Thinking Ahead

Dramaturgical study of meetings between general practitioners and representatives of pharmaceutical companiesCommentary: dramaturgical model gives valuable insight

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7327.1481 (Published 22 December 2001) Cite this as: BMJ 2001;323:1481

Abstract

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.

What is already known on this topic

What is already known on this topic Pharmaceutical representatives influence physicians' prescribing in ways that are often unacknowledged by the physicians themselves

Meetings with pharmaceutical representatives are associated with increased prescribing costs and less rational prescribing

What this study adds

What this study adds Meetings between pharmaceutical representatives and general practitioners follow a consistent format that is implicitly understood by each player

General practitioners may cooperate because representatives make them feel valued

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

    1. Maggie Somerset (m.somerset{at}bristol.ac.uk), lecturer,
    2. Marjorie Weiss, lecturer,
    3. Tom Fahey, senior lecturer
    1. Division of Primary Health Care, University of Bristol, Bristol BS6 6JL
    2. Bath Spa University College, Bath, BA2 9BN
    1. Correspondence to: M Somerset

      Abstract

      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.

      What is already known on this topic

      What is already known on this topic Pharmaceutical representatives influence physicians' prescribing in ways that are often unacknowledged by the physicians themselves

      Meetings with pharmaceutical representatives are associated with increased prescribing costs and less rational prescribing

      What this study adds

      What this study adds Meetings between pharmaceutical representatives and general practitioners follow a consistent format that is implicitly understood by each player

      General practitioners may cooperate because representatives make them feel valued

      Footnotes

      • Funding MS is in receipt of an NHS national primary care researcher development award and TH an NHS research and development national primary care career scientist award, but the study had no specific funding.

      • Competing interests During the course of this research TF acquired 15 pens, two stethoscopes, eight jotters, two desk planners, a fluffy toy, and innumerable invitations (none accepted) to meetings at which a “local expert” would be lecturing as a prelude to a slap-up dinner.

        Commentary: dramaturgical model gives valuable insight

        1. Robert Mears (r.mears{at}bathspa.ac.uk), head of social sciences
        1. Division of Primary Health Care, University of Bristol, Bristol BS6 6JL
        2. Bath Spa University College, Bath, BA2 9BN

          Footnotes

          • Competing interests None declared.

          • Embedded Image Further examples of the interactions appear on bmj.com

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