Drug Rep Tricks, Revisited

March 10th, 2005

Filed under: Medicine

It’s been a while since I’ve talked about drug reps. Last time, I discussed some of their common sales techniques, techniques that I took exception to. Today, I’d like to mention four more tricks of the trade I’ve noticed.

Previously, the techniques I mentioned were industry-wide and many of them could be blamed on the sales information provided by the pharmaceutical home office. This time, I’m looking at techniques used by certain individual reps.

Now, I like drug reps as people, I’m just not fond of them as a profession. You know that unctuous salesman at Circuit City who won’t take no for an answer and follows you around? Now imagine that salesman coming into your office and interrupting you while you’re trying to work. That’s what it’s like.

  • False agreements – “Doctor, the last time we talked you agreed to try Gorillastatin on half of your patients with high cholesterol.”
    No, no I didn’t. I would never make such a bone-headed agreement. My patients are not guinea pigs. I will prescribe what I believe to be best for them, not randomly put them on some drug the rep claims is “better.”
    Every day, some rep tries to convince me that I made such an agreement. Each time they do this, they shoot their credibility lower and lower.
  • Fake Thanks – “Doctor, I’d like to thank you for increasing your prescribing of Gorillastatin.” As the rep says this, he looks in my eye and gives my hand a good shake.
    I very rarely prescribe the drug in question and certainly haven’t started prescribing it more. Does he think I don’t know my own prescribing habits? Is he trying to convince me that I prescribe it more than I do?
    Back in college, a friend of mine worked as a car dealer. He would tell us about some of the techniques used by dealers to increase sales. One of these techniques was to compliment the condition of the trade-in car, no matter how bad it really was. This seems an awfully lot like that.
  • Bring the Boss – Drug reps will often bring their supervisor into the office with them. Human nature being what it is, we want to help people look better in front of their boss, so we pay more attention to what they’re saying. I get a little suspicious when half of the drug reps have their boss with them at any given time.
  • Appeal to Authority — “Dr. BigCardiologist uses this cholesterol drug exclusively.” Assuming this statement is true (which it probably isn’t), Dr. BigCardiologist has a much different patient population than mine and different prescribing habits. And haven’t I seen his name listed as a speaker on at some of your dinners? This is no more than a blatant appeal to authority.
    This is often combined with anecdotal evidence on a patient from that office. Anecdotal evidence is anecdotal evidence, no matter whose office it comes from.

10 Responses to “ Drug Rep Tricks, Revisited ”

  1. David Oakes
    March 10th, 2005 at 5:58 pm

    They would sell a lot more comics if they put Gorillastatin on the covers.

  2. Nate Atkinson
    March 10th, 2005 at 6:29 pm

    I worked front desk at an internal medicine clinic in the bay area for about a year. Our senior doc. would not give drug reps the time of day, and the other md’s and pa were almost as indifferent. This drove the reps nuts, and they’d try to get to them through the desk staff. We’d get pizzas, donuts, chocolate, to say nothing of the pens, note pads, coffee cups and stuffed animals made by nine year-olds in china. My favorite sample came to my mom’s office, she’s a clinical psychologist but works with psychiatrists who perscribe. It was a pound of Starbucks coffee, plastered with stickers for an anti-anxiety med.
    Anyway, I got to know these reps pretty well. Some were better than others. There’d be the down on his luck sales rep. he’d stop by the entemens outlet and slap some stickers on a day old pound cake. There’d be the cute, funny girl rep who’d dole out M&M’s if you could answer questions about her product: “And why does ___ offer the best in bladder control?” One particularly aggressive rep would walk past the front desk to the m.a. station, quickly dump the company wares on the desk and stand around until somebody with an m.d. could sign for it.
    The wierd thing was, even though the doctors refused to talk to these people, they’d still get medicine from them. They’d figure out who was OK, and that rep would come in at an appointed time. The doctor would sign for it between patients and that would be that. Occasionally this transaction would overlap with an unannounced visit from another rep, who’d look on with wonder and disgust.
    Between that job and grad school I was working as a waiter in a restaurant near some hospital in a neighboring city. Two drug reps I recognized from before came in for lunch on the company card. They recognized me, and immediately, without any attempt at human interaction or for a wine list asked me how to get to that head doctor. One track minds these people. I was just lucky they didn’t tip in highlighters and hand sanitizer.
    -NATE

  3. Aaron Sapp
    March 10th, 2005 at 8:28 pm

    The department where I trained was very anti-drug rep. It was only during my time there that they started letting the drug reps feed us lunch. Sometimes they would also get a few minutes to talk to us. It was always followed by a talk from our department PharmD who pointed out the techniques they used and told us the facts about the drug discussed and the others in the class.

