Employed physicians-and their patients-are at a true disadvantage in putting restrictions on visits by pharmaceutical firms.
As an independent physician, I am free to see pharmaceutical representatives at my office and accept medication samples.
Since the samples are non-controlled substances, I am not required to track them by the State of Illinois. I use the samples to try patients on new medications or even for patients with no insurance. I have the ability to provide them with free medication until I can do a step audit or get a preauthorization from the insurance company.
I will always try to find time to speak with the representative between patients. If they would like to bring a lunch, that is fine but not required to spend a few minutes with me discussing their product.
The representative will explain the product in detail with side effect profile and formulary status in the area before leaving samples that I can give out to my patients. Generally the representative will visit my office once or twice a month.
The physicians in my area who are employees do not see representatives unless they provide lunch for the office and only infrequently. The Joint Commission regards these offices as extension of the hospital and the offices must track any free medication they receive. To save time and paperwork, the hospitals they are employed by do not let them accept samples at all.
The lack of samples stops these physicians from using the newest drug therapies available for the benefit of the patient. How can you get clinical experience with a medication if you do not use the drug due to the desire of the employer to save time and money?
A pattern may develop over time separating the independent physicians’ level of usage of newer medications from that of the employed physicians not using these drugs. This will not be to the benefit of the patient who depends on the physician to do the best possible job in treating their illness.
My peers are concerned that by not getting experience with newer medications they are no longer staying up to date with the practice of medicine. They are also having to change patient's medications to those approved by their employer which in some instances are not as effective as they would like.