No Such Thing As A Free Lunch //How Corruption in the Pharmaceutical Industry Affects YOU

By Yitta Halberstam Mandelbaum

In the rooms, the salespeople come and go, striding confidently with their wheeled satchels to the receptionist’s desk, smiling broadly, their hands raised in cheerful, familiar waves at the employees huddled over their computers, buzzed in almost immediately, ushered ahead of the legions of patients who have shifted and fidgeted in their seats during what seems an interminable wait (when you are anxious, physical time transmogrifies into psychological time, so even a few extra minutes can prove unnerving),waiting impatiently for their names to be called. But somehow these mysterious strangers—all dressed in conservative suits and impeccably groomed—are granted entrée with the respect accorded visiting dignitaries. And in a small sense, they are.

From my perch in myriad doctors’ reception areas over the decades, I have watched members of this cadre make frequent appearances, marveling how clone-like they seem to be, practically indistinguishable one from another, maintaining the exact same look, demeanor, and language. Have they all been sculpted out of the same clay, programmed to behave a certain way? Who are these men and women? Even in plush Park Avenue waiting rooms, both their attire and attitude clearly strike discordant notes: they are not patients, that is certain. One day, overcome by curiosity I could no longer contain, I approached a woman who had been consigned to a chair and instructed to wait (gasp), and asked her point blank who she was and what she was doing in the doctor’s office.
“I’m a sales rep for a pharmaceutical company,” she answered pleasantly, flashing expensive pearly whites.

“So what exactly is it that you come to see the doctor about?” I persisted.

“Oh, I just drop off some samples and talk to him briefly about new drugs the company has recently introduced. Doctors are so overwhelmed by their busy practices, they don’t always have the time to keep abreast of the latest developments in the drug industry. It’s just a courtesy call,” she said. I nodded in interest, thanked her for her time, and returned to my seat, un-jarred. Nothing about her response had given me cause for concern, and like many of my peers, I remained blissfully unaware of the machinations of the pharmaceutical industry, completely clueless that sales reps are in fact the “foot soldiers” of Big Pharma, reaping approximately $5 billion a year for their outreach efforts to doctors. “Dropping off samples” certainly does not describe the extent of what these sales reps are primed to do.

About five and a half years ago, though, I was given a rare glimpse into how they really operate. I had just been diagnosed with diabetes, and my GP recommended that I make an appointment with a “top” endocrinologist. Anxious about the consultation, my nerves continued to fray as I sat in the reception room awaiting my turn. Eagerly jumping to my feet when a nurse announced my name, I was escorted to the doctor’s book-lined study and he waved me into a comfortable arm chair, while he perused the pages of the questionnaire I had just filled out. He seemed to be an amiable man, I thought. Too amiable, I learned soon enough.

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