AMA: Be open about drug reps in exams

The Association also gave its opinion and presented guidelines on boutique medicine and stem cell research.

By Tanya Albert, AMNews staff. July 7, 2003.

Chicago -- If you're going to invite a drug rep into the exam room, you better let the patient know exactly who that person is.

If the patient isn't OK with the idea, the pharmaceutical sales representative can't sit in on the exam.

The American Medical Association set these new guidelines at its Annual Meeting in response to requests from drug sales reps to shadow doctors for a day for educational purposes.

Some physicians are paid up to $500 a day if they consent to the arrangement. But many fear -- particularly when they get a second shadowing request from the same pharmaceutical salesperson -- that the drug rep is only trying to find out what drugs the doctor is prescribing.

"I don't allow second-time shadowing," said Illinois gastroenterologist Howard Chodash, MD, who added that he donates any money he gets from the arrangement to charity.

Also of concern is that patients aren't being properly informed about who is sitting in on their exams. Former pharmaceutical sales representative Barbara Felt-Miller confirmed that fear.

Felt-Miller told physicians that when she shadowed doctors during the five years she made calls on their offices as a sales representative, doctors often didn't explain to patients who she represented.

"My concern today is for patient privacy," said Felt-Miller, who has been treated for Crohn's disease for 26 years. "I never took an oath. The things I viewed in the exam room were left up to my discretion [to talk about or not]."