Friday, November 03, 2006

Lunchtime Medical Education

I think it's interesting that some medical schools are helping our medical students learn how to deal with the pharmaceutical sales rep pitches at lunchtime by "appealing to physicians' natural skepticism." But my skepticism meter registers more about the effectiveness of this teaching. I have been more impressed that there is usually little pitch offered by reps when they bring lunch: they seem just as happpy to take a break for lunch as those they're feeding. So any medical student or resident who lashes into a sales rep "nice" enough to bring in lunch would likely be perceived as impolite or cocky, wouldn't they? So will doctors really challenge the reps if they are perceived by their peers this way?

Even worse is when you're successful at poking a hole in one of the drug rep's claims (which is quite easy). Then the rep has an excuse to return to your office again with a "clarification" or literature search.

And then they're back again, aren't they. In your face.



Anonymous said...

these professors are full of crapola. there is plenty of medicine to learn during medical school. every hour they take for stupid stuff like this detracts from the quality of the medical education students receive.

the institutions and administrators are pandering to the press and the public, and it makes me sad, frankly. they need to focus more on the basics of what the students need.

i was assisting in a surgery a few months ago with a 4th year medical student (1 month prior to graduation). it was a cabg. this student was going to be a ct surgeon. as you know, the field of ct surgery has been decimated in recent years and has had trouble filling their training slots. i showed him the cxr to demonstrate the cardiomegaly. he thought it was the stomach. :(
now we can cut him some slack for being pimped but after 1 month on a ct surgery rotation he couldn't tell the heart on a cxr?

well, at least he'll know how to handle the pharma reps.

Anonymous said...

Are Drug Reps Really Necessary?

One of the main functions of pharmaceutical representatives is to provide free samples to doctor’s offices presently instead of authentic persuasion, and these samples in themselves cost billions to the pharmaceutical industry. Yet arguably, samples are the most influential tool in influencing the prescribing habit of a health care provider. Let me be clear on that point: Its samples, not a representative, who may be the top influencer of prescribing habits.

Yet considering that drug promotion cost overall is approaching 20 billion a year, combined with about 5 billion spent on drug reps themselves, what if there is another way for doctors to get free drug samples, which is what they desire for their patients to initiate various treatment regimens? What if prescribers could with great elation avoid drug reps entirely?
There is, actually, a way to do this, but it is limited. With some select, smaller pharma companies, doctors have the ability to order samples by printing order forms on line for certain medications through certain web sites associated with the manufacturers of these samples. Some examples are such medications that can be ordered in this way are keflex, extendryl, and allerx. Possibly several more can or are available to prescribers in this way. Others, however, cannot be acquired by this method.

So in some situations, a doctor can go on line, print off a sample order form, fax it into a designated fax number after completion of the form, and the samples are shipped directly to the doctor’s office with some products thanks to their manufacturers who provide this avenue. There is no review of the doctor’s prescribing habits. No embellishments from reps actually sounds pretty good.

Usually, this system is available for those smaller companies with very small sales forces to compensate for what may be vacant territories, but can be applied to any pharmaceutical company who, upon discretion, could implement such a system.

Now, why is this not done more often? Apparently, it is legal to obtain samples in this manner. If samples are the number one influencer of prescribing habits, why spend all the money on reps to deliver samples personally? It’s worth exploring, possibly, since the drug rep profession has evolved into those who become UPS in a nice suit.

Think of the money that could be saved if more pharma companies offered samples to doctors in this manner. Furthermore, additional benefits with this ideal system are that there is no interruption of the doctor’s practice. And again, there is no risk of bias presented to the doctor by a rep, as they would avoid contact with reps if they order samples through this way- to have the samples directly to be shipped to their office.

When samples are shipped to doctors’ offices in this manner, prescribing information of the particular med is included with the samples shipped. Doctors can order and utilize samples according to their discretion, and would be free of interference from the marketing elements of pharmaceutical corporations. Patients benefit when this occurs.
Considering the high costs associated with the pharmaceutical industry, having samples shipped directly to doctor’s offices should be utilized more than it is presently- regardless of the size of the pharmaceutical company.
Something to think about as one ponders cost savings regarding this issue.

“The new source of power is not money in the hands of a few but information in the hands of many.”
---- John Naisbitt

Dan Abshear