I'm Your Pusherman...

I was floating around the office of my LPP (Longitudinal Preceptorship Program) as I normally do--feeling and looking perhaps a bit awkward, not sure where exactly to stand in the narrow hallway, sporting my emblem of medical knowledge, the stethoscope and entertaining thoughts of what was in store for the afternoon in this pediatric practice. Gracefully, skillfully, she swooped me into conversation: Angela, making the hallway even narrower and impassable, introduced herself and proceeded to corner me into a conversation about current ADHD treatments and diagnosis. She was from J & J (that's Johnson & Johnson if you're outside of the biz). Perhaps the snicker that grew in the corners of my lips made it obvious to her that I was not listening to a word she said but instead churning over statistics about drug reps and their devious game. There is a really interesting report on the rules and tactics of this game here. Below are a few of the most interesting points:

• The rep categorizes the doctor based on 8 categories and tailors their tactics based on that categorization; this is a finely tuned science.
• Despite the self control that we all want to believe we have over our influences, those little samples that pharmaceutical reps distribute so freely actually affect the decisions that doctors make (otherwise, they wouldn't give 'em out!)
• As much training as physicians have in behavior change, the psychology of habituation, and the mind's interpretation of everyday events, drug reps are able to give doctors a taste of their own medicine. The gift giving works, the relationship building makes money, and, perhaps tritely, everyone is human--most of all physicians themselves.
  

As I was cycling through the information that I had heard about pharmaceutical sales watching Angela's lips move, I was reminded of a song by Curtis Mayfield and thought that this well-dressed, well-groomed woman was nothing more than a pusherman:

"...I'm your doctor, when in need
want some coke, have some weed
you know me, I'm your friend
your main boy, thick and thin
I'm your pusherman,
I'm your pusherman."