Details, details: What your colleagues think of drug reps

Most physicians like working with detail people. Still, the relationship can get rocky at times. Here's why.

By Dennis Murray
Senior Editor

Not a day goes by, it seems, without a pharmaceutical sales representative visiting your office to discuss new products. In fact, in a spot check of Medical Economics readers, almost 40 percent of the physicians we contacted reported seeing three or more reps a day. The poll was conducted last fall in the pages of this magazine by sister publication Pharmaceutical Representative. While it was intended to help readers of that publication find out what doctors want from detail reps, we thought you'd like to see how your colleagues feel about these visits.

Most of the physicians who responded to the poll tell us they welcome detail reps with open arms, and that a majority of the reps are courteous, professional, and respectful of their time. Overall, respondents believe reps are well informed about their companies' products—their indications, efficacy, dosing, adverse reactions, and cost—and do a good job of educating doctors during their brief visits. When the call isn't designed to introduce a new product, though, more than half the respondents say their main reason for seeing a rep isn't for information, but for samples.

A small percentage of the doctors polled, however, refuse to see reps. "What they have to tell me I already know or I can look up from a more reliable source," explains a Minnesota pediatrician. "Overall," adds a Florida internist, "I gained little or nothing by letting reps into my office."

Even those who do gain something aren't always satisfied. For instance, three out of four respondents don't believe that the information sales reps provide about their products is 100 percent accurate.

Moreover, doctors bristle when reps repeat what was discussed during a previous visit. "Don't talk a lot if you don't have something new to say!" one physician complained.

A bigger problem, it seems, is when sales reps drop in unannounced, often with a meal or freebies for the staff. "I want them to call and schedule a time, even if they're just leaving samples," says a Maryland family physician. Those sentiments are echoed by a Missouri internist, who says, "Respect my time, and my patients' time."

A Vermont FP recalls that, "a sales rep snuck past my receptionist to confront me with product information, after the receptionist specifically told him I didn't have time to speak with him." An Oklahoma GP goes one better: "An aggressive rep tried to crawl through our receptionist's window to keep talking to me."

Doctors also cite a lack of manners in some reps. "One of them told me and my staff a tasteless joke," says an orthopedic surgeon from Ohio. "I told him it wasn't appreciated and that if he repeated it, he'd be banned from the office. Soon thereafter, I received a written, unsolicited apology signed by him, his partner, and his regional manager."

When reps' behavior crosses the line

These aren't isolated incidents, unfortunately. Nearly 40 percent of the doctors we polled report that a rep has acted inappropriately. Physicians say they're astounded at the lengths to which some will go to make a sale. "One rep cried in front of me and my partner when she asked us to write more prescriptions for Rezulin," says a California internist. "A week later, the drug was pulled from the market."

Other reps evidently believe the Madison Avenue rule that sex sells. "Two women came into the office wearing red lipstick, dangling earrings, tops with plunging necklines, and shimmery pantyhose," one doctor told us. "I asked both of them never to come back."

Another physician says, "A female rep made advances by trying to play footsie with me. She persisted even though I backed away and talked about my wife and kids. I left the room. She hasn't returned."

A rep in New Jersey did something much less overt, but irksome nonetheless: "He left direct-to-consumer advertising in my waiting room, without asking me first," says a pulmonologist. Another doctor says a rep replaced the clock in his employees' break room with one bearing his company's corporate logo. He also replaced all of the office calendars. "I then went to my desk," this physician recalls, "and found it covered with product information."

Think that's effrontery? Then consider how a rep treated a Pennsylvania GP after the doctor said he didn't want to discuss a particular drug anymore. "He followed me down the hall and accused me of taking money to write prescriptions for his competitor's product," the doctor says. Needless to say, the rep wasn't welcomed in the GP's office again.

For some reps, no area of the office is off limits—including exam rooms. "One rep barged in while I was with a patient and demanded to discuss a product with me," says a Texas internist.

Physicians have been ambushed in the waiting room, too. "A rep wouldn't stop her presentation, despite my repeated attempts to assure her that I understood what she was saying. Patients walked out of the office right in front of her, because they were tired of waiting for me."

Some physicians have been angered enough to file complaints against reps, with mixed results. Says one who was successful, "I wrote the company about a particular rep, and he never appeared in our office again."

Samples and other freebies are the carrots

Many doctors swallow their pride when dealing with sales reps because they want to continue receiving free samples. Not surprisingly, a few reps have latched onto this and tried to use doctors' fondness for samples to their advantage.

"Two reps insisted that we write more prescriptions for their drugs, or else they wouldn't leave samples anymore," reports a DO in Kansas. And in Michigan, a sales rep threatened to withhold samples if he couldn't be seen immediately. "We told him, 'See ya,' " the physician says.

Playing games with samples is a further source of irritation for doctors. Some reps will go into the storeroom without permission and rearrange the samples, moving their products to the front of the cabinet and a competitor's to the back. More unscrupulous reps will throw away or even take a competitor's samples. One doctor says he caught a rep trying to steal Viagra.

Despite these horror stories, most doctors see reps every day without incident. "I've made some very good friends with reps over the years," says a general surgeon in New Mexico. "They, too, have a job to do." Adds a Colorado FP: "All of the drug reps we see are very nice."

Moreover, complaints aside, physicians also clearly want as much from reps as they can get: Two out of three respondents say it's either "very important" or "somewhat important" that their spouse or partner and their children be included in a drug company-sponsored program. For most doctors, it seems, a free dinner or vacation makes up for any hassles.

 

Dennis Murray. Details, details: What your colleagues think of drug reps. Medical Economics 2002;11:41.