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A Dinner with Drug Reps: Dan Ariely
Old 11-07-2011, 01:34 PM   #1
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A Dinner with Drug Reps: Dan Ariely

http://danariely.com/

From his blog:

"Janet Schwartz of Tulane University and I recently spent an evening with a few pharmaceutical reps, men who used to be in the business of selling a wide range of drugs to treat all kinds of diseases and conditions, ... we knew that there was more to the story, so we tried the pharmaceutical reps at their own game – we took them to a nice dinner and kept the wine flowing. Once we got them generously lubricated, they were ready to spill. And what we learned was fairly shocking."

I don't know how shocking most of the findings are, but I like his final recommendation. I find him to be a most thoughtful and interesting writer with a wry sense of humor.

I'd recommend his books for those who enjoy this area of expertise.
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Old 11-07-2011, 01:41 PM   #2
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Got a link to the blog? -ERD50
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Old 11-07-2011, 01:51 PM   #3
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Got a link to the blog? -ERD50
added it. forgot the 1st time around. sorry.
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Old 11-07-2011, 01:51 PM   #4
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Dan Ariely » Blog Archive A Dinner with Drug Reps «

Here is what may be the best quote from that piece!

"Psychological studies show that people quickly start believing what is coming out of their own mouths, even when they are paid to say it. This is a clear case of cognitive dissonance at play; doctors reason that if they are touting this drug, they must believe in it themselves — and so they change their beliefs to match up with their speech."

Ha
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Old 11-07-2011, 07:35 PM   #5
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His book "Predictably Irrational" is really worth reading. Discussed it at a Bogleheads meeting. I met him at Burning Man where he was making a presentation. Very thoughtful
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Old 11-07-2011, 08:01 PM   #6
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His book "Predictably Irrational" is really worth reading. Discussed it at a Bogleheads meeting. I met him at Burning Man where he was making a presentation. Very thoughtful
His personal story is very compelling also. He ws badly burned over 70% of his body, and his face was badly damaged. He was in terrible pain for a very long time, and also and went from being a good looking young man to being not so. The story of how he came to terms with all this is something to read.


…My heart’s in Accra » Painful questions from Dan Ariely

Ha
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Old 11-07-2011, 08:31 PM   #7
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If you follow the links to his website you can read the PDF version of the paper that he wrote on pain. It goes into a lot of detail, and it's not for the squeamish or faint of heart.
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Old 11-07-2011, 08:45 PM   #8
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Dan Ariely » Blog Archive A Dinner with Drug Reps «

Here is what may be the best quote from that piece!

"Psychological studies show that people quickly start believing what is coming out of their own mouths, even when they are paid to say it. This is a clear case of cognitive dissonance at play; doctors reason that if they are touting this drug, they must believe in it themselves — and so they change their beliefs to match up with their speech."

Ha
I recall hearing an NPR feature on this drug rep subject a few years back. I always am skeptical that the interviewee ( a former drug rep) is dressing up the story for the audience. But if half of what he described was accurate, it is scary just how much these doctors were influenced by a smooth salesman.

-ERD50
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Old 11-07-2011, 09:08 PM   #9
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This kind of influence is of great concern to professional medical associations and many of them have codes of ethics prohibiting the type of perqs mentioned. In the pharmaceutical industry, visiting physicians and using strategies to reinforce their endorsement of medications is known as "physician detailing". Pharma companies do it because it is effective. In recent years, physician leaders have used physician detailing to influence their colleagues to support change, with some success.
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Old 11-08-2011, 04:21 AM   #10
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It's the same with technology - saw it all the time "this here gadget will really save your patient, practice, etc, etc." Had to talk a few docs down from what would have been million dollar mistakes....lithotripters ring a bell? They were going to really help all people with gall bladders, kidney stones, anything hard in a soft space that caused pain.....hmmm, sometimes, but not as much as originally thought and as built out (those devices needed some serious infrastructure!).
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Old 11-08-2011, 04:46 AM   #11
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Waaay back in the late '80s, my first college job was working in the medical center at the University of Washington. One of my duties was manning the booth for grand rounds. Many people in our office didn't want that slot because you had to be there promptly at 7am. The perk? Free coffee and donuts. The sponsors? Big pharma, pretty much a different drug every week.

I love Dan Ariely. Just finished "Predictably Irrational" and loved it.

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Old 11-08-2011, 08:07 AM   #12
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.......... I met him at Burning Man where he was making a presentation.........
Quote:
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.......... He was badly burned over 70% of his body, and his face was badly damaged..................
Ha
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Old 11-09-2011, 09:00 AM   #13
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oxycontin-purdue-pharma

Insight into the genesis, promotion and fallout from opioid painkillers in general and OxyContin in particular. The dark side of prescription meds including addiction and abuse is looked into.

