One quote from the article by Fugh-Berman and Ahari that particularly struck me appears under the Comments section for acquiescent doctors in Table 1, and reads as follows: ‘Of course, most of these doctors think themselves immune to such influence. This is an illusion reps try to maintain’. The idea here is obviously that most doctors consider themselves to be uninfluenced by the gift-giving of drug reps, contrary to empirical prescription-tracking data, while such drug reps endeavour to sustain this illusion or false pretense. The simple question now arises of why drug reps do in fact try to maintain this illusion, i.e. try not to reveal that doctors are in fact influenced in their prescribing by the gifts of drug reps. One obvious reason is that if some doctors were sufficiently convinced by drug reps that they were actually influenced by the gifts of such reps in their prescribing behaviours, then they would cease accepting gifts from such reps in order to regain some prescribing impartiality. In this way, such drug reps would probably no longer be able to influence such doctors towards prescribing the drugs advertised by these reps, and so the drugs reps would conceivably fail in their vocational duties with respect to these doctors. Therefore, drug reps might try to sustain this aforementioned illusion in order to preclude this undesirable consequence. Nonetheless, this reasoning for why drug reps would attempt to maintain this illusion relies on the assumption that all or most doctors would react in the described way to the knowledge that they are in fact influenced by drug reps’ gift-giving. To the contrary, perhaps some doctors might unashamedly accept this knowledge and yet still continue to accept and desire gifts from drug reps on the grounds that such gifts have been and continue to be desirable for and valuable to such doctors. Therefore, it may be that with some doctors, drug reps do not necessarily have to consciously endeavour to uphold the illusion potentially believed by these doctors, namely that these doctors are not influenced in their prescribing behaviour by the gift-giving tactics of drug reps.
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