tag:blogger.com,1999:blog-29955732.post116957480538563319..comments2024-03-01T04:58:03.785-05:00Comments on Doctor Anonymous: Drug Rep RantDr. Ahttp://www.blogger.com/profile/05207266669522973903noreply@blogger.comBlogger34125tag:blogger.com,1999:blog-29955732.post-36335733554029423332009-03-27T20:04:00.000-04:002009-03-27T20:04:00.000-04:00Complaining about it here while being unable to ha...Complaining about it here while being unable to have an honest, decent exchange with the rep about the items that won't make you prescribe his product is avoidant and passive to me. If you are bothered by the lunches, why cant you just say no to these lunches. And if you want your staff not to be deprived of those lunches, well then welcome the lunches and the conversation with the rep but to appear very accomodating, smiling, while seething inside shows your disorder in interpersonal dealings. Something to think about. Be real, that's all. Heck, I've had a lot of reps through but they know that their lunches are not our handshakes. They are merely business and social necessities of each other's trade. That's fine with me. But I make sure I am the doctor and be forthcoming and honest without being rude to the guy/gal who are just doing his/her job.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-81510907060499208102008-05-26T23:24:00.000-04:002008-05-26T23:24:00.000-04:00You Have Now Been Sampled (Drug Reps, Part 2)While...You Have Now Been Sampled (Drug Reps, Part 2)<BR/><BR/>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.<BR/><BR/>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. <BR/><BR/>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.<BR/><BR/> 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:<BR/><BR/>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.<BR/><BR/>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.<BR/><BR/>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.<BR/><BR/>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.<BR/><BR/>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. <BR/><BR/>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.<BR/><BR/>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.<BR/><BR/>“What you don’t do can be a destructive force.” --- Eleanor Roosevelt<BR/><BR/>Dan AbshearAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-89034768882801650152007-05-04T03:17:00.000-04:002007-05-04T03:17:00.000-04:00Clint, that is the biggest crock of hooha out ther...Clint, that is the biggest crock of hooha out there. The "busy doctor" argument is a worn-out chestnut. All I have to say is, I wouldn't be a very good doctor if my best source of information was a drug rep. That would be just pathetic.<BR/><BR/>Dr. Anonymous, I think you posted a reasonable narrative of a drug rep visit, and I have been there many times, my brother. Amen to you.Michael Benjaminhttps://www.blogger.com/profile/03466740474375411027noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-22055535687851447012007-04-19T14:30:00.000-04:002007-04-19T14:30:00.000-04:00It's interesting because I spent 14 years in the p...It's interesting because I spent 14 years in the pharmaceutical industry with many of those as a rep. I'm retired from the industry so I can comment as an outsider now. Yes, there are some pushy reps out there but there are also many (usually very experienced) reps who are not pushy. I was one of them. I always used my time with doctors to share published clinical studies with them. Many doctors just don't have the time to keep up with all the journals so I approached my job as to help them keep up to date with some studies they may have missed. This was usually much appreciated. So it just depends on the rep. Most of the doctors I dealt with welcomed me whether they used my company's products or not.Clinthttps://www.blogger.com/profile/04626245326767740798noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-16446566435778865182007-03-06T13:39:00.000-05:002007-03-06T13:39:00.000-05:00You are not doing anyone any favours by going to t...You are not doing anyone any favours by going to the luncheon as a 'courtesy' to the drug rep for providing the meal. I happen to be a drug rep but more importantly I'am a consumer. I hate to be sold and especially asked for a committment. How do I avoid this? I tell the rep. You would find less reps coming around providing lunch if you were honest with them about their products / therapeuic area. I have had doc's tell me they will not use my drug because it is just too difficult to dose and they don't have enough time in a day to explain the strategy to their patients. I get that. Im not there to make your lives anymore hectic than they already are. Im there to provide a service and if my service is not of value then I wont waste your time - but pls dont waste my time either. Some docs - especially GP's - have a 'know it all' attitude and shut down when a rep (who is clearly inferior in the eyes of MDs) is explaining the fundamentals of their product. Who else is