Saturday, November 10, 2007

Looking Over the Shoulders of the Drug Reps: Who Are They?

Some colleagues of mine on the Healthy Skepticism listserv have lately been commenting on some postings on the "Cafe Pharma" blog (warning: it's at least PG-13 if not R):

I am not sure just how this changes over time; but when I logged on, the discussion thread had to do with some reps sharing stories of how they had deliberately contaminated the food they brought into physicians' offices to "get even" with various people who gave them a hard time or who did not value their services. Others took issue with such behavior. One resident, who maintains his own blog, wrote to say that now he had yet another reason not to take any food from reps, thereby setting off a torrent of abuse from the reps directed at the resident, replete with suggestions as to with whom his wife was sleeping when he was on duty.

I was guided to this blog one time before by an in-the-know acquaintance, and after 10 minutes of reading gave up in disgust. I chose at that time not to mention this blog or its contents in any of my writing on ethics and the industry, as it seemed way too cheap a shot to take at the reps as a group.

On this occasion as I read the postings I am struck by the range. Some of the reps seem thoughtful and decent and trying to maintain integrity. Others are embarrassingly juvenile, obscene, and just plain mean in their postings.

I have tried hard in my own work never to villainize reps. As I see it, reps have an impossible job. From the company's point of view, they have one function only, to move product. I ask at every opportunity for someone to tell me about a single rep who was ever paid a single bonus for anything other than quantity of drug sales--and no one has ever given me an example.

The other part of their job is to lie about this. They have to lie to two people. First they have to lie to us, because we demand it. We will not easily and comfortably take all the goodies they shove our way, unless they keep repeating over to us the soothing rationalization, "It's education, not marketing." Second they often have to lie to themselves because they can live with themselves much easier if they can see themselves as educators and not as mere salespeople. Or at least they can lie to us more glibly if they lie to themselves first.

In one respect, I can concur completely with the blog postings, as much as I am repulsed by the packaging. If I sort through the obscenities, one basic idea seems to stand out. These reps despise docs and office staff who first scarf up their food and other goodies whenever they get the chance, and then believe that they can turn around the treat the reps who brought the stuff like dirt.

I agree totally. Whether that means it's ethical to deliberately sneeze in their lasagna is an issue we can take up at another time.


Anonymous said...

You should remember that the pharma companies themselves likely have PR people to monitor and "seed" these boards with their own views under guise of 'anonymous' reps. This is known as 'managing the narrative.'

I believe they also monitor the financial boards that allow comments such as yahoo finance. A former co-worker in PR was very aware of what was written there.

Jim Sabin said...

For me this is an amazing posting. The drug rep board reflects a tragedy -- that the interaction between pharmaceuticals and medicine has moved to such a level of hate. Your comments about drug reps are compassionate and wise. Presumably the reps are no worse (or better) than other human beings, including physicians. Their postings suggest that just as primary care physicians are altered in mood, attitude, and comportment by their working conditions, especially compensation, the same is true for these drug reps. They are the foot soldiers of a drug industry in hot pursuit of blockbuster profits, and the drug industry itself is at the mercy of equity owners looking for short term gains. The drug reps are caught between employers who value them for what they can sell and physicians who want the perks the reps offer and, at least sometimes, access to information, but who hold them in contempt. What a painful situation!

Anonymous said...

It illustrates the need for pharma comanies to hire those they believe have all of those intrinsic qualities that bore many, such as character, honesty, integrity, etc. It also illustrates the anger of reps. at what they have been forced to become by thier employers.

The pharma industry clearly selects those to be reps based in large part on looks or personality or popularity. Clearly, there is no correlation between such qualities and any decency of a person. In fact, frequently, they are in opposition with each other.