Rapid Responses to:

REVIEWS:
Jeanne Lenzer
Confessions of a drug rep
BMJ 2005; 330: 911 [Full text]
*Rapid Responses: Submit a response to this article

Rapid Responses published:

[Read Rapid Response] Patient' interest vs Company interest
Pantula S.R.K. Sastry   (16 April 2005)
[Read Rapid Response] Best ever BMJ?
David E. Bratt   (17 April 2005)
[Read Rapid Response] Horses and Water?
Tamer Sadek   (17 April 2005)
[Read Rapid Response] Don´t let them in!
Michael R Barr   (22 April 2005)

Patient' interest vs Company interest 16 April 2005
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Pantula S.R.K. Sastry,
Consultant Medical Oncologist and Bone marrow transplant physician
Tata Memorial Hospital

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Re: Patient' interest vs Company interest

The various tactics used by pharma company seem to include some unfair business practices. I did not know that the repertoir of a representative included data regarding my prescribing behaviour.

Often I have been requested by drug reps to push the sales of their product somehow. I would often ask if their parent or loved one is my patient what would they expect of me pushing the sale of some company or the best interest of their loved one? they would invariably answer the interest of their loved one and not sales of x company. So this is what is expected of a doctor by every one as a person and is slightly different when one is a drug sales rep. I think insight in to the technics of boosting sales by company's should be necessary reading for all prescribing doctors. Lastly every doctor should remember that his duty is to keep his patient's best interest and not the bottom line of some MNC. Dr.P.S.R.K.Sastry Asst Prof & Medical Oncologist & BMT physician Tata Memorial Hospital Mumbai India

Competing interests: None declared

Best ever BMJ? 17 April 2005
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David E. Bratt,
Paediatrician, solo, private practice
36 Ranjit Kumar St., St. James, Port-of-Spain, Trinidad, West Indies

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Re: Best ever BMJ?

Must say this excellent confession is a fitting finale to one of the best ever BMJ's. I can't wait to show it to some of "my" drug reps. Wonder if they'll be forewarned by this letter. Talk about "Big Brother"!

Competing interests: None declared

Horses and Water? 17 April 2005
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Tamer Sadek,
SHO A&E
Luton and Dunstable Hospital

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Re: Horses and Water?

Having watched for several years the furore regarding influence of prescribing I am reminded of a phrase used on me by a drug rep.

"You can lead a horse to water but you can't make them drink"

We are under no obligation to prescribe anything a drug rep peddles to us. We have no loyalty to them and we are not beholden to them. I see no conflict of interest in hearing what they have to say, if we choose to even receive them, and then making our own minds. We have the ability as trained medical practitioners to do our own research and make our own choices. I am married to a drug rep and feel no obligation to prescribe any of her products.

Perhaps instead of attacking the reps who are supposedly "armed and dangerous" we should look to ourselves and ask, "do we have the courage of our own convictions? Do we still have the ability to decide for ourselves?"

So while the reps may lead us to their own watering hole nobody is forcing us to drink it.

Competing interests: Married to a medical sales representative for Pfizer

Don´t let them in! 22 April 2005
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Michael R Barr,
Medical editor
Free-lance consultant, New York City 10002

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Re: Don´t let them in!

The last time I went to see my doctor for my quarterly check-up, half of the waiting room was taken up by well-dressed, good-looking drug reps hovering like star struck paparazzi for my doc to come out of the consult room. Each with his or her little suitcase of samples on wheels. Each was granted all of 2-3 seconds for some kind of pitch. Then he signed their little book and off they went to the next address on the day´s docket. What do they -- or my doc -- even get out of this mostly symbolic exchange? (The office doesn´t allow the purveying of meals.)

My former physician had a policy of NO DRUG REPS in his office. Period. His rationale was that it violated the confidentiality of his patients with a sometimes stigmatized medical condition. Stigma or not, I wish more physicians would adopt such a policy. (And while we´re at it, can we do something about those DTC drug ads in the US? They´re forbidden in every other country in the world -- except for New Zealand.)

Competing interests: Patient and "AIDS activist" with a pharma related website: www.shillfactor.net