The Caregiver

"Everyone should check out Dan Abshear's post under the discussion board on patient/caregivers rights. . . and I mean everyone, i.e., patients, advocates, providers, reps, etc. It's one of the most concise pieces on the topic I've ever read, born of experience."

--- Dr. Mark

As one who did patient care for over a decade before becoming a medical salesman, I'd like to offer these recommendations to those patient caregivers who are perhaps new to their profession:

1. Do not let those in the pharmaceutical or medical device industries, for example, interfere with or take priority over patient care.

2. Do not let the industry befriend your staff to gain access to doctors that work with them who are restoring the health of their patients.

3. Do have nurses only accept drug samples from drug reps. No literature of any kind from them. Likely, any clinical information the drug rep may have regarding the drug samples he or she may leave you is inaccurate.

4. Do let those you work with know they have a right to refuse interaction with the medical industries in their practice.

5. Do not answer questions from drug reps about what doctors prefer prescribing for their patients as it relates to their promoted products, or anything else about the health care providers at your location, for that matter.

6. Do not accept any promotional material unless it is truly beneficial for their patients, without branding on the material offered to members who work at your clinic or medical institution.

7. Do let the nurses know that drug reps. are overall not in their clinical setting to facilitate patient care, but to rather increase the volume of what they many be promoting, as this is the etiology for their interaction with you.

8. Do let others who you work wth that, if asked by medical representatives to have a disease screening day of some sort at your facility, or has invitations for such a screening for you or others to attend, consider refusing this request. Often, the screenings are conducted by front groups to expand the diagnostic boundaries of a particular disease state.

9. Do make others you may work with aware, or reiterate to them, that generic drugs are preferred over branded drugs for many reasons, including cost and experience with the medication while providing the safety and efficacy your patients need. Such drugs are listed in what is called an Orange Book.

10. Do let the nurse know that drug reps have in their possession the prescribing or buying habits of health care providers, and will tailor their interaction with them and the prescribers based on this data.

11. Do let others you may work with know that the drug reps are, overall, decent and friendly people who are just doing what they are instructed to do by their employer, and they should be aware of what they may be doing could be detrimental to the health of their patients, if such situations develop.

12. Do let those you may work with know that medical representatives who may be in your patient treatment area can question doctors about what they may choose to prescribe a patient. Yet such representatives should be aware that their time at your patient treatment area is limited.

13. Do let others you may work with know that there are doctors who receive inducements, incentives, rebates, and remuneration from particular drug reps.

These gifts that are actually bribes are largely based on the prescriber's affinity for the drug. rep's promoted products or the volume of prescriptions a doctor writes compared with other health care providers.

The potential consequences of accepting such bribes which the industry calls many things, including 'gifts', could have on the health of patients and the choices of treatment for them. Such bribing may cloud the judgment of the health care providers who receive such gifts..

14. Let others you may work with know that pharmaceuticals are not the answer to all symptoms or medical conditions. This is of particular importance when it comes to the issue of utilizing psychotropic drugs and antibiotics, as drugs are very over-utilized in the United States.

15. Let others who may work with you know that they should make patient care paramount when seeing patients, and should not let the industry coerce them into thinking otherwise.

In other words, their idealism and passion straight out of school should be maintained, however difficult this may be at times. As a patient caregiver, you may get overwhelmed at times.

16. Let others you may work with know that, in the U.S., medical reps. have little training, education, or clinical knowledge relevant to what they may be promoting, however may have charming personalities and appear to possess quality genetic stock.

What they may share with you about their promoted drugs is likely embellished or fabricated, if not fully understood by the medical representative.

17. Let others you may work with know that whatever is done for or with patients should be entirely for their benefit, and not for the benefit of a drug company or a health care provider, if such a situation develops or are noticed.

18. Speaking from the perception of the situation in the U.S., there is a shortage of nurses, and the demands on them are cumbersome and exhausting. Remind the nurses that this should not affect the treatment and care they give their patients, as difficult as this may be for the nurses.

The pharmaceutical industry only amplifies this situation in various ways at certain times and locations. To say again, do not allow others to interfere with patient care.

19. Let others you may work with know that their vocations are noble and needed, and what they do for others most choose not to consider, such as drug reps., for example.

20. "Nursing would be a dream job if there were no doctors." --- Imo Philips

Dan Abshear