...and thinking ahead

Dramaturgical study of meetings between general practitioners and representatives of pharmaceutical companies

Maggie Somerset, lecturer,  Marjorie Weiss, lecturer,  Tom Fahey, senior lecturer. 

Division of Primary Health Care, University of Bristol, Bristol BS6 6JL

Correspondence to: M Somerset m.somerset{at}bristol.ac.uk

Objectives: To examine the interaction between general practitioners and pharmaceutical company representatives.
Design: Qualitative study of 13 consecutive meetings between general practitioner and pharmaceutical representatives. A dramaturgical model was used to inform analysis of the transcribed verbal interactions.
Setting: Practice in south west England.
Participants: 13 pharmaceutical company representatives and one general practitioner.
Results: The encounters were acted out in six scenes. Scene 1 was initiated by the pharmaceutical representative, who acknowledged the relative status of the two players. Scene 2 provided the opportunity for the representative to check the general practitioner's knowledge about the product. Scene 3 was used to propose clinical and cost benefits associated with the product. During scene 4, the general practitioner took centre stage and challenged aspects of this information. Scene 5 involved a recovery strategy as the representative fought to regain equilibrium. In the final scene, the representative tried to ensure future contacts.
Conclusion: Encounters between general practitioners and pharmaceutical representatives follow a consistent format that is implicitly understood by each player. It is naive to suppose that pharmaceutical representatives are passive resources for drug information. General practitioners might benefit from someone who can provide unbiased information about prescribing in a manner that is supportive and sympathetic to the demands of practice.