Medical students ignorant about drug company marketing strategies

Medical residents need to learn that there’s “no free lunch” when it comes to their interactions with drug company representatives, warned researchers from Wake Forest University Baptist Medical Center in a report for Academic Medicine.

The researchers said there is a “compelling need” for medical residency training programs to include information about drug company marketing techniques and how physician interactions with sales representatives can affect what medications they prescribe.

“Pharmaceutical companies spend billions of dollars on marketing with the goal of changing doctors’ behaviors – and there’s good data that shows it works,” said Raquel Watkins, M.D., lead researcher and assistant professor of internal medicine. “To be informed decision-makers, physicians need to be aware of this potential conflict of interest.”

The researchers found that just 25% of internal medicine residency programs in the United States have formal instruction on how to interact with drug company sales representatives. The researchers conducted a survey of 200 internal medicine faculty members and residents that found low levels of knowledge about drug company marketing techniques and professional guidelines on interacting with sales representatives.

Research has shown that the way doctors prescribe medicine is influenced by their meetings with drug company representatives. In a study reported in the Journal of General Internal Medicine in 2000, for example, 90% of physicians said they would dispense a drug sample for treating hypertension that differed from their preferred drug choice. Less than 10% of the residents surveyed were familiar this research!

The researchers designed a training program for medical students, including videotaped interviews with patients about how they are affected by drug costs and their thoughts on gifts from drug companies to doctors. Residents also learned about drug company marketing strategies and how to critically interpret promotional materials. They also reviewed statements from professional organizations about the interactions between physicians and drug company representatives.

Before the pilot unit was implemented, residents took a test to measure their knowledge about how patients perceive relationships between physicians and drug company representatives, the ethical issues surrounding the relationships, and the level of marketing by the pharmaceutical industry. The residents had a mean score of 33%. On the same test after the pilot unit, the mean score was 86%.

“Our research shows a compelling need for innovative approaches to provide residents the skills, knowledge and attitudes to interact appropriately with pharmaceutical representatives,” said Watkins.

SOURCE: “Residents Need Training to Interact with Pharmaceutical Representatives,” Wake Forest University Baptist Medical Center, April 15, 2004.