Just
in case you are a physician looking for a reason to avoid drug reps,
you should read this article on PLOS Medicine.  It is an
enlightening, if sickening, inside view of pharmaceutical sales
practices.

face="Helvetica, Arial, sans-serif"> href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040150">Following
the Script: How Drug Reps Make Friends and Influence Doctors
Adriane
Fugh-Berman*, Shahram Ahari
April
24, 2007

…Unlike
the door-to-door vendors of cosmetics and vacuum cleaners, drug reps do
not sell their product directly to buyers. Consumers pay for
prescription drugs, but physicians control access. Drug reps increase
drug sales by influencing physicians, and they do so with finely
titrated doses of friendship. This article, which grew out of
conversations between a former drug rep (SA) and a physician who
researches pharmaceutical marketing (AFB), reveals the strategies used
by reps to manipulate physician prescribing…

The article includes a couple of tables showing the tactics used by
drug reps to influence physicians.  Most of these are things I
had already figured out, but it is still upsetting to see it all laid
out in black and white.

Reps
may be genuinely friendly, but they are not genuine friends. Drug reps
are selected for their presentability and outgoing natures, and are
trained to be observant, personable, and helpful. They are also trained
to assess physicians’ personalities, practice styles, and preferences,
and to relay this information back to the company. Personal information
may be more important than prescribing preferences. Reps ask for and
remember details about a physician’s family life, professional
interests, and recreational pursuits. A photo on a desk presents an
opportunity to inquire about family members and memorize whatever
tidbits are offered (including names, birthdays, and interests); these
are usually typed into a database after the encounter. Reps scour a
doctor’s office for objects—a tennis racquet, Russian novels,
seventies rock music, fashion magazines, travel mementos, or cultural
or religious symbols—that can be used to establish a personal
connection with the doctor.

Right.  These people do not have photographic memories.
 They have contact management software that has data fields
for the names of your spouse and kids, pets, sports, whatever.
 After they see you, they go out to their car, pull out their
laptop, and enter any new tidbit they’ve gleaned from you or your staff.

Pharmaceutical
companies monitor the return on investment of detailing—and
all promotional efforts—by prescription tracking. Information
distribution companies, also called health information organizations
(including IMS Health, Dendrite, Verispan, and Wolters Kluwer),
purchase prescription records from pharmacies. The majority of
pharmacies sell these records; IMS Health, the largest information
distribution company, procures records on about 70% of prescriptions
filled in community pharmacies…

…In 2005, database product sales, including an unknown amount from
licensing Masterfile information, provided more than $44 million to the
AMA…

Don’t worry, there is no patient-specific information in these records,
so there is no privacy rule being violated.  Still, it is kind
of creepy to realize how much people are tracking what you do.
 The reason why is fairly obvious:

For
example, Medical Marketing Service “enhances the AMA
Masterfile with non-AMA data from a variety of sources to not only
include demographic selections, but also behavioral and psychographic
selections that help you to better target your perfect
prospects”.

The goal of this demographic slicing and dicing is to identify
physicians who are most susceptible to marketing efforts…

…In Pharmaceutical Executive, Ron Brand of IMS
Consulting writes “‥integrated segmentation analyzes
individual prescribing behaviors, demographics, and psychographics
(attitudes, beliefs, and values) to fine-tune sales targets.

Oh, so I’m a “sales target,” now?  Thank you for the
compliment.