Sex, Drugs, and Public Health

May 14, 2011

PUSHERS

Filed under: Uncategorized — cbmosher @ 3:52 pm

They have three goals.

They want to get you hooked. So they give you free samples. Once you’re dependent on it, it gets real expensive real fast.

They need to get you to listen to them for their initial pitch, so they can dangle their bait. That’s why they exude the personality of “nice guy” or “nice girl.” If you don’t analyze them any deeper, that’s all they need.

They want to keep you coming to them for your drugs, so they purchase your loyalty to their Brand, using gifts, free samples, and advertising.

All three goals remain constant. What’s changed, over the course of my career in Medicine and Public Health, is their tactics. When I was new to this business, a trim, healthy young guy in a suit and shiny shoes stuck out his hand:

“Nice to meet you, Doctor. I’m Tim. How’s your day going?”

He had an easy smile, and knowledge of football. After a minute and a half, he slipped into his spiel:

“For your patients with hypertension, a recent study in JAMA – I have a copy of it right here for you – shows that this product performed better than all the beta blockers. I’m going to leave you a supply so you can try it on your patients. No charge, Doctor.”

Soon the cartel assigned a new Pusher to my office – an attractive redheaded girl who wore a dress perfectly tailored to her curves, and high heels. Perhaps the young guy was re-assigned to an office with woman physicians.

Then, in addition to the free samples she gave me in hopes that my patients (and I) would get hooked, she invited me to dinner. Dinner with a medical lecture. These were always held at the priciest restaurant in town. I never went, but several of my colleagues did.

The most recent shift in tactics bypasses the guy with the prescription pad entirely. Now, like Pushers at a High School, they market their drugs directly to the kids – i.e. our patients:

“Ask your doctor if our drug is right for you” is pretty much like saying “ask your Mommy and Daddy if they’ll let you have a little sip of wine before dinner.”

It puts the physician (like Mommy and Daddy) in a no-win position. Which is exactly how the Pushers like it. After the T.V. ad with promises of butterflies fluttering around the patients, and smiling people with happy lives, the physician has only two options: write for the requested drug, or say “I don’t think this is the right drug for you,”  and live with the consequences. In the first case, you take on the responsibility for the cost of the drug, and for its failure to work and/or for its side effects. In the second case, you get into a fifteen-minute argument with your own patient. As with users of illegal drugs, the physician turns into a whore.

A neglected whore. With the success of the direct pushing (advertising) of their drugs to patients, the cartels can cut out the expense of pushing to the docs. So, these days, neither the young guy in the suit nor the redhead in her high heels are anywhere to be found.

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