Brody: Why Physicians Should Refuse to See Pharmaceutical Reps

It is all about the company we keep, writes Howard Brody in the current issue of Annals of Family Medicine, in what is easily the best and most straightforward, honest excoriation of the idea that physicians can see drug reps in their offices without compromising their integrity. Brody gives the question careful thought - and writes this piece directly to the docs who are doing the most interacting with drug reps: family clinicians. His conclusions are straight up.

A majority of medical practitioners spend part of their time talking with and receiving gifts from pharmaceutical sales representatives (reps). Asked why they do so, most would initially be puzzled at the question. It is very likely that they have come to this place as a result of long-standing habit rather than conscious choice. Nonetheless, the decision to spend one’s time in this fashion has important ethical implications...The evidence available today ... seems conclusive on 2 points—first, that we are indeed heavily influenced by reps; and second, that we ourselves are very poor judges of the extent of that influence.10 To the extent that we claim to be scientific practitioners, we would seem obligated to take this evidence into account in deciding upon our proper professional behavior.