Today we will talk about an interesting issue of health care sector which somehow skips our eye many a times. Yes talking about the drug company representatives (referred as ‘reps’ in this writing) who visit doctors office to advertise their products. Let me start with a story I came across during my practice experiences. It was the early days in my medical practice life, as a young doctor just started functioning and was quite innocent about the behind screen culture of drug company representatives vs. doctors.
I regularly encountered about 10-12 reps a day and the first illusion I use to get is, they seemed to be extremely knowledgeable persons by their dressing outfits, style of speaking and professional courtesy (although they may be knowledgeable don’t want to argue on that).
Each of the reps generally used to speak a minute or more about their products. Finally when they are done they will leave some leaflets (of expensive print quality) about their product so that we can refer later and prescribe. After the leaflet comes the most delicious part, a gift which ranges from a small pen to a car or freeze or a fortnight trip to Switzerland and in future they might offer doctors a space travel too (since space travel is getting easy these days). Although I don’t support this culture of giving gifts but when you are gifted it pours in some greed at least in the unconscious mind.
But if we try thinking from where the drug company will make out the money it spends for advertising and giving gifts to doctors, obviously not from their pocket rather from the consumers wallet who have to pay more while buying drugs for these luxurious offers to doctors made by the drug companies.
While writing this article another issue bubbling in my mind are the ‘middlemen’ (not sure if the wording is correct) found in hospital settings and how they work. You may not know but such also exist, I remember one such middleman I came across who was well oriented with what type of patients visit a doctor’s office daily. I found him requesting a doctor to order CAT scan to all patients who come with the complain of headache even it might not be needed; generally people take headaches seriously since many fears that they might have a brain tumor and easily agrees to get a CAT scan and for every CAT scan the doctor orders the middleman will give a share to the doctor. Although that doctor denied the offer not sure if every doctor does the same. There are many other types of middlemen related to medical profession and mostly found in developing world, since today we are focusing on the reps lets not talk more about middlemen to stay on track.
Coming back to the medical reps issue, we already talked about the gift part now lets focus on what about their claims or information they share with the doctor. Starting with my own experience, they deliberately try putting certain words I found in their speech to appear stunningly appealing and convincing to the doctor, following are some examples of such words- ’evidence based medicine’, ‘randomized control trial’, ‘sensitivity’, ‘specificity’, ‘positive predictive value’, ‘double blind’ and so on. Although not necessarily they understand all the words they say; rather they might be trained to speak the language the doctors like to listen or understands better.
It’s not completely true that they don’t inform the doctor with correct information, but they might not be sharing the COMPLETE information about their product. Based on my experience while encountering medical reps myself or in other doctor’s office they almost never spoke a single line about the adverse side effects of a drug they are speaking about. However, one can argue that this author’s experiences can be too individual specific but various news and studies found across the web too suggest similar trends (check this- http://www.everydayhealth.com/healthy-living/pharmaceutical-reps-often-fail-to-inform-docs-of-drug-side-effects-7437.aspx). However, I don’t think its the drug rep’s who should be blamed alone may be they have no other way besides following their host company’s training and instruction guidelines about the marketing and presentation methods to doctors.
Nevertheless, I will conclude this post with a hope that practice and conducts of medical reps will be tailored for the betterment of mankind based on truth rather than the deliberate displays of business stunts. People should raise voice to compel the government’s to bring in bills to protect the basic human rights of health and wellness of their citizen.