A physician e-mails me his thoughts on drug rep detailing:
I have been thinking about the drug rep thing. I see them. I eat their lunch and I shake them down for enormous quantities of samples. I try to play their arguments off against each other and I treat them decently.I also send every patient for whom I write a new prescription home with a trial (one to four weeks worth of everything I can). Nobody hates anything more than buying a months worth of a statin (whether it is $10 or $100) and being told to ditch it a week later. I also give them as many samples at each return visit as I can.
I figure that I decrease the cost of prescription drugs by from 10 to 30% for my patients. I also get a starting point to evaluate drugs that I might not have otherwise . . . I read their journal handouts and then try to look for the holes. I insist that my medical students accompany me to the dinners so that on the way back we can try to dissect the speaker’s points and prejudices.
Avoiding the drug companies and their advertisements is not the answer.
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{ 2 comments }
I dont think that avoiding them should be enforced by regulators, but it is the answer for some. I think that is an individual decision. What is clearly irresponsible is to consider them a sufficient and reliable source of information.
If you have the time to go to presentations that you know you have to dissect with a detailed knowledge of the drugs, then fine. My time is too valuable for that (well, ok maybe not, I am surfing blogs afterall).
The problem I had with samples was that I discovered that giving them to the people who asked for them meant they went to the most entitled, not the neediest. Once I set my mind to targeting the samples to the needy, I found it was more effective to use the pharmaceutical assistance programs–and I didn’t have to beg drug reps.
There are times when you can simultaneously give the patient a benefit from the samples and also not necessarily play into the drug reps hands.
Like giving the patient samples of something that also comes in a similar version but is cheaper; you try them out on the Brand, prescribe the generic-very-similar drug.
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