Tuesday, November 29, 2005

Why Aren't Mostly Male Doctors More Insulted?

Big Pharma relies on physicians and the power to write prescriptions to move their drugs in the pseudo-marketplace of health care.

I have seen the unbelieveable "bribes" that Big Pharma will give doctors my whole life. My Dad used to be proud of what he could get from the drug reps on the days they made their calling on him in the office. He would place all the trinkets and gifts he got from other drug reps prominently on this desk so that whomever walked into his office would know the stakes of any future "negotiations." My Dad used to make a great deal of money giving talks on the drugs, in very exotic places of course. And, from time to time, my Dad has used Big Pharma and it "generosity" for his humanitarian purposes. He got Astra Zeneca, for example, to donate a great deal of equipment for his clinic on Maui.

The recent regulations on Big Pharma, however, have dried up that well a bit. When I was a board meeting a few months ago for the academic society of psychiatrists and philosophers I belong to, I discovered the new route for getting drug company money: apply to their foundations. When you think like a corporation--which is tantamount to thinking like a socio-path, if we are going to think of corporations like individuals--then you figure out how to use them. Corporations want to appear nice and good, so give them the opportunity to fund your little conference with their philanthropy funds. They get to advertise their generosity, you get to have your conference in style, and the drug reps can show up and mingle a bit with the doctors.

And, mingling with doctors is what Big Pharma relies on now to get its drugs out there. The NYTimes has a mint of a piece today on drug reps. Did you know that a perfect resume builder for pharmaceutical representative is cheerleading?

And in a crowded field of 90,000 drug representatives, where individual clients wield vast prescription-writing influence over patients' medication, who better than cheerleaders to sway the hearts of the nation's doctors, still mostly men.

"There's a saying that you'll never meet an ugly drug rep," said Dr. Thomas Carli of the University of Michigan. He led efforts to limit access to the representatives who once trolled hospital hallways. But Dr. Carli, who notes that even male drug representatives are athletic and handsome, predicts that the drug industry, whose image has suffered from safety problems and aggressive marketing tactics, will soon come to realize that "the days of this sexual marketing are really quite limited."

Yes, yes, I could give a long disquistion on why it is so lame that to get ahead in this service economy you need to be a perky, prozaced, blonde. But, why bother?

I think the more interesting question is why the mostly male doctors aren't offended at how Big Pharma plays them. Isn't it an interesting that the stereotype of male identity, leads sales reps to play on their sexual appetites rather than their rational thinking skills to move their products? What always bemuses me is that men are rather proud of this fact; they don't generally feel belittled, duped or cajoled when a gorgeous woman is sent in there to play them.

But, what sort of image of male sexuality is really being traded on here? That men are so weak, so slavish to their hormones, that you can get them to do whatever they want if you dangle a perky blonde (or irresistible red head in the case of Roger Rabbit) in front of them? Why doesn't it offend more of these mostly male doctors that their expertise and judgment as M.D. isn't being appealed to here, but rather their venality and prurience?