Pressured to prescribe

  1. Pressured to prescribe

    The drug rep was only too happy to fill his sample closet with an antipsychotic. But as an internist, he felt it was outside his domain.


    ...When the drug rep persisted in trying to persuade me to prescribe the drug, I grew angry. Raising my voice, I accused her of trying to jeopardize patient care.

    At that point, she said the company had given her a directive to reach out to as many internists as possible. The company felt that we internists as a group were underutilizing the drug, she said....


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  2. 10 Comments

  3. by   oramar
    Bless this MD, a fine physician for sure. I don't know how doctors stand it anymore. With phamaceutical companies telling them what to prescribe and insurance companies tell them what they can't prescribe, they must wonder why they ever bothered going to medical school.
  4. by   P_RN
    My doc sees reps only on Tuesdays between 8 and 830 am. ANd while I was without insurance he filled almost all my meds from his cupboards.

    He refuses to yield to Medco who sends a letter just about every month wanting me to ask for a change to a cheaper generic. (mind you not an equivalent but something that can be Rx for that condition) I can't take ACE inhibitors, or beta blockers, and I do well on Ca Channel blockers. (uhhh more expensive) and I get what he prescribes.
    Meds are expensive, but my having a stroke or renal shutdown or whatever is MORE isn't it?
  5. by   juan de la cruz
    Quote from spacenurse
    Pressured to prescribe

    ...When the drug rep persisted in trying to persuade me to prescribe the drug, I grew angry. Raising my voice, I accused her of trying to jeopardize patient care.

    At that point, she said the company had given her a directive to reach out to as many internists as possible. The company felt that we internists as a group were underutilizing the drug, she said....
    Product marketing directed at healthcare providers is a hot topic right now. The American Medical Association is actually espousing a "just say no" approach to physicians who are barraged by pharmaceutical reps on a daily basis. This practice is driving up the cost of medications more and more. Just think of the money these companies spend on pens, dinners, paid vacations and conferences for providers who are more than willing to be "pimped" into buying into more expensive brand name products instead of generic, time-tested drugs that have been studied extensively for effectiveness.

    Nowadays, even mid-level providers such as myself are targets of these marketing schemes. Just attend an NP coneference and witness for yourself how many pharmaceutical companies show up and entice the attendees with their bright-colored goodies.

    Anyway. I am for ending this practice. The hospital I work for have just implemented strict rules about vendors coming into our facility. Promotional products of any kind, food supplied by vendors or literature distributed by vendors, will no longer permitted in the premises. I heard this trend is happening in most large hospital systems in the country as well.
  6. by   TrudyRN
    Quote from pinoyNP
    Product marketing directed at healthcare providers is a hot topic right now. The American Medical Association is actually espousing a "just say no" approach to physicians who are barraged by pharmaceutical reps on a daily basis. This practice is driving up the cost of medications more and more. Just think of the money these companies spend on pens, dinners, paid vacations and conferences for providers who are more than willing to be "pimped" into buying into more expensive brand name products instead of generic, time-tested drugs that have been studied extensively for effectiveness.

    Nowadays, even mid-level providers such as myself are targets of these marketing schemes. Just attend an NP coneference and witness for yourself how many pharmaceutical companies show up and entice the attendees with their bright-colored goodies.

    Anyway. I am for ending this practice. The hospital I work for have just implemented strict rules about vendors coming into our facility. Promotional products of any kind, food supplied by vendors or literature distributed by vendors, will no longer permitted in the premises. I heard this trend is happening in most large hospital systems in the country as well.
    Yeah, but then where would I get my pens? LOL
  7. by   juan de la cruz
    Awww, alright, let's keep the pens, the other stuff we can do without! (just kidding) LOL
  8. by   EmerNurse
    can we keep the little note pads too? i particularly like the ones shaped like an anatomical heart, or a pill bottle, or whatever. kind of medical whimsey.

    on this topic, has anyone read the book doubleday books | critical condition by donald l. barlett and james b. steele? it's a couple years old (2004) but seems not much has changed in the last 2 years anyway.

    has an entire chapter on pharm companies and their efforts to get docs to prescribe - i found the book very interesting.
  9. by   jetscreamer101
    I have noticed recently that drug reps are targeting LTC. Not a huge amount, but there have been several at my facility.
  10. by   oramar
    I wondering if they are after NPs in the states where NPs can write perscriptions? If they haven't thought of it yet they probably will soon.
  11. by   Quickbeam
    I'm a community health nurse and I work health fairs and booths at conventions all over my state. I'm often sitting next to a drug company rep for 8 hours at a time. I do this 20 or 30 times a year so I get a real eyeful.

    The company reps (and I include durable medical and all medical products people in this as well) are no different than car salesmen/women. They have a quota. They have to produce. They have target objective. Its a business. The depth of their health care knowledge is often razor thin, connected only to what their company wants them to know.

    I sat at a health fair last month listening to 2 reps from one company talk about how to sabotage the display of a competitor and how to get "in" with endocrinologists in certain key regions. This included sending the MD's wife flowers and toys for the kids. They actually said that an endocrinologist in one city was "any means possible", in that they were told to get their product in his office no matter what. The rep got to the office at 5 AM to get into the waiting room early. There were also discussions of paid vacations, large gifts and lavish dinners for the MDs and their families.

    It freaked me out the first time I heard a conversation like this. Now I just think it is the industry norm. Frightening.
  12. by   rph3664
    As a pharmacy student, I did clinical rotations on an Indian reservation whose formulary was tightly controlled by the Federal government. We STILL got drug reps even though the nearest big town was 40 miles away.

    We always took the free pens and notepads, and my preceptor would always go to the sink and do a surgical scrub of his arms.


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