drug reps at CMHC asking you to sign for samples

[finalpsychyear]

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Every week I travel 1 day to a CMHC where one latuda rep who stocks the place with injections always asking me for signing things and then multiple others who are wanting to tell me about some drug or another or wanting samples signed for. In my PP i always make them give the staff and me a lunch for this but have been just signing their documents regardless.


Is it perfectly reasonable to expect a lunch for any drug rep even if at CMHC setting wanting you to sign off on samples or is this only fair if its your own PP? I am the only MD at the facility the day I am there.

 

[birchswing]

Every week I travel 1 day to a CMHC where one latuda rep who stocks the place with injections always asking me for signing things and then multiple others who are wanting to tell me about some drug or another or wanting samples signed for. In my PP i always make them give the staff and me a lunch for this but have been just signing their documents regardless.


Is it perfectly reasonable to expect a lunch for any drug rep even if at CMHC setting wanting you to sign off on samples or is this only fair if its your own PP? I am the only MD at the facility the day I am there.

Everything about this is disgusting.

I wish novopsych had written it as satire.

 

[st2205]

Everything about this is disgusting.

I wish novopsych had written it as satire.

Lunch or GTFO.

 

[st2205]

Everything about this is disgusting.

I wish novopsych had written it as satire.

And there’s nothing disgusting about this. It’s a CMHC FFS. None of those people are ever going to be having their insurance, or lack thereof, be paying for Latuda. They’ll be living off samples. Latuda probably just hopes it bolsters the demand of people out there wanting Latuda. I think society’s black and white thinking often gets the best of us, thinking that if someone benefits from something, it’s only because of some big-bad, large corporate-greed conspiracy that’s taking advantage of people (well, it is, just not in any way, shape, or form that people assume it is).

/rant

 

[birchswing]

And there’s nothing disgusting about this. It’s a CMHC FFS. None of those people are ever going to be having their insurance, or lack thereof, be paying for Latuda. They’ll be living off samples. Latuda probably just hopes it bolsters the demand of people out there wanting Latuda. I think society’s black and white thinking often gets the best of us, thinking that if someone benefits from something, it’s only because of some big-bad, large corporate-greed conspiracy that’s taking advantage of people (well, it is, just not in any way, shape, or form that people assume it is).

/rant

OP said it's a Latuda rep who brings injections. Latuda doesn't have an injection form, though, so not sure if OP was referring to Latuda itself or some other product (but Sunovion doesn't have any injectable products). Anyhow, Medicaid in my state covers Latuda, and many (most?) people at a service board would have Medicaid.

And if you're saying the one benefitting in this relationship is the patients/doctors receiving free drugs, then why are you asserting the drug reps need to provide a free lunch or GTFO? Aren't the free drugs the free lunch? Or just maybe, the free drugs are free marketing and an enormous financial opportunity for Sunovion. The doctors at the services board will be prescribing meds long after they've left that particular clinic.

 

[bashir]

OP said it's a Latuda rep who brings injections. Latuda doesn't have an injection form, though, so not sure if OP was referring to Latuda itself or some other product (but Sunovion doesn't have any injectable products). Anyhow, Medicaid in my state covers Latuda, and many (most?) people at a service board would have Medicaid.

And if you're saying the one benefitting in this relationship is the patients/doctors receiving free drugs, then why are you asserting the drug reps need to provide a free lunch or GTFO? Aren't the free drugs the free lunch? Or just maybe, the free drugs are free marketing and an enormous financial opportunity for Sunovion. The doctors at the services board will be prescribing meds long after they've left that particular clinic.

If the product is free, you are the product.

 

[st2205]

OP said it's a Latuda rep who brings injections. Latuda doesn't have an injection form, though, so not sure if OP was referring to Latuda itself or some other product (but Sunovion doesn't have any injectable products). Anyhow, Medicaid in my state covers Latuda, and many (most?) people at a service board would have Medicaid.

And if you're saying the one benefitting in this relationship is the patients/doctors receiving free drugs, then why are you asserting the drug reps need to provide a free lunch or GTFO? Aren't the free drugs the free lunch? Or just maybe, the free drugs are free marketing and an enormous financial opportunity for Sunovion. The doctors at the services board will be prescribing meds long after they've left that particular clinic.

I’m taken away from finishing my bureaucracy-mandated box checking to sign for their stupid samples that I 1) don’t use and 2) won’t prescribe, so them providing some free lunch so I don’t have to waste my time walking to McDonald’s in exchange for me not being able to click those all-to-important boxes seems like a fair trade of time.

