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Don't be the devil in the details
It's the small thingsthe detailsthat often prove the difficult part of any plan, where things fall apart. And I think it's the small things, the peripheral things, that complicate relationships between doctors and the pharmaceutical detail reps who call on them.
That relationship has gotten a lot of press lately. Pieces on pharmaceutical advertising and promotional campaigns have appeared in The Wall Street Journal, The Washington Post, Business Week, and any number of other major publications. You'll find our own article on the subject in this issue. It detailspardon the punthe results of a poll taken by our sister magazine Pharmaceutical Representative in these pages last November.
We've focused on some of the stories you told about encounters with reps; editors at our sister publication did a piece that was more instructive for their readers and should have a positive impact on your dealings with them. It laid out your preferences in everything from the time of day that's best to call to what you want covered in presentations.
What troubles me most, though, are the answers to questions about industry-sponsored events. Only 9 percent of the 336 respondents say they don't attend any such functions. Almost half say they attend a rep-sponsored event at least once a month, another 10 percent do so at least once a week. And here's the kicker: Two out of three of those who go to industry-sponsored events say it's "very" or "somewhat" important that their spouse or partner and children be included in the invitation!
Patients won't benefit one bit from having the doctor's spouse out on the golf course (unless of course the spouse is also a physician) or the doctor's kid at a Dodgers game. But it seems like many doctors aren't satisfied with just getting information about a drug or the disease it's designed to treat from detail reps. They want a bunch of goodiesfor the whole family.
Do you know how much it costs to maintain all those sky boxes at sports stadiums? Not to mention whether you ought to accept expensive invitations. The AMA has had guidelines spelling out what constitutes appropriate gifts from industry since 1990. A panel presentation at the annual session of the ACP-ASIM in April urged physicians to consider at each meeting with a drug rep whether there's a true educational benefit to the time spent or the "gift" that's left behind.
Next month, a new set of guidelines will go into effect. The Pharmaceutical Research & Manufacturers of America (PhRMA) adopted a new marketing code that prohibits events and items "intended for the personal benefit of healthcare professionals." Out are the sporting events, theater tickets, music CDs, VCRs, and golf balls. Compliance with the code is voluntary, but the industry is to be applauded for taking steps to put interactions with physicians back on a solid educational footing.
Doctors need to help them keep it there. It's up to you to help them stay focused on providing helpful clinical information and tools that you can use in your practice.
Those of you who responded to the Pharmaceutical Representative poll last year helped to a degreeyou told them what you want to hear from reps, how you want them to behave in your office, even whether you believe them or not. But that comment about wanting spouses and kids included in invitations gave another message: Your prescriptions can be bought.
I know that most of you don't ask for and don't expect such favors. And chances are you don't feel that you're influenced by freebieselaborate or not. But sometimes form is as important as substance, appearance as important as reality. Don't demand more from detail reps than they ought to be presenting. Otherwise, you'll be the devil in the details.
Marianne Mattera. Memo From the Editor: Don't be the devil in the details. Medical Economics 2002;11:4.