A few years ago, PhRMA decided to "self-police" and did away with all the social and/or ticketed events that pharmaceutical reps used to take doctors to. Gone were the ballgames, concerts, golf outings, Broadway shows, wine tastings, circuses, and yes, even complimentary car washes. Among the reps I knew at the time, the young, single ones were generally upset about this "assault" on their social lives. Most of the older, married reps, however, breathed a sigh of relief upon learning that they'd probably be getting more time at home with their families, and would not have to ever attend a Megadeath concert. The physicians who had become accustomed to partaking of these events were seething; they had become very used to attending and, in fact, felt a sense of entitlement to continue to do so. That, coupled with the "no spouse" policy, led to decreased rep access to certain offices.

Now we are faced with the latest house cleaning, as PhRMA has decided to implement a no restaurant meals, pens, pads, or hand soap rule as of January 1, 2009. PhRMA CEO, Billy Tauzin, said he hopes the code additions will create "more credible" standards for doctor-sales rep interactions. So, by that logic, it seems to me that if a rep ever gave me a pen, then my interaction with that rep was "not so credible." This apparently hasn't bothered PhRMA until now. I look forward to 2009 when my interactions with reps become "more credible"! I'll report on how different the messaging I receive becomes once the pens and post-its disappear. I predict that this will change absolutely nothing.

Tauzin went on to say that, "I don't think you'll find a physician who will acknowledge that the gift of a pen or a cup with a company's name on it influences their prescribing patterns," he said. "But there are people who believe that, and as long as that's a perception out there we felt we ought to end that." So apparently PhRMA's new policy is not based on logic (that pens don't influence prescribing), but a nebulous perception out there. Drug companies have been giving out pens for decades, and there has been opposition to this practice for decades. Why did PhRMA decide to bend to the pressure and change their policy now?

According to a statement from PhRMA, representatives "can still provide the occasional, modest meal in a healthcare professional's office "in conjunction with informational presentations." What does that mean? Aren't "informational presentations" what representatives have supposed to have been giving all along? PhRMA's statement continues: "meetings between sales representatives and doctors should be focused on informing healthcare professionals about products, sharing scientific and educational information and supporting research and education." Again, maybe I'm missing something, but I thought that this always has been what representatives are supposed to do.

I agree with Tauzin that giving pens (and even meals) to doctors does not influence prescribing. It is extremely insulting to physicians to imply that they can be bought for the price of a steak the ate at a pharmaceutical event. If a physician feels so pressured to prescribe a product based on receiving a free meal, he or she should probably not be prescribing medications to people in the first place.

Certain politicians have made a major issue of these dinners, pens and other relatively inexpensive items that drug reps have traditionally given to doctors. Perhaps a very close look should be taken at the lobbyists who give these same legislators major gifts, as compared to what the doctors are being given. And if the medical field is singled out by certain legislators as a "special" field because it involves the public's health, I would suggest that similar gift rules be put in place for other industries involved in public health and safety, such as the airline industry, military contractors and the auto industry, to name just a few.