Honest ‘Reps’? Influenced Physicians?

In Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales Practices, by Michael Oldani, we are provided an insight into the exciting world of the pharmaceutical salesperson. One of the more enlightening points discussed in the article was that of ‘spin selling’ (or ‘spin doctoring’), where the pharmaceutical rep is taught to turn around each and every objection they are presented with (whether from physicians, patients, or nurses), and turn it into a positive selling point, “something to be valued and sold for the patient’s benefit.” (Oldani, 328) If the drug really will do the job well for the situation the rep is pushing it, this might not be a problem. More likely though is that the drug may simply be only suitable (and not necessarily the best) for a situation in which a physician raises an objection, and the ‘spin’ of the rep may have the potential to undermine the discretion of the physician, or dismiss their concerns by sweeping them under the rug, so to speak.

Another interesting, yet concerning point that Oldani presents, is the reality that small gifts can indeed have a substantial impact on prescribing habits. In his example of ‘using coffee to sell’, Oldani had, in his later years as a pharmaceutical rep, started giving out cards at a familiar hospital to doctors, which entitled the bearer to ten free cups of coffee. Within a month of starting this, Oldani was “clearly in demand for [his] coffee cards. [He] was receiving phone calls from residents and staff doctors for cards. … [And he] handed them out to anyone who could write a prescription of Antibiotic S.” (335) What was special about these coffee cards was that they had a sticker on the back with information about ‘Antibiotic S’, a ‘me-too drug’ that was not moving, but Oldani needed to sell. After the news of free coffee quickly spread, Oldani’s sales exploded and surpassed the quota he needed to reach. 

Whether this was just a good marketing ploy or there was a sudden ‘need’ for Antibiotic S, I now find myself doubting the first part of the quote presented at the beginning of the paper, and indeed believing the second:

“Doctors aren’t that corruptible. The (drug reps provide good information, and they are functioning in a system where that is how you sell medicine. The most comical thing is doctors’ attitudes. You will never hear a physician say, “This is influencing me.” They are just so arrogant and naive.”


P.S. ‘Spin-doctoring’ sure brought me back. Not sure if this reflects one way or another on my age, but it’s worth it.

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