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Healthy Skepticism Library item: 17994

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Somerset M, Weiss M, Fahey T.
Dramaturgical study of meetings between general practitioners and representatives of pharmaceutical companies; Commentary: dramaturgical model gives valuable insight.
BMJ 2001 Dec 22-29; 323:(7327):1481-4
http://www.bmj.com/cgi/content/full/323/7327/1481?view=long&pmid=11751364


Abstract:

OBJECTIVES: To examine the interaction between general practitioners and pharmaceutical company representatives. DESIGN: Qualitative study of 13 consecutive meetings between general practitioner and pharmaceutical representatives. A dramaturgical model was used to inform analysis of the transcribed verbal interactions. SETTING: Practice in south west England. PARTICIPANTS: 13 pharmaceutical company representatives and one general practitioner. RESULTS: The encounters were acted out in six scenes. Scene 1 was initiated by the pharmaceutical representative, who acknowledged the relative status of the two players. Scene 2 provided the opportunity for the representative to check the general practitioner’s knowledge about the product. Scene 3 was used to propose clinical and cost benefits associated with the product. During scene 4, the general practitioner took centre stage and challenged aspects of this information. Scene 5 involved a recovery strategy as the representative fought to regain equilibrium. In the final scene, the representative tried to ensure future contacts. CONCLUSION: Encounters between general practitioners and pharmaceutical representatives follow a consistent format that is implicitly understood by each player. It is naive to suppose that pharmaceutical representatives are passive resources for drug information. General practitioners might benefit from someone who can provide unbiased information about prescribing in a manner that is supportive and sympathetic to the demands of practice. What is already known on this topic Pharmaceutical representatives influence physicians’ prescribing in ways that are often unacknowledged by the physicians themselves Meetings with pharmaceutical representatives are associated with increased prescribing costs and less rational prescribing What this study adds Meetings between pharmaceutical representatives and general practitioners follow a consistent format that is implicitly understood by each player General practitioners may cooperate because representatives make them feel valued

Keywords:
* Drug Industry* * Family Practice* * Humans * Interprofessional Relations*

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909