Drug Lunches

I guess the sales pitches paid off today, I wrote scripts for both Skelaxin AND Avinza after they bought us lunch. Coincidence? I don't know. The female drug rep made lots of conversation today about triathlons (she'd cheered me on (her husband was also running) during the Boise Ironman 70.3 in June) and the male drug rep spoke a lot to another nameless doctor at our office who attended the same college this nameless doctor's child is currently attending. Fun, light-hearted shared interest conversation or crafty salesmanship? Who knows? Less luck for Micardis / Spiriva who brought coffee and bagels this morning - no scripts for either of those for a long time. The Micardis rep is that annoying rep who absolutely cannot make eye contact - it's very disconcerting.

The pharmaceutical representatives ("Drug Reps") bring coffee and breakfast to our office every morning and lunch every afternoon (with a few unfilled spots occasionally). The lavishing of gifts by these salespeople has actually dropped way down from the heyday when I was treated to a guided fly fishing expedition on a local river, overnight stays at Timberline with ski lessons, and luxury box seats at the Rose Garden for Blazers Basketball. (The latter was particularly memorable as it was my first and only Blazer game, and the night we learned the Hillary Clinton was elected to her first NY Senate seat while no one could figure out whether Bush or Gore was going to win the presidency. Everyone was watching the TV's in the box showing the news and ignoring the Blazer game down below).

Nowadays we get the free food, and trinkets, but no more of the big-ticket items. I'm ok with that (who wouldn't be with free food), but it does bother me that they've taken all the doctor perk money and dumped it into prime-time commercials. How about just making the drugs cheaper?

The "new pharma guidelines" are now calling for a stop to the little physician trinkets: pens, reflex hammers, post-it notes. So the days of Vyvanse and Flomax sticky notes are fast coming to an end. I expect the food won't be far behind - and it will be back to instant oatmeal, sardines, and almonds from my office stash of food.

It's an interesting aspect of my working life, walking into the sales pitches twice a day. You learn to recognize (and call the reps on it) the "closes", such as "Can you think of a reason why you wouldn't prescribe _____?" or the blatant "Will you promise to use _____?" Occasionally we'll get a plead about their "numbers" being down, and how just a few scripts would really help them out. There are manager ride-along days, where the reps have their bosses with them and have to "use the glossies" as we say (pull out all the printed sales materials) and really hit their points and throw out their closing statements. We allow it when the managers are there, usually play along ("Yes, I remember you telling me BARBARA about the benefits of Levaquin last time you were here, and you're right, I have noticed that the side effect profile really IS comparable to placebo in the multiple patients of mine who've benefited from all the extraordinary characteristics that make Levaquin my first choice in quinolone antibiotics!")

Reps actually have it pretty hard these days. There are constant lay-offs, and no one is sure that they'll have a job the next day. We try to be sympathetic at our office and let the salespeople do their thing. Doctors refuse to acknowledge that the sales pitches have any effect on their prescribing habits, but I'm sure we wouldn't keep seeing reps if that were the case. Still, although I have my favorites in each class of medicine, I really do try to preach that drugs are not the answer to every problem, and use the cheap, generics whenever possible. I'm sure the food and the feigned interest "How're things going Dr. Schieber? Are you training hard these days?" exerts some effect, though.

We kill the messenger a lot. The reps often get an ear full about drug prices, or all the TV advertising - things that they don't have a lot of control over. One drug rep made a comment about "enjoy the food, because if the Democrats get elected we'll all be out of a job". Not a smooth move when the three biggest liberal prescribers (including me) happened to be the ones going through the line. It's much more likely that we WON'T prescribe a drug because we don't like a certain sales rep, than we WILL if we do like them. Lesson: politics and sales don't mix unless you're damn sure you know what side of the political fence you're selling to. Overall it's kind of a symbiotic relationship that keeps the good looking college grads in fancy clothes and company cars, and keeps us and our staff fed. Remember that the next time you're paying $85 dollars for your migraine medicine.

Other news:

• HOT HOT HOT. It's supposed to hit over 100 degrees tomorrow. Yikes!
• Dad (Rich Schieber) had surgery to his hand to screw down the bone pieces. Not fun! He had a lot of pain initially (you think? screws into bone), but was doing better on POD (post-op day) #2, when I went over and hung out to see how he was and watch the Olympics with he and mom.
• I've semi-committed to the Mississippi Blues Marathon (January 3, 2009), since I didn't get to run Portland (busted toe). I'm planning to start running in about two weeks (that'll be 6 weeks out from my fracture), and got my training plan typed out onto my calendar yesterday.
• We're lovin' our laundry line, but it sure makes the clothes stiff.
• A good friend came back from Czecheslov....Czeckeslovakia.....overseas, and stopped by today, that was cool!
• I haven't been studying my Spanish nearly enough (read: not at all)
• I had to pull a small "Hey you kids, get off my lawn" last night to a group of skateboarders using our cement ramp by the back door and our (overturned) picnic bench as their own personal skate park. I told them they could "use the concrete, but leave the furniture where it is".