we can have free samples handy for patients to “try before buying”. But a few years ago, after we analyzed the dynamics of having the pharmaceutical representatives come to our office, we decided to go cold turkey, and placed a general prohibition of drug reps in our office. At the same time, I’ve also stopped attending drug company sponsored dinners and events.

 

Firstly, what we realized was that a few minutes here and there does add up to a lot of time during the day.  Three to ten minutes given to a drug rep means time taken away from patients care both from our staff and the doctor. Secondly, the paraphernalia left behind was cluttering up our office, and making it a vehicle for pharmaceutical advertising.

 

Lastly, study after study shows that doctors are heavily influenced by pharmaceutical marketing—in particular, the company representative’s “detailing” visits.  In 2002, pharmaceutical companies spent $21billion on promotional drug spending, and in 2000, $2.5 billion on direct to consumer advertising. In 1995, the total number of research and marketing jobs in the pharmaceutical industry was about the same (55,000 to 49,000 respectively), but by 2000, the number of marketing jobs doubled (87,000) while jobs in pharmaceutical research decreased to 48,000.  In a recent year, the Fortune 500 drug companies spent 30% of revenues on marketing and administration vs. 12% on research and development.

 

As a result of our new policy, we do not have any drug samples to offer our patients.  Regardless of the convenience of taking samples that the doctor give you, there is one clear motive by the pharmaceutical industry to give out millions of dollars of free drug samples:  To entice doctors and patients to use more of their medications, regardless of the cost.  

 

Doctors are humans too, and are easily swayed by which representative was in the office last, or who took them out for a nice dinner.  I used to think that I could be objective in my prescribing habits, but after a few months’ analysis on my prescribing habits, I realized that I too could be swayed by how often then reps come to the office or who takes me out to dinner.  

 

Of course, I can’t avoid pharmaceutical company events altogether, as many of our major educational conferences and meetings are sponsored by multiple pharmaceutical companies.  But I can do my part to keep these events to a minimum.  Now the only way for me to keep up with the latest information regarding medications is via the old fashioned way:  I read about it in my medical journals.