Opinion | Pharma Reps: A Blessing or a Curse?

Are pharma reps on balance a curse or a blessing to medical practices? On some days it is not unusual to believe the former, that the pharmaceutical representative is another obnoxious intrusion into the ever-decreasing time available to spend with patients.

Some doctors habitually see these reps for a few seconds, just long enough to sign for samples and then return to patients. Remarkably, a large proportion of practices have policies forbidding physician visits with pharma reps.

But I feel strongly that this is a mistake. Pharmaceutical reps can and should be an invaluable asset to medical practices. They furnish providers with educational materials, updates on their products, and brochures and websites aimed at improving medication compliance with patients. They can be particularly invaluable with providing materials in foreign languages — a valuable resource in diverse neighborhoods and cities.

Also, pharmaceutical and medical manufacturing representatives exist as one degree of separation from inbound referrals. If pharma reps or device vendors know of your expertise or area of interest, they may recommend your practice not only to other physicians but also to friends and colleagues. The reverse can also apply — pharmaceutical reps know that doctors who act rudely to them may also act rudely to patients. Who wants that kind of word of mouth going around?

If you want to capitalize on the benefits that reps can bring, see them in a timely fashion. Being made to wait is their hot button. This is not to say, of course, that a provider must devote big chunks of time to the encounters.

To improve the efficiency of time spent with the pharma reps, consider asking for an agenda for their next visit. You can send a letter in advance or have a receptionist provide one when scheduling the appointment (see sample below).

The letter asks each pharmaceutical representative to state the nature and length of the upcoming visit. You can then decide whether the visit is worthwhile. If so, give them an allotted time for the visit. To the pharmaceutical rep or vendor, the letter and a commitment to the allotted time are a fair trade for being seen on time.

One sure-fire method of keeping the pharma rep focused for the allotted time is to place a small hourglass on your desk, turning it over at the beginning of the meeting. I have used the agenda letter and hourglass for years and have never heard a pharma rep or vendor object.

One other caveat is to avoid allowing a pharmaceutical rep access to the clinical office during patient hours. Patients feel second class when a pharma rep — who is usually easily identified with a briefcase bearing a corporate name and logo — is allowed to see a doctor before they do.

Sadly, we are seeing declining reimbursements, rising overhead costs, and stagnant or decreasing physician incomes. We have also experienced reduced time with patients. All this leaves less time to spend with commercial representatives. But these factors need not spell the end of pharmaceutical rep and vendor benefits.

Instead, we must focus on maintaining those relationships with growing attention to efficiency. And of course, it’s reasonable to approach the information from pharmaceutical reps with a healthy dose of skepticism and high bar for evidence. In the end, meeting with pharma reps while using my suggested approach is a win not so much for the representative but for our patients.

Here is a sample appointment letter to a pharmaceutical representative:

Dear <name>,

As you know, ongoing dramatic changes in healthcare leave providers with less time to see more patients. Consequently, I/we have less time to spend with pharmaceutical representatives and vendors.

However, I/we want to continue with a beneficial relationship with you and your company, so I/we must keep our visits short and focused.

From now on, I/we would appreciate your preparing an agenda for each of our meetings. I would ask that you please include topics to discuss, questions for me and the practice, and how much time you would like.

I will then ask my receptionist to make the appointment for you. In return, I pledge to make every effort to see you on time.

Thank you very much for your accommodations. I believe this plan will help us become more efficient.

Sincerely,

<your name>

Neil Baum, MD, is a urologist in New Orleans, the corporate medical officer of Vanguard Communications, adjunct professor of the Tulane University School of Medicine, and the author of The Complete Guide to a Successful Medical Practice (Springer 2015). Baum has no affiliations with any pharmaceutical companies or medical device companies, and has had none for years.