1-1banner
 
medpundit
 

 
Commentary on medical news by a practicing physician.
 

 
Google
  • Epocrates MedSearch Drug Lookup




  • MASTER BLOGS





    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov




    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.




    "Opinions are like sphincters, everyone has one." - Chris Rangel



    email: medpundit-at-ameritech.net

    or if that doesn't work try:

    medpundit-at-en.com



    Medpundit RSS


    Quirky Museums and Fun Stuff


    Who is medpundit?


    Tech Central Station Columns



    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews

    Review


    Medical Blogs

    rangelMD

    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc

    richard[WINTERS]

    code:theWebSocket

    Psychscape

    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It

    medmusings

    SOAP Notes

    Obels

    Cut-to -Cure

    Black Triangle

    CodeBlueBlog

    Medlogs

    Kevin, M.D

    The Lingual Nerve

    Galen's Log

    EchoJournal

    Shrinkette

    Doctor Mental

    Blogborygmi

    JournalClub

    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House

    .PARALLEL UNIVERSES.

    SoundPractice

    Medgadget
    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day

    BioEdge

    The Business Word Inc.

    Point of Law

    In the Pipeline

    Cronaca

    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station

    Blogcritics

    Overlawyered.com

    Quackwatch

    Junkscience

    The Skeptic's Dictionary



    Recommended Reading

    The Doctor Stories by William Carlos Williams


    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn


    Intoxicated by My Illness by Anatole Broyard


    Raising the Dead by Richard Selzer


    Autobiography of a Face by Lucy Grealy


    The Man Who Mistook His Wife for a Hat by Oliver Sacks


    The Sea and Poison by Shusaku Endo


    A Midwife's Tale by Laurel Thatcher Ulrich




    MEDICAL LINKS

    familydoctor.org

    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info

     



    button

    Thursday, April 13, 2006

    Waiting Room Reading: This month's issue of the Atlantic Monthly has a depressing article on drug pushers - the legal kind. Here's a story from the salad days told by a former drug rep:

    One of the more important clinics Carbona called on was a practice there consisting of about fifty doctors. Although the practice had plenty of patients, it was struggling. This problem was not uncommon. When the movement toward corporate-style medicine got under way, in the 1980's and 1990's, many doctors found themselves ill-equipped to run a business; they didn't know much about how to actually make money. Carbona was detailing this practice twice a week and had gotten to know some of the clinicians pretty well. At one point a group of them asked him for help. "Gene, you work for a successful business," Carbona recalls them saying. "Is there any advice you could give us to help us turn the practice around?" At this point he kne he had stumbled upon an extraordinary opportunity.

    Carbona decided that the clinic needed a "practice-management consultant." And he and his colleagues at Astra Merck knew just the man: a finanical planner and accountant with whom they were very friendly. They wrote up a contract. They agreed to pay the consultant a flat fee of about $50,000 to advise the clinic. But they also gave him another incentive. Carbona says, "We told him that if he was successful there would be more business for him in the future, and by "successful," we meant a rise in prescriptions for our drugs.

    The consultant did an extremely thorough job.....He turned the practice into a profitable, smoothly running financial machine. And prescriptions for Astra Merck soared.

    When I asked Carbona how the consultant had increased Astra Merck's market share within the clinic so dramatically, he said that the consultant never pressed the doctors directly. Instead, he talked up Carbona. "Gene has put his neck on the line for you guys," he would tell them. "If this thing doesn't work, he might get fired."...."Those guys went berserk for me," Carbona says. Doctors at the newly vitalized practice prescribed so many Astra Merck drugs that he got a $140,000 bonus. The scheme was so successful that Carbona and his colleagues at Astra Merck decided to duplicate it in other practices.


    True? Or salesman braggadocio?

    The article goes on to posit that today, drug reps are being replaced by doctors. That's true, although I suspect this has always been one of their more successful strategies. They're just realizing now that it's a lot cheaper to get some respected specialists (or "thought leaders") in a community to talk up their drugs than to pay a salesman to do it. If you can convince a town's gastroenterologist to use the newest proton-pump inhibitor, then pretty soon all the generalists in the town will be using it, too, because suddenly it becomes the standard of care for that community. They've come to realize that the same strategy can work just as easily on a national level - with far more profit for them.

    Beware of specialists selling drugs.
     

    posted by Sydney on 4/13/2006 09:31:00 AM 0 comments

    0 Comments:

    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page

    Ads

    Home   |   Archives

    Copyright 2006