Former pharmaceutical reps have given us an insight into the sales techniques used by reps in influencing doctors. For example, Fugh-Berman and Ahari shared some illuminating examples in the quotes below, and describe how reps use ‘finely titrated doses of friendship’.
Our ‘No Advertising Please’ campaign does not imply that pharmaceutical reps are not personable folk doing a competent job for their employers. They are generally courteous and friendly. But it is not their job to actually be your friend in the usual reciprocal sense of the term. They are trained to respond to various types of doctors’ personalities in the most effective manner, as Fugh-Berman suggests:
A friendly physician makes the rep’s job easy, because the rep can use the “friendship” to request favors, in the form of prescriptions. Physicians who view the relationship as a straightforward goods-for-prescriptions exchange are dealt with in a businesslike manner. Skeptical doctors who favor evidence over charm are approached respectfully, supplied with reprints from the medical literature, and wooed as teachers.
In Australia, the direct giving of expensive gifts such as overseas trips and entertainment worth thousands of dollars has been curtailed not because it wasn’t cost-effective for the industry, but because it became difficult to argue that it was not, in effect, blatant bribery. However, even relatively low-value gifts have been shown to introduce a sense of obligated reciprocity. (Oldani)
Gifts create both expectation and obligation. The importance of developing loyalty through gifting cannot be overstated…The essence of pharmaceutical gifting is ‘bribes that aren’t considered bribes’.