Magazine article Drug Topics

Confessions of a Counter-Detailer, Part 2: Tchotchkes

Magazine article Drug Topics

Confessions of a Counter-Detailer, Part 2: Tchotchkes

Article excerpt


If you want to lose weight, you have to consume fewer calories or bum more calories through exercise or increased physical activity. Both tactics involve changing behaviors or habits. The same is true for prescribing practices, which are behaviors or habits developed over time. Physicians develop prescribing behaviors based upon various factors.

Conditioned behaviors

I remember when I was a pharmacy student on a medicine rotation in the mid-1980s, attending morning report at the VA hospital located on the west side of Chicago.

The pharmaceutical representatives had their product displays strategically located next to the food table. As the residents and attendings walked into the room, they would first pass by the promotional materials on their way to the food. They'd scoop up various tchotchkes and slip them into the pockets of their lab coats.

These folks were conditioned to go to the display tables and look for the "goodies" before moving on to the food. At the display tables, the drug reps would engage the physicians in brief conversations about their latest brand products. Sure enough, the physicians would start using the new brand medications, and the use of "older" and non-promoted brand medications would decrease.

"Leave-behind" envy

Back in the summer of 2007, I began meeting with physicians to discuss the preferential use of generic medications over brands. Usually we met in their office lunchrooms, As I sat and waited, I'd look at the various items in the room. The clock on the wall bore a brand-medication logo. So did the salt and pepper shakers. On the refrigerator door, magnets sporting brand-medication logos held various restaurant take-out menus in place. Looking more closely, I'd see cups, letter openers, pens, sticky notes, and examination-room table-liners, all bearing promotional logos. The office staff seemed oblivious to all this brand information. I wasn't.

"Wow!" I thought, "Lots of stuff!" I felt inadequate. I felt a sort of "leave-behind" envy; I didn't have anything to leave for the doctors, I thought to myself, "I need some leave-behinds' - some tchotchkes."

Wikipedia describes tchotchke (typically pronounced "CHACHkee") as a Yiddish word meaning "small toys, gewgaws, knickknacks, baubles, lagniappes, trinkets, or kitsch. …

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