 

[bashir]

I’m taken away from finishing my bureaucracy-mandated box checking to sign for their stupid samples that I 1) don’t use and 2) won’t prescribe, so them providing some free lunch so I don’t have to waste my time walking to McDonald’s in exchange for me not being able to click those all-to-important boxes seems like a fair trade of time.

Now I'm really confused. Why do you accept the samples if you don't use them?

 

[st2205]

Now I'm really confused. Why do you accept the samples if you don't use them?

Multiple psychiatrists and mid-levels in clinic. I suppose I could be “that guy” and not sign out of some moral stand, being willing to die on that hill. But I guess my “never use them” comment is a bit hyperbolous as about every four months or so I’ll head back for some samples when I don’t have the energy to full-court-press on an externalizing patient wishing to continue the medication carousel.

 

[birchswing]

Multiple psychiatrists and mid-levels in clinic. I suppose I could be “that guy” and not sign out of some moral stand, being willing to die on that hill. But I guess my “never use them” comment is a bit hyperbolous as about every four months or so I’ll head back for some samples when I don’t have the energy to full-court-press on an externalizing patient wishing to continue the medication carousel.

The practice's inertia forces you to sign the papers. The patient forced you to give out marketing drugs (the "samples" are themselves advertisements that come in drug form).

It's not an indictment against you. They're normal defenses. It's just that the drug companies are good at what they do and the government is pretty middling at what it's supposed to do.

 

[Armadillos]

In community mental health settings I think you can get paralyzed if you worry too much about large scale societal/economic implications. Instead I try to focus on what’s best for individual patients. For a depressed bipolar patient with no insurance getting Latuda samples and then set up on patient assistance for free Latuda is a great outcome.

 

[st2205]

The practice's inertia forces you to sign the papers. The patient forced you to give out marketing drugs (the "samples" are themselves advertisements that come in drug form).

It's not an indictment against you. They're normal defenses. It's just that the drug companies are good at what they do and the government is pretty middling at what it's supposed to do.

Patients aren’t forcing anything. And, contrary to popular belief, it’s quite rare that patients come in requesting trade name medications from commercials. Occasionally (less than quarterly), they’ll bring it up, only being vaguely familiar, because they saw the commercial, but it’s more just curiousity. Daily, however, people ask for benzos, either by name or by “Xana-something.”

 

[SmallBird]

In community mental health settings I think you can get paralyzed if you worry too much about large scale societal/economic implications. Instead I try to focus on what’s best for individual patients. For a depressed bipolar patient with no insurance getting Latuda samples and then set up on patient assistance for free Latuda is a great outcome.

For every 100 patients I wish I could find a good CBT therapist, or an exposure based treatment, or a supportive housing environment, there is maybe .1 where I think that the issue is a brain-based disease process that is more likely to respond to an expensive new drug than the generic atypicals.

 

[MacDonaldTriad]

Guy: "Would you sleep with me for a million dollars"
Woman: "A million dollars, I suppose so, yes"
Guy: "Would you sleep with me for a dollar"
Woman: "A dollar, of course not, what kind of woman do you think I am"
Guy: "We already established that, now we are just negotiating price"

Why would insisting they provide lunch change the moral equation?

 

[birchswing]

Patients aren’t forcing anything. And, contrary to popular belief, it’s quite rare that patients come in requesting trade name medications from commercials. Occasionally (less than quarterly), they’ll bring it up, only being vaguely familiar, because they saw the commercial, but it’s more just curiousity. Daily, however, people ask for benzos, either by name or by “Xana-something.”

I was parroting back to you in different words what you were saying. You were implying that you had little agency and that your hands were tied--that you signed for the drugs just to keep the peace and that you only handed them out when your patients had cornered you and you didn't have the will to full-court press them. I was suggesting that these are defense mechanisms and that you do have agency. These things aren't happening to you as if you're just observing them. You are accepting drug samples, and you are handing them out. The second point I made is that the drug companies are good at what they do so that this seems like only natural matter of course and that it's a system doctors feel they aren't participating in or not influenced by as much as they actually are. But as this thread shows, they have people trained to salivate like Pavlovian dogs when they show up and there's no food.

 

[milesed]

The only times we see reps is at lunches or if we have a patient needing an emergency supply of something and I just sign and go. They don't pay for my time.