Howard Brody Explores Darkest CafePharma

On the Hooked: Ethics, Medicine, and Pharma blog, Howard Brody posted about his foray into the world of the CafePharma bulletin board, and focused on a debate - that is a polite term for it - which started when an anonymous person asked "do you ever mess with the food [provided free to a medical office] before lunch?" This produced a lively and scatalogical exchange, made livelier, if that is the word, by the participation of PandaBearMD (who blogs here). Since nearly everything on this bulletin board is anonymous, it is a bit hard to determine which stories are true, and which rants are authentic. But Brody summarized his thoughts thus:

I have tried hard in my own work never to villainize reps. As I see it, reps have an impossible job. From the company's point of view, they have one function only, to move product. I ask at every opportunity for someone to tell me about a single rep who was ever paid a single bonus for anything other than quantity of drug sales--and no one has ever given me an example.

The other part of their job is to lie about this. They have to lie to two people. First they have to lie to us, because we demand it. We will not easily and comfortably take all the goodies they shove our way, unless they keep repeating over to us the soothing rationalization, "It's education, not marketing." Second they often have to lie to themselves because they can live with themselves much easier if they can see themselves as educators and not as mere salespeople. Or at least they can lie to us more glibly if they lie to themselves first.

In one respect, I can concur completely with the blog postings, as much as I am repulsed by the packaging. If I sort through the obscenities, one basic idea seems to stand out. These reps despise docs and office staff who first scarf up their food and other goodies whenever they get the chance, and then believe that they can turn around the treat the reps who brought the stuff like dirt.

And I would like to believe that this posting really was heart-felt:

What ever happened for our respect for the doctors AND their respect for us. At some point this has fallen by the wayside. No wonder why no one likes us or respects us anymore.

If a doc lets us into his/her office, then they should expect to be 'sold' or 'pitched' on a product. This would be an intellegent discussion between two educated professionals. We feed them as a 'thank-you' for their business and for listening to us.

We have to realize that we can't get all docs to write all of our products all of the time! If they don't like us or do not want to be 'sold', then PLEASE - just don't let us in. That simple. Don't eat or accept our food either. Simply divorce yourselves from us.

Perhaps if we all have this understanding, we can begin to respect each other once again.