going to provide you with up to date info? Journals? Colleagues? Doubtful - Take your head out of your ass and man up when you don't have any interest in the topic of the day. You will be doing yourself, the rep and your patients a huge favour.C.C.https://www.blogger.com/profile/01464439921015176317noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-63949791355301752752007-02-25T02:15:00.000-05:002007-02-25T02:15:00.000-05:00It's not about the food, or the push to prescribe,...It's not about the food, or the push to prescribe, it's about sharing information in an interactive environment. If you want a rep to shut up, tell them to shut up. Then share your concerns with them so they leave your meeting more informed. They will take your experience and insight to the next lunch. At the end of the day, or week, you can take or leave what a rep has to share. Hopefully, the information you get is worth a few minutes of attention. If not, at least you won't go away hungry. Just a thought from a rep who actually cares about you and your patients.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-25636321697758437192007-02-02T16:24:00.000-05:002007-02-02T16:24:00.000-05:00I must be in the minority. I have never been upse...I must be in the minority. I have never been upset by having a drug rep. visit. I think they try to be nonintrusive. Although most of the time they have not been great resources for knowledge I appreciate having samples to provide patients who are short of funds or coverage and especially like to try a medication and prove its value for that patient before I ask them to spend their hard earned cash on it.<br />The patient education matierials have also been a value. Recently, the patient information provided on the new vaccine gardasil has allowed me to give information that my patients can take home to review with their daughters and make an informed decision about either requesting the vaccine or waiting till they are older.<br />I don't feel obligated to use their products because of any promotional lunch and I believe they all understand that a pizza is not going to change how any physician directs care for their patients.kenhttps://www.blogger.com/profile/16003915643421992948noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-80040852083470684402007-02-01T17:43:00.000-05:002007-02-01T17:43:00.000-05:00I think that doctors are much more at fault for th...I think that doctors are much more at fault for the cost of rising health care. They cap the number of doctors in med school and residency to keep the cost high.<br />Uncap those med schools....let more doctors graduate and compete.<br /><br />As for sales people....sounds like you are a terrible sales person when it comes to selling the patient on taking his drug. Let's face it...we are ALL SALES PEOPLE.<br />A teacher sells education...study hard to children/parents.<br />A lawyer sells their service.<br />A taxi sells rides.<br />Everyone in America is envious of those that make money and doctor...your head is on the block now that you thrown away your human shield...the drug rep...<br />I will see your head rolling soon.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1170006105250909462007-01-28T12:41:00.000-05:002007-01-28T12:41:00.000-05:00As a pharmacy technician, and also as a friend of ...As a pharmacy technician, and also as a friend of a drug rep, I have conflicting opinions on this subject. I have sat through many a drug rep spiel. Most of the time it was just in one ear and out the other, while I wondered to myself if this rep had ANY idea what, exactly, their so-called "miracle" drug actually did. Do the drug reps really know what other treatment options are out there? Do they understand the differences between their product and the "competition"? I had a rep come in pushing Synthroid, of all things!!! I mean, come on. So when I mentioned something about levothyroxine (generic drug name of exact same above-mentioned drug) she gave me this blank look and asked me what that was!!!!<BR/>I do agree however, that drug reps do have their place if they are well-trained, well-informed and NOT ex-lawyers, ex-Arts grads, etc. It's sad that one of the only stipulations Pharmaceutical companies have for hiring drug reps is that they have graduated with a degree. They don't care WHAT degree. You could get a degree in "dog walking" and they would consider hiring you. I think the pharmaceutical companies need to re-think who they hire and get some knowledgable people instead of just the "hotties".Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169957336194264072007-01-27T23:08:00.000-05:002007-01-27T23:08:00.000-05:00the way the reps do it is by providing lunch for t...the way the reps do it is by providing lunch for the entire office, i.e. the nurses and secretaries too.<BR/><BR/>then if you tell the rep to f off, you're the bad guy and everyone hates you. fiendishly clever, really.