Wednesday, August 29, 2007

The Inside Scoop on Reps: Who's Right?

When I wrote HOOKED, I had the privilege of interviewing at length two now-medical-students, formerly drug reps, and talking more briefly with a third. Based on what they told me I devoted a chapter to the activities of a typical drug rep, including the training the rep receives and how the reps try to sell physicians on their products.

When I saw the article by Ahari and Fugh-Berman in PLoS Medicine, in which the first author describes his fomer career as a drug rep (see my posts on the article dated April 26, 2007), I was pleased to see a general confirmation of what I had written, along with additional details as to the precise psychological profiling techniques that reps use to size up each physician and to select the sales approach that works best for each.

Now, Kevin O'Reilly, writing in American Medical News, has dug out (rather belatedly one would think) the Ahari-Fugh-Berman paper, and provides a summary of their report along with denials from a couple of former drug reps. (I am quoted at the end of the article as supporting Ahari's account.)

The former reps who took issue with Ahari's characterization (I should add that Ahari has an MPH and is now doing health services research at UCSF) are:
  • Pam Marinko: "the very kind of thing that gives drug reps such a bad reputation"... Ahari "cherry-picked" certain sales practices and "served it all up in a negative light"..."It's absurd to suggest that a physician would make a prescribing decision based on whether he liked a drug rep."
  • Sarah Taylor: "My experience wasn't anything like that"

Just what do these former reps do today? Marinko is CEO of Proficient Learning LLC, a drug rep training firm in Wilmington, NC. Taylor is author of The Secrets of Successful Pharmaceutical Salespeople. I will let you decide whether those people sound suficiently free of bias to commment fairly on Ahari's allegations.

(Incidentally, another former drug rep, now an academic, who paints a picture of the rep business in terms very similar to Ahari's is Michael Oldani, now a professor of anthropology--see HOOKED for references to his publications.)

Just a nice extra touch--Marinko is so convinced that detailing is the best way for docs to get the latest drug information, that she refuses to go to any physician who has a won't-see-drug-reps policy. I wish her well.

O'Reilly K. Professional issues: Drug rep creates stir with details on tricks of his trade. American Medical News, Sept. 3, 2007.


Unknown said...

Here is a link to my AMNews story:

It should be publicly accessible for a couple of months yet. You're right that the story is belated, but don't you agree it was more than worth the wait?

Howard Brody said...

Kevin--thanks very much for leaving us the link. For sure, your comments and trenchant analysis were well worth waiting for! I think in the business world they call it "value added."

Anonymous said...

As a seasoned big pharma rep, the most successful process of influencing the prescribing habits, in it's simplest terms, is share and speak with honesty to the doctor consistently referring in some way on how your products could possibly and authentically benefit thier patients. Integrity wins every time in the long run.

Anonymous said...

For the sake of argument, let's agree that most doctors are fairly intelligent, for thier schooling, if nothing else.

Now, don't you think most doctors, unless they are green and fresh from school, are well aware that whatever you tell them is incomplete, at best?

It's about samples and inducements, and certainly not what a medical reps says to a doctor, in large part.