Set ground rules for drug rep interactions

Ethics Forum. Nov. 7, 2005.

How do you deal with drug reps asking for your time?

A member of your staff stops you and asks, "The drug rep is waiting to see you. Do you have a moment?"

Reply:

Budgeting time from my clinical or research day for unexpected interruptions, let alone pharmaceutical reps, is often challenging. When I make time for a drug rep I expect something of value in return. Am I compromising my integrity and ethics during these brief encounters?

My first encounter with a drug rep as a practicing physician was in rural Canada. Our community health center consisted of 10 doctors and several nurse practitioners. The head physician asked me to come in and "say hi to the rep."

The actual drug and accompanying message are long gone from my memory, but the words that the head physician shared with me immediately afterwards still reverberate in my head: "Sam, you just have to listen to what the rep says, say you will prescribe the drug, sign for samples then shake hands." Those were the good old days.

Of late, greater scrutiny regarding physician-drug rep relations is the norm. The AMA's position statement on gifts to physicians from the drug industry, first published in 1991, has been updated to reflect current medical practice. The Pharmaceutical Research and Manufacturers of America since has adopted these updated guidelines.