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169862515731502612007-01-26T20:48:00.000-05:002007-01-26T20:48:00.000-05:00I hope you're not dissing the funky charts and gra...I hope you're not dissing the funky charts and graphs, as my life's work is to churn out the data to support them. I probably made the ones for the competing products, too. Amazing what you can do with data. ;)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169842123613277632007-01-26T15:08:00.000-05:002007-01-26T15:08:00.000-05:00If the drug rep causes this must internal angst, t...If the drug rep causes this must internal angst, tell the jerk that NO, you're not gonna have the free lunch today. Sorry, but to come online and sulk about it just doesn't make sense to me.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169785176275807452007-01-25T23:19:00.000-05:002007-01-25T23:19:00.000-05:00Wow! I had no idea that drug reps are that intrus...Wow! I had no idea that drug reps are that intrusive. It sure seems to pay well-- I teach criminal law at a law school, and a few of my students became drug reps instead of defense attorneys or prosecutors. I thought that was sad at the time, but now it seems even sadder.Mark Oslerhttps://www.blogger.com/profile/12260378085599864212noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169690474028031422007-01-24T21:01:00.000-05:002007-01-24T21:01:00.000-05:00Fortunately, I have a terrific MD (Internist) but ...Fortunately, I have a terrific MD (Internist) but because I've lost my job and my husband's insurance stinks we're going to have to switch to an HMO. Gasp!!! I guess I'll be going to Mexico along with my friend to obtain our meds because the price is sooooo high here.<BR/>I concur with the previous writer about Topamax ("Dope-a-max"). <BR/>Thanks for your blog and giving us an opportunity to see things from the other side of the stethoscope!<BR/>Blessings,<BR/>GracieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169683941310321532007-01-24T19:12:00.000-05:002007-01-24T19:12:00.000-05:00Cool blog. I hate sales reps, too.Cool blog. I hate sales reps, too.Dr. Snarkhttps://www.blogger.com/profile/13188090339975999512noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169678686194773012007-01-24T17:44:00.000-05:002007-01-24T17:44:00.000-05:00I'm not the first to notice: The funk is ovah!But ...I'm not the first to notice: The funk is ovah!<BR/><BR/>But I'd balk at sticking myself too.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169676667208186312007-01-24T17:11:00.000-05:002007-01-24T17:11:00.000-05:00As a person with type 2 diabetes, I currently have...As a person with type 2 diabetes, I currently have an AC1 of 5.1 ....WITH oral medications (not insulin). My doctor(a family practice doctor that I have seen for the past 20 yrs) knows my preference is to stay away from shots for as long as possible, but that I am also committed to staying healthy without complications even more. One day, as the disease progresses, I may have to consider other meds or shots to control my diabetes..but for now I dont...and for that I am thankful. In fact, he suggested that as I continue to loose weight, that we might consider just diet and exercise alone (without meds). Not everyone that has diabetes needs insulin right off the bat. Different things work for different people differently. There is a saying that "your mileage may vary" where treating diabetes is concerned. This certainly is true as what works for me might send someone else's blood glucose through the roof and vice versa. No one could convince me that a shot would be less painful and more convenient than the two pills I take twice a day. The only thing that would convince me insulin might be a better choice for me would be seeing my AC1 and daily numbers rise to an unacceptable level where my diabetes could not be controlled with just oral meds, diet and exercise. I would be offended if I was treated like a piece of meat when I went into the Dr's office...where it might be assumed that one size fits all in treating patients. Thankfully my Dr was sensitive to this and listened to me as he offered his expertise in treating me.Muddyhttps://www.blogger.com/profile/12029171822020331268noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169675636921977382007-01-24T16:53:00.000-05:002007-01-24T16:53:00.000-05:00I agree with the doctor,drug company's are greedy,...I agree with the doctor,drug company's are greedy,and so are the reps.As far as insulin goes,I wouldn't rush people that fear the needle. I would tell them to read diabetic magazine,so they can read,and learn about people that use the product,so they will feel more comfortable about insulin shots.Ive been on Insulin for almost 7-years now,for my type 2.<BR/>and that helped me into insulin shots. RobertAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169669951380537112007-01-24T15:19:00.000-05:002007-01-24T15:19:00.000-05:00Actually my sense is that federal funding for rese...Actually my sense is that federal funding for research has been declining and the privately funded studies by the drug companies are picking up this slack.