Drug Company Reps Visiting Va Doctors

[hedgey]

First of all, this is not in a VA run facility. This is a contract VA clinic run by a Contract Healthcare Corporation, out here in the boonies.

I have seen with my own eyes the glamor-puss drug reps coming in & out of the clinic, with their little wheelie suitcases in tow.

I'd seen this before, at my old private doctor's office, many times over the years. His nurse told me that Ol' Doc Smith made a good living off the perks - trips, gifts, coupons that were essentially cashed in for ... cash. She told me that the Reps came in, gave him a truck load of goodies and in turn, he wrote scripts for their drugs. Mind you, he would only write the scripts if he thought the drugs would be effective, but the more he wrote for, say, effexor, the more goodies he got from Merck (might be a different pharma, but you get the picture).

(I once ran into the local AARP head who had a petition for over-50's to sign for our congressman to force Pharmaceuticals to release information on perks given to doctors in exchange for scripts written. It never happened, or not to my knowledge.)

I've never seen a drug rep at the VAMC, and I never saw one when our clinic was run by the VA directly. But I've been seeing them lately. I asked another vet and was he said that since Valor was a contractor, drug reps could certainly come in and peddle their drugs to the doctors.

So I asked my VA therapist about this. He groaned and shook his head and said he couldn't understand why the VA would allow it. But it might explain why my DH's Contract Healthcare psychiatrist insisted on giving him two newer medications (that both made him sick and/or loopy) and refused to let DH try the older meds that his therapist told him he was likely to get. Flat out refused to change his meds to anything else, mine or any others. Told DH if he wouldn't take the meds he prescribed and felt he was in crisis, go to the emergency room. What is up with that? I never heard of a psychiatrist or any doctor who wouldn't allow a patient to stop meds that made them feel ill.

I know, this psychiatrist is cheerfully writing in his notes that DH is uncooperative and refuses medication. Luckily, DH's therapist is part of a special Rural Healthcare Clinic and DH will be able to see their psychiatrist shortly - one who actually works for the VA, not a contractor.

But back to the main question. How is okay that Drug Reps are being allowed access to doctors who write scripts for veterans? Why is the VA allowing doctors who treat veterans to be influenced by Drug Companies? This can't be right. I know there's influencing going on, because when you go into the individual examining rooms, you see the Paxil note pads, the Enberel coffee cups, etc. (I can't remember the exact names I've seen, but you know what I mean. Goodies from the Reps.).

You know the Drug companies aren't giving anything away for nothing. I heard from someone who no longer works there (complete gossip, hearsay) that at least one of the doctors there is making a nice little part-time income from them.

So what do I do? Am I right to be outraged? Am I just freakin' paranoid, as usual?

Edited to Add:

Well I googled and I found this instructional essay for Drug Reps interested in selling to the VA. So at least there are limits to what they can give VA doctors located in real facilities. Limited.

http://pharmrep.findpharma.com/pharmrep/Selling+to+Physicians/A-different-world/ArticleStandard/Article/detail/316594

I know that the docs need information on what's available, etc., but shouldn't that come down from within the VA healthcare system, not from a 20-year old cutie with a commission on their mind?

Edited August 26, 2011 by hedgey

[Stilt]

I am a diabetic. I take Metformin and Glipizide to control it. These two drugs are very effective and patients rely on them heavily. Now, I wonder how it came to be that doctors know to prescribe these drugs for diabetics. Could it be that many years back a sales rep walked into a doctor's office and promoted these drugs?

My point is this there is nothing wrong with pharmaceutical representatives promoting their products even if it means visiting doctor offices to do so. I believe doctors are smart enough know which meds to accept and which to reject. Further, medicines, before they are dispensed to patients must be approved by the FDA. That means a drug has gone through testing and has proven itself to be effective against a given disease.

Many doctors do not keep pace with every development in the medical field. Representatives from pharmaceuticals, medical equipment and supplies, software and hardware manufacturers, etc., hit the road and make personal contact with doctors to let them know what is available. So, if you have chosen your doctor carefully, I am sure he or she is smart enough to look after your interest.

Edited August 26, 2011 by Stilt

[chr49]

I am a diabetic. I take Metformin and Glipizide to control it. These two drugs are very effective and patients rely on them heavily. Now, I wonder how it came to be that doctors know to prescribe these drugs for diabetics. Could it be that many years back a sales rep walked into a doctor's office and promoted these drugs?

My point is this – there is nothing wrong with pharmaceutical representatives promoting their products even if it means visiting doctor offices to do so. I believe doctors are smart enough know which meds to accept and which to reject. Further, medicines, before they are dispensed to patients must be approved by the FDA. That means a drug has gone through testing and has proven itself to be effective against a given disease.

Many doctors do not keep pace with every development in the medical field. Representatives from pharmaceuticals, medical equipment and supplies, software and hardware manufacturers, etc., hit the road and make personal contact with doctors to let them know what is available. So, if you have chosen your doctor carefully, I am sure he or she is smart enough to look after your interest.

Stilt,

I completely agree with you and thank you for presenting the other side of the story.

My wife worked in a doctor's office for 12 years. She saw many pharmaceutical reps come thru and sat thru most of the new drug presentations because she was the office nurse and learned a lot in doing so. She said the only freebies she ever saw were the samples that were left at the office and a rare pre-arranged lunch for the entire office (for a new drug presentation). The drugs samples they left helped many people that wouldn't have been able to pay for the medications themselves. Many of these pharmaceutical companies have special programs for low income people that can't afford their drugs. The purpose of having reps see the physician was/is to introduce new drugs, teach the side effects and interactions, discuss any issues/problems with their medications and put samples of the product in the doctor's hands so he can try them. With the amount of new drugs being introduced on a regular basis, this is extremely helpful for physicians. If not for pharmaceutical reps, they could easily stick with the old products never realizing that there were newer and better options for their patients.

I'm not saying there's no corruption. There could be but there's a lot of good being done by pharmaceutical reps and the doctors that receive & prescribe the drugs too.

Edited August 27, 2011 by chr49

[Pete53]

My HMO Doc's office no longer gives or gets samples. They don't want to play that game anymore.

[Notorious Kelly]

There have been scandalous stories about these reps.

As a phone system technician I was a fly on the wall to people and worked extensively in medical offices, so I've wondered about them for quite some time.

Every trip to the doc's they want me to take 2 or 3 more pills; I refuse and only take 1 daily medication.

Sales is a dirty business....

[Stilt]

There have been scandalous stories about these reps.

As a phone system technician I was a fly on the wall to people and worked extensively in medical offices, so I've wondered about them for quite some time.

Every trip to the doc's they want me to take 2 or 3 more pills; I refuse and only take 1 daily medication.

Sales is a dirty business....

Instead of disobeying doctor orders why don't you find a doctor that you can trust. Or, better yet, ask the doctor to explain what purpose each pill serves. Otherwise, what is the point to going to a doctor for a problem and ignoring his/her instructions. Today, scientist can manufacture a particular drug to do a specific function. Take my case for example, I am a diabetic and have been prescribed Metformin and Glipizide to control it. Why both? Read here. If I follow your logic and stop using one of the meds, my blood sugars would go through the roof. If you keep disobeying doctor instructions you are really going to be Notorious, Notoriously dead. You don't strike me as a person trained in the chemistry of medicines. You should stop acting like you are.

[john999]

I am glad some of us here still belive in the tooth fairy and Easter Bunny. Vioxx killed a few thousand people, but we will never know since the ones who could testify are all dead. Please tell me why drugs sold in the USA are ten times as expensive as any place else on earth.