  4. Chris Brown
    March 12th, 2005 at 8:11 am

    I still havent found a regualar doctor yet, but in my visits to different doctor I always make a mental note not to keep seeing a doctor by the amount of free pens/clocks/post-its/etc crap they have in their office. I saw one doctor who I swear if he could would have had his toilet seat lid sponsored by that incontinence drug.

    I remember reading in I think Mother Jones, a few years back about a movement by doctors to recycle all that crap they get, and deny shenanigens like the drug reps like to pull from happening in their practice.

    On the other hand, I have been in doctor’s office we the doctor will give you all the free trial medications so you woldn’t have to go to the Pharmicist to fill a subscription.

  5. Scott
    March 12th, 2005 at 8:11 am

    I do my best to keep all drug-emblazoned equipment out of my exam rooms, and the office as well. To me, it’s that “appearance of impropriety” issue. I don’t want anyone thinking that I can be bought.

    Check out the No Free Lunch site. They’re a group similar to what you’re mentioning.

    Medication samples have their uses, but it’s best to remember that they are advertisements in and of themselves. They are always for expensive non-generic drugs. They’re convenient to hand out, so the companies figure you’ll start someone on the samples then keep prescribing it, as opposed to a lower cost generic.

  6. Waking Up Costs
    March 15th, 2005 at 6:08 am

    Four Drug Rep Tricks Plus One Of My Own

    Polite Dissent is a blog I just discovered thanks to Grand Rounds. He/she has the same take on some of the techniques used by drug detail people as I do: False agreements Fake Thanks Bring the Boss Appeal to Authority I’ll just add my own to this very…

  7. GasPundit
    March 15th, 2005 at 10:50 am

    Here’s a trick for zinging the rep’s who dare to bring in their boss, taught and demonstrated by a terrific pharmacist from my days as a pharm tech:

    Make very nice, it’s great to see you, oh hi Mr/Mrs Boss.

    Oh and by the way, did you remember those articles I asked you for? Yeah, don’t you remember, I’d asked you about X formulation of drug Y, about its kinetics? Oh, you forgot those articles? Huh. Well, it was nice meeting you Bossperson, good seeing you again reppy.

    (Even better?)
    Sorry, Boss-person, we’re just meeting this afternoon to discuss x-class of drugs. The other reps brought us in some educational articles, and we were hoping to have some from your company as well. Yeah, this discussion will be influencing our formulary committee. But that’s ok, we’ll just use what we’ve got from the other companies. I’m sure their articles are fair and balanced like yours would be. Hey, maybe next year when we’re reviewing our formulary again you’ll try to remember those articles?

  8. Scott
    March 15th, 2005 at 11:34 am
    Official Comment

    Oh, that’s evil. I like it!

  9. Jonathan Dresner
    March 17th, 2005 at 3:12 pm

    I had a doctor once write me a prescription with a pen emblazoned with the name of the drug he was prescribing. I got cynical real quick (and the drug didn’t help much, either).

  10. james smith
    February 4th, 2008 at 7:53 am

    oh my goodness you people are pretty bad to reps! I am a rep and I dont believe that a rep can make a doctor use their product. I go in when its convient for the GP and have chat for a few minutes about the product its benefits/contraindications etc. The doctor decides himself if he wants to prescribe it, he has had the training and will know if he wants to use the product. The rep is just a way of reminding the GP about products on the market. No self respecting GP is bought off by a lunch in the the practice but what is the matter with taking the lunch??? As long as the rep and doctor are ethical and the rep sees at a time that is appropriate for the GP there shouldnt be a problem. Oh and on the boss thing, My boss comes out with me twice a month and lets be honest I dont like it either , however trying to make the rep look stupid infront of there boss isnt very clever, nice or ethical and if a rep tried to do anything like that you would be the first to shout fromn the hills about this unethical rep.

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