<BR/><BR/>The free marketeers might see this as a good thing, but it's a little like allowing the fox to guard the henhouse, no? <BR/><BR/>You would be surprised at how the pharms pitch their products to the news media, even out here in Podunksville. They know my name; they have my phone number; they know my e-mail address. At various times they've sent me trinkets such as a pen shaped like a hypodermic needle, a snow globe containing faux drug capsules, etc. etc. The mind boggles at the waste of money.Pieces of Mindhttps://www.blogger.com/profile/14622621519712148952noreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169661561782770722007-01-24T12:59:00.000-05:002007-01-24T12:59:00.000-05:00It must be highly annoying sitting through all tha...It must be highly annoying sitting through all that thrice a week, I agree that pitching it to the patient is not quite so simple as pitching it to the doc.. Even when the reps are right.(most drugs-you gotta wonder about, they're probably not even as effective as older/proven ones) It's also kind of sad(to me,anyway) said patients' viewpoint regarding insulin injections(though common) maybe they need to see examples of people living a long + healthy life on it. I'm sure you have a few model diabetic patients you could use as examples.. Either that, or I can come over and knock some sense into their heads.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169659943845199202007-01-24T12:32:00.000-05:002007-01-24T12:32:00.000-05:00I don't know, I would sit through just about anyth...I don't know, I would sit through just about anything for a free lunch but I work in a non-profit and am broke. I should have gone to med school when I had the chance.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169657310579367972007-01-24T11:48:00.000-05:002007-01-24T11:48:00.000-05:00I enjoyed this post also. I can't really comment ...I enjoyed this post also. I can't really comment on the intricacies of the exact situation as I an not a doctor but I suppose this may be a place for you to practice your diplomacy skills?<BR/><BR/>I would think of the pharm. reps as tools. Use them for what you need and don't allow them to irritate you if you can.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169655945711322832007-01-24T11:25:00.000-05:002007-01-24T11:25:00.000-05:00I probably spend way too much time with the reps i...I probably spend way too much time with the reps in our office, especially if they bring lunch, but I have a canned response as soon as a rep pressures me to "try just one patient" on his/her product: "I am unable to predict the type of patient I'm going to see over the next several days, nor can I determine in advance if your product would be appropriate for my patient. So, no, I will not promise you that I will write for your product within the next several days -- or if at all. Thanks for lunch and your time." Smile graciously. The change from the discourse we had prior to the question is so obvious, even the most determined rep realizes he's crossed the line. That "hard sell" turns me off EVERY time. <BR/><BR/>Keep up the good work -- and don't be tense regarding those lunches 'cause you'll end up with indigestion!<BR/><BR/>AAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169650729910734372007-01-24T09:58:00.000-05:002007-01-24T09:58:00.000-05:00i used to sell different sorts of products before,...i used to sell different sorts of products before, so i can have allowance for school. money that i will never have if i don't sell anything.<BR/><BR/>it might piss other people off if i tell them about the products i sell, but i will never sell anything if i never tell anyone.<BR/><BR/>dr. A, i know where you're coming from, and i agree with why you are fuming mad at how insistent some reps are. to save you the trouble of feeling negative things about the rep, here's my unsolicited advise: you can try looking at the whole situation this way: they are just doing their jobs, because if they don't, they would be lousy employees, and will not make money that they need.<BR/><BR/>i know it takes a lot not to be rude to sales people, because really, why would we listen to someone tell us about something we don't like or need? but it wouldn't really hurt to just politely say no either. so you may be fuming mad, but at least you have the decency to be polite. that still makes you a good person. so, i think what i'm saying is: keep up the fake smile, with a real good intention. you are making one rep's life less miserable. you make a difference!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-29955732.post-1169643408842308592007-01-24T07:56:00.000-05:002007-01-24T07:56:00.000-05:00Dr. A. totally off topic but I wondered if you are...Dr. A. totally off topic but I wondered if you are having problems getting in to Bobby's site? I try and nothing. It's like it is completely gone! I was wondering if maybe he is having PC problems? <BR/><BR/>ThanksAnonymousnoreply@blogger.com