Every time a doctor writes a prescription, the drug companies are watching. Using national computer tracking firms, they monitor which doctors are prescribing which drugs. Once they know who's not buying their products, they go to work.
Dr. Jehan El-Bayoumi, of the George Washington University Medical Center, says she sees drug company representatives on a daily basis. "In the clinic, in the hospital, they come to our offices," she says.
Pharmaceutical companies in America today employ an army of 55,000 representatives, who target doctors like El-Bayoumi. The reps spend $5 billion a year - that's $13,000 per doctor - pitching products to them and filling their world with advertisements. "The clock, actually, has some advertising on it, our Kleenex box is an advertisement, even the occupied/non-occupied sign," says Dr. El-Bayoumi.
Dr. Shira Doron and Dr. Shari Rosenbaum are medical residents at George Washington University Medical Center. Young doctors like them are pitched most heavily by the drug reps. Recounting one incident, Dr. Doron said, "They gave us dinner and drinks and then they gave us game cards so that we could play games at The ESPN Zone," a sports theme restaurant.
Most doctors will tell you that all that salesmanship doesn't affect them. "I would never prescribe a drug because the drug rep gave me a good pen; I mean, that would never happen," says Dr. Doron.
But studies show the marketing works. None of the drug companies we approached would let us talk to their reps, but an industry spokesman defended them.
Alan Holmer, the president of Pharmaceutical Research and Manufacturers of America says, "educating busy doctors about new cures and treatments is not like marketing corn flakes. It's even more challenging today, as medicines have become more sophisticated."
Drug reps, whose job is to push newer, more expensive drugs, leave closets full of free samples and hope that doctors will prescribe their remedies instead of cheaper alternatives. "Most likely we all get influenced," says Dr. El-Bayoumi.
Dr. Jerry Avorn, of Harvard Medical School, is taking a lesson from the slick drug ads. He is producing his own un-advertisements in an effort to teach his residents how to see past the hard sell. "We don't teach people well enough how to do that, and then they're out there in the world prescribing and we're not arming them against some of the more extreme claims," he says.
If doctors and hospitals know this, then why do they let the reps in the door? Because, while they might not want them, they do need them. Pharmaceutical companies don't just sell drugs, they offer information on nw treatments and critical funding for research.
As Dr. El-Bayoumi explains, "the drug companies do provide information as funding is being cut, and that is a fiscal reality. We may not have a choice but to turn to them for clearly biased information."
Doctors call it a gray area but admit it's a danger zone. "You listen to a talk, you get tickets to the Kennedy Center," says Dr El-Bayoumi.
As long as they keep saying yes, they run the risk of selling out.