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Why I Don't Waste Time on Drug Reps (video)

Overdosed America: The Broken Promise of American Medicine (P.S.)
Opened My Eyes
Two years ago I decided that I wasted more time talking to Drug Rep's (those pretty people in suits you always see in your doctor's office, who often get to cut line in front of you) than it was worth.  We started stopping them at the front desk; they could leave samples if they liked, but I would no longer spend any time talking to them.  We made this decision for several reasons, I'll let you in on the most important.

Generic Drugs -The list of generic medications keeps growing almost every day.  There are now so many available that I seldom write prescriptions for name-brand drugs.  The two times I might write the name-brand version of a pill is if the medicine was started by a specialist, or if the patient asks for name-brand.  There was a time when generics were unreliable; those days are long, long gone.  You can find more good info on generic medicines here.

Confessions of an Rx Drug Pusher
Great Book
When patients ask for a name-brand there is usually a reason; either they just saw the TV commercial and were so persuaded by the paid actors that they will pay extra for this pill, even though the guy who is trained to make that decision (me) is sitting right there on his stool telling them the generic is just as good, or they had a friend recommend a certain pill and they are eager to give it a try, or they want the name-brand of something for its re-sale value...

I used to try to reason with such people but quickly realized that TV commercials and non-MD friends evidently seem to give more reliable medical advice that a silly doctor and so I just smile and write them the prescription (except for the re-sale folks).  Usually we get a call from the pharmacy in a couple of hours from a flustered pharmacist (and the patient still yelling in the background) who has just made it known that insurance will not cover the televised pill, and that it will cost the patient $256 every month to take said pill.  We quickly apologize for our error and change the medicine to the generic, and everyone is again happy.

Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients
Eye-Opening Book
Patient Time -More than once, out of the corner of my eye I would see some sweet older lady patient eye-balling me as I talked to the pretty Drug Rep who was eating into the patient's time.  For a few years I told myself that Drug Reps contributed to my on-going education and this inconvenience couldn't be helped.

The only place you will see pretty Drug Reps in my office today is at the front desk trying to con their way down my hall (and failing).  I would much rather help another patient or two in a days time than listen to the canned sales pitch from a Drug Rep.

Science vs. Cuteness - The more I thought about the seeming inconsistency of the attractive people who knew so much about medicine despite lacking an MD degree, the more it bothered me.  So I started doing a little research, read a book or three, and came to the obvious conclusion.

I thought back to my days of roaming the halls in the Biochemistry and Cell & Molecular Biology Labs and I remembered something; there were very few really cute people there, and none of them were well-dressed!  These Drug-Reps are trained and polished to appeal to my weaknesses as a doctor, to study me, take notes about me for their partners to use, and to trick me into making a decision that I might not have made otherwise.  In order for one to be a good doctor science has to win over cuteness every time.

On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health
Another Good Book
Appearance - The little old lady eye-balling me for letting the attractive Drug Rep cut in front of her was right.  This drug rep was only going to tell me what his/her company wanted me to know.  They would minimize any unfortunate findings in the research data.

Even though I was talking to the Drug Reps with the best of intentions, my patients were basically getting the message that I would rather spend my time talking to attractive, well-dressed Reps than to my patients.  That certainly is not true, and I don't want to give any such appearance to my patients.

What about the Free Samples - Times have changed.  In the past those free samples could actually help patients.  That was back in the days when Synthroid and Coumadin were brand new.  Both these and hundreds of other important drugs are now generic which means no samples are left.  Samples nowadays usually are for drugs that are very expensive and are of little more benefit than the generic equivalent.  Oh, and they no longer leave any Viagra samples, sorry.

So much money is spent on Drug Ads that different dosages of the same pill often cost the same amount; this should tell you how much the drug itself really costs.  For example, Viagra comes in 25, 50 and 100mg doses which all cost the same amount.  How is it possible that the 4x's greater dose of 100mg cost the same as 25mg?  It's because the chemical itself is relatively cheap; the multi-millions in Drug Ads, however, are anything but cheap.

Recently I found the video below, and I found it to be a little disturbing.  It was made by a former Drug Rep who has "come clean" about the tactics, strategy and truth-stretching that are common when drug companies communicate with doctors.  There is a whole science behind taking a college graduate and training them to walk and talk and act in such a way that doctors feel comfortable around them, and indeed, respect their advice.  This lady seems to be pulling out all the stops and I think this information is very important for everyone who trusts their doctor's advicer.

Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer
Another Disturbing Book
Watch this video, share it with friends, like it on FB, link to it every way you can.  This information need to get to as many of your friends and family members as possible so they don't waste another dime on pills that work no better than generic.  Nicely ask your own doctor to consider no longer seeing drug reps; I guarantee you he/she is already thinking about it and only needs some nudging (and maybe some eye-balling).

Those nice people in the expensive suits have a job to do.  It is not to make you healthier, it is not to make you feel better, it is not to make you less depressed; their job is to get your doctor to prescribe the pill their company makes in order to make their share-holders more money.  It doesn't get more simple than that.

Click the arrow to watch this disturbing video...

Click the arrow to watch this disturbing video...

Make no mistake, some patients are quite sick and need to take medicine, some need to take a lot of medicine in order to function at a level meaningful to them.  But we all need to remember that TV commercials are not there to educate us, they are there to sell a product.  In the case of this product (pills), the company needs a middle man (your doctor) to close the sale.  Taking a daily pill is a big commitment and should not be taken lightly.

What the Drug Companies Won't Tell You and Your Doctor Doesn't Know: The Alternative Treatments That May Change Your Life--and the Prescriptions That Could Harm You
Buy for Your Doctor
No doctor worth his stethoscope is going to be offended by a well-informed, curious patient asking questions, but you have to remember that most doctors have been doing this for a while and we are not (should not be) as easily tricked by the big multi-national pharma companies and their million-dollar commercials as the uninformed patient/consumer.  Email this article to your doctor and ask what he/she thinks...

Feel free to bring a list of questions you have for me, print info off a website, or even bring your friend who recommended the pill; I promise I will listen and together we will decide the best course.  It worries me when a doctor is offended by a patient who has been doing some of their own research; every patient should be very knowledgeable about their own condition and the medicine they might need.  But, if I'm trying to tell you you don't need a pill, or that a generic pill will do just fine, remember that I make the same amount whether or not you take the name-brand pill; since I don't see Drug Reps, I tend to focus on what is truly best for you and your pocketbook.  Trust your doctor, and if you don't trust your doctor, find a new one.


  1. I only wish more Family Doctors would step up and make this decision. I have had nothing but positive feed-back from patients...

  2. Good for you!! I see these people no better than street dealers!

  3. I think Drug Reps, as individuals, feel in their heart they are doing a good job and doing doctors and patients a service. The problem is, the most damage often gets done by folks with good intentions...

  4. Anonymous02 June, 2012

    Very nice

  5. Anonymous02 June, 2012

    I just found your blog via a friend's Facebook post. I would say I am mostly in agreement with what you say, especially the notion that a physician is more qualified than a detail rep to judge the merits of a particular drug, but there is something you overlook. Generic drugs exist BECAUSE OF brand-name drugs. The latter cost so much more because they have to cover the cost of research and development that eventually lead to these discoveries. No R&D = no brand-name drugs = no generics.