Finding time for sales reps

In the past, use of incentive programs was one way, however, over the past several years, governmental regulations, as well as professional organizations' ethical standards, have largely controlled such programs based on a potential conflict of interest with physician prescribing habits.

On Call asked dermatologists around the country if they are still receptive to visits from pharmaceutical sales people, if they find the visits useful and how they fit visits into their busy schedules.

Stephen D. Behlmer, M.D., of Helena, Mont., has been in practice for 25 years. He is willing to see reps but adds that he doesn't get as much out of them anymore.

Thomas E. Fleming, M.D., of Sandusky, Ohio, also is receptive, but he agrees that the visits aren't as productive as they used to be.

He says, "There are reps we want to see in our office because they leave useful information for us; other reps have products we're very familiar with, that have been around a long time, and there's not a lot to add."

New products

Dr. Behlmer adds that visits from sales reps are one way of getting up-to-date on new products, and the visits can be useful for patients, in that drug companies sometimes offer rebate coupons.

In practice for 13 years, Joan R. Carl, M.D., from Richmond, Va., agrees.

"With the new biologicals, I think the reps are helpful because it's a new area of medicine that is coming in that we aren't as familiar with - that's more important than if they're just coming out with a new antibiotic or topical steroid cream."

Dr. Behlmer adds, "They don't give out nearly as many samples as they used to, however, and that hurts."

"Unfortunately," Dr. Fleming says, "that's the case, especially with topical steroids. We don't get many samples compared to 10 years ago. A lot of that is because, with the availability of generics, there is less of a reason to promote their product when 90 percent of the time, their prescriptions will get substituted for generics anyway."

In Farmington Hills, Mich., Stephen J. Forche, M.D., finds himself less receptive to sales calls because of the price disparity with generics.

"As a result, pharmaceutical reps are becoming much more pressured. The more there's a price disparity between branded and generics, the more there is pressure for them to sell. So my thoughts, when I see a pharmaceutical rep, are that I don't want to be pressured."

Dr. Carl says she has noticed the attitude behind the presentations has changed since the time she was a drug rep before attending medical school.

"Too often, it's not a balanced presentation like I was trained to do. Reps should convey the positive points of the medication, but they should also give the side effects or responses you may not see often. I don't see that very often nowadays."