I was asked by a student for my thoughts regarding the advertisement of medications. Time and time again, you will have patients coming in to see you asking for a certain medication because they “saw it on tv”, or their friend is on it, so it MUST work. Her thoughts were that this will cause patients to make inappropriate choices regarding their health care. This can be true to some extent, but theres definitely more to it.
There are two entities we have to deal with here: pharm reps and the media. Lets start with the pharm reps. They come in to your office, try and pitch you a sale, and ask that you write for their product. They will also invite you to dinner, where you can learn more about how “wonderful” their product is compared to the competition. Do not see them as sharks who are out to get you. Instead, I want you to look at it from a different perspective. This is no different then going to a car dealership and the salesman trying to up sell every accessory made. This is no different then going to a restaurant, where you have an entire menu to choose from, but the waiter suggests certain dishes. The pharm reps are simply giving you options; they are giving suggestions. It is ultimately YOU who will be writing the script. Have conversations and get to know them. Believe it or not, they have feelings too lol. They are entering your office, where you are in control. If you portray a confident and positive energy, they will be drawn to you, and will not try and sell you anything. Giving off confidence will actually intimidate them. The problem arises when you do not portray this energy. They will see it right away, and take advantage of it. I mean, I can’t blame them; its their job and they need to make a living too. Talk with confidence, and no one will ever take advantage of you. Give off a good energy, and they will be so much more focused on how you present yourself, that they will ditch the hard sale, and chat with you much more pleasantly.
Now, what about the patient who comes in asking for a specific drug? Don’t immediately dismiss them, there are many quality products out there that are being advertised. First, ask them why they want that drug. A lot of times its not that they are set on a specific medication, its just thats the only option they know. Once you come to realize this, you can then discuss other options, give your opinion as to which is better, and then allow their input. This is NOT a dictatorship. Your job as a physician assistant is to give all of the information to your patient so they can make an informed decision regarding their health. Your job is not to dictate their health for them; the only exception being is if you are 100% opposed to doing something. I am not asking you to compromise your self worth or your morals by any means, but these are going to be exceptions rather than the norm.
Bottom line, don’t be intimidated by suggestions. Do not feel as if you are being forced to do anything. You are ultimately in control, and once you can realize that, then it just becomes another conversation with another person. I want you to facilitate your patients healthcare, not dictate it. There is no right or wrong in medicine, and every one will do things a little bit differently. Ultimately, you need to individualize every treatment plan, because no two patients are the same.
Do you have any experience dealing with these situations? I’d love to hear them…leave me a comment and let me know!