Psychological Warfare Techniques -- Used on Your Doctor

Pharmaceutical sales reps are trained in tactics that are on par with some of the most potent brainwashing techniques used throughout the world, according to an in-depth report co-written by former Eli Lilly drug rep Shahram Ahari, and Adriane Fugh-Berman, associate professor of physiology and biophysics at Georgetown University Medical Center in Washington, D.C..

Pharmaceutical companies spend more than $15 billion each year promoting prescription drugs in the United States.

These campaigns are designed to effectively alter prescribing behavior, to sell more of the high-profit drugs (as opposed to the most effective, and least dangerous).

Newstarget July 30, 2007

PLoS Medicine 4(4): e150, April 24, 2007 (Free Full-Text Article)

Dr. Mercola's Comments:

The fact that sales reps for drug companies serve no useful function other than driving up sales for their blockbuster drugs -- at your expense -- is no surprise. What may shock you though, is just how insidious their sales tactics really are.

Last weekend I saw a woman who used to work for me 13 years ago.  She wound up going to a four year naturopathic college, but prior to going to ND school she worked as a drug rep.  I heard firsthand, detailed stories of the corrupt and deceitful practices they use.  I am hoping I can convince her to write an article that goes into more details.

Rest assured that there is MASSIVE waste and fraud in the drug industry. In the end, you are the one paying the price twice, by emptying out your wallet and endangering your health with drugs you probably don't need in the first place.

Drug reps are not your run-of-the-mill salespeople. They are meticulously trained to spot the weaknesses of every client. Doctors usually believe they are immune to persuasion tactics, and drug reps know just how important it is to maintain that illusion.

Last year pharmaceutical companies spent over $16 BILLION on physician advertising -- a fancy word for bribing individual doctors. And the industry claims it's worth every penny, which only proves that drug reps most definitely increase drug sales, by influencing physicians to change their prescription habits.  That is $10,000 for every doctor in the US.

But exactly how do they do it? What makes otherwise well educated, intelligent doctors turn their backs on their Hippocratic Oath (to do no harm) and do the complete opposite (prescribe completely unnecessary drugs)?

It turns out that doctors are mostly unaware of just how extensive and detailed the drug companies’ profiling of them is. Not only are reps trained to assess their personality, practice style, and medical preferences, they’re also instructed to sniff out personal information, like the names of family members, birthdays, and family interests -- as well as the physician’s professional interests and recreational pursuits.

All of this information goes into a database for future reference. When the time comes to devise an “incentive” -- say a dinner, sporting event, or membership -- it is custom tailored to suit the prey. It’s all about establishing personal rapport. Oftentimes doctors mistake the reps’ cleverly disguised interest in them as personal friendship. This is exactly how it’s designed to work!

Physicians are clinically dissected into “types” based on their personality, and encounters are specifically tailored for maximum effect.

“Friendly” physicians get the buddy treatment. Samples and gifts are given, not because it’s part of the job, but because the rep “likes” them. Lunch may be brought in under the guise that the doctor actually provides “pleasant relief from all other docs out there.”

Aloof and skeptical physicians receive journal articles and extensive data that counter the documented apprehensions he or she may have...

“Mercenary” physicians (who generally don’t prescribe as many drugs) receive a clear message that the dinner they just accepted implies their willingness to prescribe a particular drug to a certain number of patients exhibiting certain symptoms. Reneging on the prescriptions-for-dinner bargain gets broadcast over the jungle drums, and suddenly reps don’t come-a-knocking with goodies anymore…

High-prescribers receive better presents, including unrestricted “educational” grants that essentially amount to cold, hard cash.

Competing-drug prescribers are deftly manipulated into understanding how the drug will work better than the competitor’s for a certain patient niche (to circumvent their reluctance to switch).

"Acquiescent" physicians who foolishly imagine that simply agreeing will get rid of the nuisance, realize all too late that there’s no such thing as a free lunch. Gifts here are subtly used to enhance subconscious guilt and social pressure to reciprocate. Sales numbers show it works like a charm.

Hard-to-see physicians are actually not dissed by drug reps, because they’ve found that a good hand-delivered lunch to the office staff, followed by snooping under the guise of a friendly chitchat, can work even better than talking to the doctor to find the right hot buttons.

"Charismatic" physicians, those who are highly credentialed with an aura of integrity, are chosen as “thought leaders” to enhance and further certain drugs. These leaders are invited, and paid, as speakers to influence their peers. Depending on their level of allegiance and tact, they may be elevated through the ranks of speakers to the national circuit and beyond, gaining personal clout and fatter wallets as they go along with the program.

In recent years, physicians have become increasingly aware of -- and dismayed by -- the additional practice of script tracking. Health information organizations, such as IMS Health, Dendrite, Verispan, and Wolters Kluwer, buy pharmacy prescription records and resell them. Drug companies keep tabs on the return on their bribes with this data, as it tells them the prescription rate of each doctor.

Patient names are not included in these records, but physicians are easily identified through either state license number, DEA number, or a pharmacy-specific identifier, through the American Medical Association’s master database. Physicians are then ranked on a 1-to-10 scale, based on how many prescriptions they write; a “10” is every reps' dream date.

This information also reveals how many of a doctor's patients receive specific drugs, how many competing drugs are prescribed compared with the target drug, and how the physician's prescribing habits change over time. It tells them if a drug is “in favor” or not, and gives them the tools to cook up a winning strategy for future manipulations.

Between 1990 and 2004, spending for prescription drugs increased five times, to a whopping $188.5 billion, and drug reps increased from 38,000 to 100,000 strong. That’s a ratio of one drug rep for every 2.5 physicians targeted for “detailing.” Talk about having a personal “Big Brother.”

The idea that reps provide some kind of valuable, informative service to physicians is total fiction, created and perpetuated by the drug industry, to keep this deadly, but profitable, scheme going.

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