Diary of a Neighborhood Pharmacist, Entry #28

Of course we believed, "sincerely," that we couldn't be bought by the drug companies. Our objectivity was beyond question – at least mine was. We never saw anything wrong with our behavior.

They look sincere, and why not? Given a large enough population, there are bound to be people with different attitudes, different concept of what their job is, but there are always drug sales reps who believe that their role is not sales, but education, that their function is not to make profits, but to bring needed information that will save lives. They are, as I've said, honest people – and if they're not, they've learned to hide it. Attila the Hun wouldn't have been a good sales rep.

But I think it's time for another digression. I'll spare you the background, only that in my middle-age I've done some work for a medical advertising agency. One of my functions is occasionally to go through the literature on a new drug, and try to find out what makes it special, what differentiates it from the other cookie-cutter drugs in the same class. At other times, I'll be asked to explain a concept in simple terms, so that the sales force can understand it. Once or twice I've had occasion to read a sales training brochure, and felt upset, not by the information, but by the writing style, which seemed to be cribbed from Little Golden Books. I like a compound complex sentence now and then, just as I enjoy the occasional dash of cayenne pepper.

Maybe I should get to the point. I am taking a drug for cholesterol reduction that I don't think I need, and that costs me 10 times as much on the co-pay as a drug that I think would work as well. I normally follow a very low cholesterol diet, and I don't think I need anything to reduce absorption of dietary cholesterol, but my physician neither checked nor asked. When she feels concerned about the cost to me, she goes in the back and pulls out some samples. And just as I felt that the occasional dinner or speaking honorarium made no difference in my objectivity, I'm sure she feels the same way about her prescribing practices. I'm sure that in some way, we're all satisfied with the way we've maintained our professional integrity. We have good reasons not to ask too many questions.

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