An interesting read. Makes me think about those old hydrocodone tablets in the cabinet. Don't like taking anything personally. I tend to prefer to put up with pain, when necessary. Probably why prescription bottle is still full. Luckily nobody around to pilfer them. Should dispose of them properly, I guess.
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Old 11-09-2011, 09:26 AM   #14
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oxycontin-purdue-pharma

Insight into the genesis, promotion and fallout from opioid painkillers in general and OxyContin in particular. The dark side of prescription meds including addiction and abuse is looked into.

An interesting read. Makes me think about those old hydrocodone tablets in the cabinet. Don't like taking anything personally. I tend to prefer to put up with pain, when necessary. Probably why prescription bottle is still full. Luckily nobody around to pilfer them. Should dispose of them properly, I guess.
I'll dispose of them for you...

Actually, codeine has an undesirable effect on my "regularity"...

And one other thing: in it's infinite wisdom, the Feds require acetaminophen to be added to codeine, which increases the likelihood that someone "abusing" the drug will also get some liver damage...

Gotta love it!
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Old 11-09-2011, 01:11 PM   #15
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Show me a doctor who wrote the wrong drug for a patient because a pharmaceutical rep "talked him into it," and I will show you a doctor who is going to screw up in other ways without the rep doing anything....lots of talk about this topic--that certain drugs are used more--but where is the evidence that only the WRONG drug ends up getting used more? Is it not possible that sometimes doctors are talked to by a rep and it is in promotion of the RIGHT treatment, which then increases in use?
In the last few years, REPS are strictly forbidden from giving much of anything to doctors, no pens, no notepads, no Post it notes with the logo, nothing- there are no more Cancun educational trips, etc...and that is all good...but why hasn't the cost of care gone down at all? Maybe that is not really the source of the problem?
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Old 11-09-2011, 01:15 PM   #16
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Actually, pharmacists catch a lot of potential wrong drug use before it happens, they are the front line. My dad has told me stories that noone would believe they sound so out there.........he was a pharmacist for 40+ years........
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Old 11-09-2011, 01:17 PM   #17
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In the last few years, REPS are strictly forbidden from giving much of anything to doctors, no pens, no notepads, no Post it notes with the logo, nothing- there are no more Cancun educational trips, etc...and that is all good...but why hasn't the cost of care gone down at all? Maybe that is not really the source of the problem?
They can still hand out food. A friend only has to buy lunch once a week from all the free rep food. It's good stuff, too. It ain't no Taco Bell.
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Old 11-09-2011, 01:22 PM   #18
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My dad has told me stories that noone would believe...
Don't you ever tire of bashing noones? I'm surprised the mods haven't stepped in to stop your ongoing unfair characterization of the noone community. Noones are people, too!
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Old 11-09-2011, 01:33 PM   #19
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Don't you ever tire of bashing noones? I'm surprised the mods haven't stepped in to stop your ongoing unfair characterization of the noone community. Noones are people, too!
Easy, Sparky. Remember, I am an FA on a DIY forum, "noone's" been listening to me for over 5 years.......
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Old 11-09-2011, 03:33 PM   #20
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In the last few years, REPS are strictly forbidden from giving much of anything to doctors, no pens, no notepads, no Post it notes with the logo, nothing- there are no more Cancun educational trips, etc...and that is all good...but why hasn't the cost of care gone down at all? Maybe that is not really the source of the problem?
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They can still hand out food. A friend only has to buy lunch once a week from all the free rep food. It's good stuff, too. It ain't no Taco Bell.
Some journalist recently compiled a database of docs that get things of value from one big pharma company. It was all either for giving speeches or getting meals. My PCP was down for almost a grand for a single meal. Ain't no Taco Bell indeed.

It can't be coincidence that drug company sales people are lined up three deep every time I go to his office. He sees them in rotation between patients. It shows in what he prescribes. 3/4 of the stuff he has prescribed to me has been more expensive than my insurance company is willing to pay for on an initial prescription, unless he justifies it in writing.

The other day the pharmacy said they needed insurance authorization and had faxed the request to the PCP's office. His nurse called me and asked why didn't I use the coupon they gave me. That miffed me a bit and I asked why they didn't just get authorization from the insurance company.
Quote:
"Because there is no way they will pay for XXXX as expensive as that, and there's no way we can justify why you need that particular XXXX as opposed to a cheaper one."
My first reaction was to ask why they prescribed something they knew would not be covered, and then I remembered all the sales reps who are my doctor's biggest buds. They are in his office all day, every day, and they even buy him expensive meals. Little wonder he does them the occasional favor - on my dime.

If the man is going to prostitute himself to the drug companies that is his business, but I don't think I should be the one who pays for it.
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