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Physicians under the influence

Pharma firms use financial and non financial tactics to influence health care provider’s attitudes and decision making.

Financial Inducements include

honoraria

gifts

speakers’ fees

unrestricted education grants

sponsored research

and other funder resources

Non financial inducements include

use of deference

the opportunity to be referred as an expert

publication productivity facilitated by industry funded ghostwriters that further the health care professionals career

“Physicians often do not recognize their vulnerability to commercial information and subtle selling techniques” (p.667)

People even doctors are more strongly influenced by messages delivered with confidence and especially if there is money involved, extracting objective information in messages becomes difficult. Most physicians think they are immune to marketing strategies and often believe their own prescribing behavior is unaffected by industry influence, while at the same time they place blame on other physicians for being susceptible to industry influence. So there is an issue with self serving biases within the culture of physicians. There is also a sense of entitlement. Physicians who receive industry funded benefits (like the ones written above) usually use those as a way to unconsciously rationalize questionable behavior regarding ethics in their practice.

Principles of Influence

Reciprocity

Obligations to help those who have helped you

Relationship between physicians and industry uses formalized gift giving rituals

physicians pay back the industry gifts through changes in their practice, however this is seen as showing loyalty in the business relationship NOT a bribe

Commitment and consistency

Pharma industry knows the power help in small commitments

Example: drug rep asks a doctor “will you try my drug on next 5 patients with diabetes?” and because this is a small request it increases the likelihood that the physician will start using the targeted drug

Drugs reps tract physicians’ prescriptions and those who haven’t honored their commitments are reminded and encouraged again and again to try the drug - so there is a lot pressure on doctors as well

Social Proof

Accepting industry gifts is a cultural norm in medicine, so it will continue to happen

Opinions of colleagues are used by industry reps to sway physicians to adopt particular way of thinking

They create social validation and conformity

Liking

Rapport increases with familiartiy

The more interactions and the longer you have a relationship matters in medicine

Drug reps spend a considerable amount of time and effort befriending physicians - they try to make everything seem like a gesture of friendship instead of a business deal

They do this by providing free samples of products, office lunches or dinners etc.

It is similar to buying love in a sense because doctors will write prescriptions for who they like because remember, doctors are people too

Physicians feel overworked, underpaid and unappreciated

Drug reps show sympathy, flattery, food, gifts, services, and income enhancing opportunities and pretend that they want nothing in return. However, this usually is beneficial for their drugs.

Drug reps will usually not continue a relationship with a physician who isn’t prescribing a targeted drug or helping in a way to boost its market share

Authority and Scarcity

Physicians want to have a “key opinion leader” status

This leads to research funding, consulting fees, and more publication productivity that the industry funds

They also feel the personal achievement of being special and important in the medical world

The concept of receiving a “key opinion leader” status obviously gives physicians the feeling they are authoritative figures and it also makes them fight for the stars because of scarcity. This is because the opportunity seems limited so it must mean its more valuable.

Through these methods the industry gives off this illusion that they are generous to physicians when really there have underlining motives.

Sah, S., & Fugh-Berman, A. (2013). Physicians under the Influence: Social Psychology and Industry Marketing Strategies. The Journal of Law, Medicine & Ethics, 41(3), 665-672.

#physicians #drugrep #manipulation #influence

The #FireWifeLife... Or Just Life.

Disclaimer: Not a wife, yet 😉

Let me start by saying that that hashtag carries a certain stigma with it that makes me puke in my mouth a bit. It makes me think of those wives who mainly pretend to have it all together and glorify their spouses job. And at least around here, the trend is the more ya talk about it, the worse you probably are at it. Just the way that cookie crumbles. I make no effort to hide this shit show. If I did, well, I wouldn’t have anything to write about. So, as a collective whole can we agree that this life is anything but glorious and we’re probably all just looking at the clock and doing the mental math and counting down the hours until we’re reunited again? Because that. Is. Me. Let me tell ya, 24 hours has never felt longer and don’t get me started on 36. Some days we’re just ships passing in the night and miss each other by a few minutes. At the same time, I also really appreciate having the bed to just me and my dogs. It’s called balance, right?

Our story: Tom and I met while I was working at the local harness racing track for a trainer. He was on standby on the medic, and I had an little run in with a 1200lb animal, and the rest is history.

At that point in my life, (which was only three months ago,) I really wasnt looking for anything at all. I was happy being single. I didn’t have time for men. Dating was rough for me. Every guy that took me out was just missing SOMETHING. Wasn’t talkative enough, too talkative, too touchy feely, or, my favorite, would just flat out undermine me. I was working three jobs and was just tired of wasting my time and had honestly taken a solid break from men. It was the holidays and I was ready to spend time with my family and enjoy a much needed break from pharma and spend time with my four legged boys.

And so my first day of winter break, I let Tom take me for a drink. A drink turned into dinner (because I am never going to say no to a beer and nachos.) Dinner turned to coming home at 1am. A car ride filled with whiskey induced singing to Bowling for Soup and Frank Turner is really what won me over. Because let me tell ya, I was skeptical that he was too good to be true because the connection we have has been there since the very beginning. He claims he fell in love with me that night. What an idiot.

Whenever his job gets brought up in conversation, people are constantly taken aback and the average response is “omg that’s so dangerous, how don’t you stress or worry all the time?!”

I don’t let the stress of his job burden me. I don’t make a conscious effort to really worry about him or his safety. He’s a trained professional. Sure, the “what if’s” creep into my head sometimes, but I’m sure he feels the same way while I’m on top of a 1200lb animal and I’m alone. But we’ve both been doing it for so long it’s second nature.

Then the second go to is “you poor thing, you must spend so much time alone!” Let me tell y’all, 90% of the time, I LOVE my alone time. I work alone and I also live alone besides my dogs. I love my ability to be independent. I live a life completely separate from his. I work my own jobs, on my own time. Sure we absolutely enjoy our time together and get as much as that together as we can, but if I didn’t have my own life outside of our relationship, I’d just be waiting for him to come home. Independence is key to making this relationship work. As I mentioned last week, I don’t have much time for anything other than work right now anyway. The balance in my life is so delicate, when it gets off by even a bit, it tends to throw the rest of my week off.

The “secret” to our relationship success from the beginning has always been open communication. About anything. Any time. 3am even. We talk about our work days. Our stresses and anxieties. Tom has a a lot of his plate- full time at the department, part time as a private paramedic, graduate school, air national guard, being a dad, and of course me. We’re never shy about how we feel. And that’s why this works. And we’re always there when the other needs us to be.

That’s not what’s going to make me a good FireWife. That’s what’s going to make me a good wife in general. I am so excited to see where he takes me. And I know that even short term, I may not get to be a legit FireWife. Tom finishes his MBA program in July and from there, who knows where we’ll end up. But for now, I’m endlessly proud and he deserves all the recognition and then some.

#firewife #firewifelife #drugrep #drugs #wife #wifelife #firefighter

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