Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: Doors Closing to Drug Reps

Drug reps are worried. For good reason. In 2013, 45% of U.S. physicians limited pharmaceutical drug reps’ access to their offices, according to sales and marketing consultant ZS Associates. This is up from 35% in 2012 and 23% in 2008.  For a variety of reasons, this trend is likely to continue:  More low-cost generic medications are being prescribed as name-brand drugs lose their patents. Fewer “blockbuster” drugs are in the pipeline. Email and web-based promotions are replacing the need for the traditional sales force. Add to this list growing government scrutiny of “big pharma’s” alleged aggressive marketing practices. How sales people are being paid is also changing. GlaxoSmithKline, for example, recently announced that it will no longer pay their U.S. sales people based on the number of prescriptions written by doctors in their territory.

The National Physicians Alliance, a 15,000-member doctors group, is asking U.S. physicians to close their doors to all drug reps in order to circumvent the conflict of interest criticism they’re getting from consumer groups. “We need to have a transparent system of disclosures that enables policy-makers, physicians, and most importantly patients to know when conflicts of interest arise,” says NPA Executive Director Dr. Jean Silver-Isenstadt. Founded in 2005 by former leaders of the American Medical Student Association, NPA has taken an aggressive stance through its ‘Unbranded Doctor’ Campaign.

“In Seattle, some of the biggest Puget Sound medical groups have closed-door policies, including Virginia Mason Medical Center, Everett Clinic, Polyclinic, and Group Health” ( Large groups throughout the country are developing well-researched formularies that place limits on their physicians’ prescribing practices. The belief in some circles is that physicians who interact with enthusiastic drug reps are more likely to prescribe higher cost medications when lower cost generics may be equally beneficial.

The locum tenens physician is not immune from deciding whether or not to see pharmaceutical company reps. Perhaps the best course of action is to simply follow whatever policy has been established by the client.