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No More Gifts From Drug Companies To Doctors. About Time!

What caught my eye about this story from the Houston Chronicle was the subtitle:

Voluntary rules cut out free gifts
sales reps use to influence physicians

The story lead: “The Pharmaceutical Research and Manufacturers of America, the major lobbying group for drug companies including Merck, Pfizer and Bristol-Myers Squibb, enacted new rules governing how sales representatives in the field can interact with physicians.”

This isn’t really news.  This new position has been developing for quite some time.  In fact, The Hospital of the University of Pennsylvania (HUP) banned gifts to doctors of any size, including free meals, back in 2006.  They aren’t alone.

Drug salespeople are under real scrutiny.  I suspect that will increase with the incoming Obama administration.  That’s good.

Many doctors have had issues for years with the tactics of drug reps, not to mention the sheer number of them.  A while back,  WSJ columnist Benjamin Brewer, a family practice doctor in Forrest, Ill., decided he would no longer see drug sales reps in his office.  One of his many complaints was that drug companies sent multiple reps to his office pushing the same drugs, hoping one of them would succeed.

I just spoke with a nurse practitioner who is in a private practice in a group with a number of doctors.  She has only received one gift from a drug rep: a textbook.  Drug reps had been providing educational lunches at her practice.  She believes that there are doctors who would prescribe drugs based upon what they might have received in gifts or favors or other freebies from drug reps.  She’s not happy about that.

One of my former doctors (before I moved),  knowing I was in sales, complained bitterly about the drug sales reps.  He described them as ill-prepared, pushy, often arrogant, and far too plentiful.  Understand that’s only one doctor’s opinion.  I’m not painting all pharmaceutical sales reps with one broad brush.  In fact, I see that the problem is with the system, not with them.

What is the issue here?  Two words come immediately to mind.  Distrust and bribery.  And the reps are in the middle.

Would a doctor really prescribe a drug that she “favors” because of unfair influence by a drug salesperson?  With more than 800,000 doctors in the U.S. (according to USA Today), you can be sure some of them do, even if only a handful.   Those few docs and their drug company co-conspirators will probably tell you there is a firewall between what gifts the docs receive (they’re small anyway, they’d say) and what drugs those docs prescribe for their patients.  Here’s a question:  So why do it?

I’m an HMO-card-carrying participant in the system.  I don’t want any doctor who treats me or anyone I care about being “influenced” by anything but the right thing for the patient.  Influence doctors through your knowledge, experience, insight and trust. No gifts, no freebies, no more.

Cartoon credit: Pennsylvania Gazette (Click on image).

UPDATE: I sent my own doctor a link to this blog post.  I received this email response.  For privacy, I only removed identifying text which I replaced with ellipses (…) :

I have never seen a drug rep nor taken a gift. When we started the Department of … at … in 19.., I stepped up and would not let the residents be exposed to drug reps. We took no freebies. There are good studies that show the prescribing practices of doctors and doctors-in-training are influenced when they are exposed to free meals and talks by drug reps or their representatives. The other departments at … thought we were crazy to not take the free lunches and agree to pay for lunch out of our dept budget. It was a great coup when the whole med school went drug rep/freebie free. …

I think the $ should go to lower the price of drugs for all. I think doctors should learn their medicine from our most reputable journals that are tightly peer reviewed. Drug companies wouldn’t put so much $ into it if freebies and reps did not “pay off”.

Anyhow, you can see it is a pet issue for me.

And for me as well, doc!


2 Responses

  1. Dave,

    I’ve been meaning to comment on this post for a few days so sorry for the delay.

    This is a really interesting issue as aside from the ethical issues you raise, it strikes right at the heart of one of the issues holding back sales from being considered a true profession. I’ve often wondered why pharma sales reps were held in such high regard when they had access to a (seemingly) bottomless pit of freebies.

    Two points though give me hope that the tide is turning. Firstly, I was at the Selling Power Sales Leadership conference in Las Vegas in March last year where Gerhard interviewed Fred Hassan, the CEO of Schering Plough. This was a great interview as Fred spoke at length about his efforts to clean up the ethical issues within the business starting with his sales group. I was amazed at how open and upfront Fred was about the ethical challenges he faced and his determination to change the culture. The culture reference resonated with me as he clearly understood that the rot had to stop and the culture had to change.

    Secondly, a close friend of mine is the Australian MD for a US medical device manufacturer (a US billion dollar company). We talk at length about sales leadership and last year he outlined to me the steps he’d taken within his business to tackle this issue. He was the first Australian medical/pharma company to set standards well beyond the self-regulated standards the industry had set. I was amazed at the stance his company had taken as it bought his reps back to the type of reward standards that other industries live by (i.e. very small gifts, a very low tolerance of entertainment).

    Hopefully more companies like the ones I’m familiar with and those that you mention and lead the medical/pharma industry into a better, more respected place.



    • Mark, thanks for the time and thought you invested in your comment to my post. I’ve encouraged by the move last week, your comments and those of the health care professionals I interviewed.

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