> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Dr M
> O'Mahony
> Sent: Monday, September 07, 1998 3:39 PM
> To: [log in to unmask]
> Subject: EB pharmaceutical reps
>
>
> Pharmaceutical companies support the development of our practice by
> subsidizing our library, journal subscriptions, and our Cochrane and Best
> evidence subscriptions. In return we listen to their sales pitch.
> In July, I produced an open letter for all the reps calling at the
> practice, in which I thanked them for their continuing support, but asked
> them to join us in raising the standard of our debate.
We've done a similar thing in our residency, following an example set here
in the states from Dave Slawson (a family physician at Univ of Virginia) and
Alan Shaughnessy (a doctor of pharmacy in Harrisburg PA). we have invited
pharm reps from the various companies that come calling to present in a half
hour session whatever they want (including, hopefully, all the non-rational
appeals) then kick them out of the room to talk about them in a "critical
appraisal" session. we have the residents fill out worksheets (developed by
slawson and shaughnessy) and then we discuss the various techniques used to
sell the product (food, appeals to curiosity, appeals to local
experts/authorities) as well as the evidence presented (concentrating on
"patient-oriented evidence, i.e. with outcomes that matter most to the
patient - morbidity, mortality, QOL, etc.). We discuss whether the
information presented will change or reinforce our current practices, and
feed this information back to the pharm rep by means of a summary worksheet.
The response - very good. The pharm reps jumped at the chance to do this,
and they've liked the feedback so far. the residents also seem to enjoy the
sessions, and I can already see a change in their attitudes towards pharm
reps in other arenas - i.e. asking more critical questions (the reps have
"complained" about this also...) Has it changed any practices/prescribing
trends? - I don't know, but would be anxious to test this...
FWIW,
john
John Epling, MD
LCDR, MC, USNR
Family Practice Residency Program
US Naval Hospital
2080 Child St.
Jacksonville, FL 32214
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