The Devil Is in the Detailing

In today’s New York Times Magazine, Daniel Carlat, a Massachusetts psychiatrist, describes his experiences in “detailing” for Wyeth Pharmaceuticals. “Pharmaceutical ‘detailing’ is the term used to describe those sales visits in which drug reps go to doctors’ offices to describe the benefits of a specific drug.” The term also encompasses the visits made by physicians like Dr. Carlat, who are paid a stipend to speak to colleagues about the benefits of certain drugs. In Dr. Carlat’s case, he was promoting the anti-depressant, Effexor. However, over time, he found himself “tweaking and pruning the truth in order to stay positive about the product,” despite certain reservations about its use. As a result of his uneasiness, he modified his presentations to provide a more balanced perspective. Here is what happened next:

Several days later, I was visited by the same district manager who first offered me the speaking job. Pleasant as always, he said: “My reps told me that you weren’t as enthusiastic about our product at your last talk. I told them that even Dr. Carlat can’t hit a home run every time. Have you been sick?�

At that moment, I decided my career as an industry-sponsored speaker was over. The manager’s message couldn’t be clearer: I was being paid to enthusiastically endorse their drug. Once I stopped doing that, I was of little value to them, no matter how much “medical education� I provided.

The entire article is well worth reading. It is entitled: Dr. Drug Rep.


2 thoughts on “The Devil Is in the Detailing

  1. I’ve heard a number of those ‘educational’ talks, and taken the bribes,(see Confessions of a Drug Lunch Slut)
    the NYT article is right on, and you might want to ask your doctor about his or her prescribing.
    no one wants to admit how much we can be influenced by easy money, flattery, free trips, or even a free lunch or a lousy pen.

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