Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, February 03, 2003
    One thing about being a doctor is that you are almost guaranteed to have pharmaceutical representatives, aka "drug reps," dropping in on you. A few places, like Kaiser, have an ironclad rule against visits by drug reps - but my group has no such policy and, as a consequence, we get lots of drop-in visitors. They come bearing drug samples, ballpoint pens, the occasional bribe (small pack of M&M's - so hard to turn down at three in the afternoon when you've got that sinking feeling!) and much, much more. I routinely threaten one drug rep with the possibility that after I retire, I will pay my expenses by throwing garage sales and selling all the junk I collect from these people.

    Here for your entertainment is a list of what is currently in my office/on my desk courtesy of drug reps, with descriptions of the medications advertised:

    1. Highlighters - set of three in different colors in a purple plastic holder. Drug: Nexium (a proton pump inhibitor. It treats ulcers)

    2. Small plastic chair, suitable for use as a bathtub toy. Drug: Wellbutrin (an antidepressant)

    3. Stress ball/hacky sack. Drug: Axert (a triptan, antimigraine drug)

    4. Tape dispenser. Drug: Protonix (another proton pump inhibitor)

    5. Small collapsible plastic telescope, Allegra (antihistamine for allergies)

    6. Hole punch, Nexium again (it is purple, as are all Nexium associated products)

    7. Set of two rechargeable penlights, Allegra

    8. Gel eye mask that can be heated or cooled, Axert (finally, an object that relates to the condition it's supposed to treat)

    9. Chapstick/lip emollient, Allegra

    10. Three pens that clip into holders suspended on cords so they can be slung around your neck. Drug: Altace (a medication for high blood pressure)

    11. Multiple ballpoint pens and Post-It notes - various

    12. Breath mints, sugar-free. Drug: Actos (an oral hypoglycemic - it treats diabetes. The mints are sugar free - get it??)

    13. A white lab coat emblazoned with "Avelox" over the pocket (a new antibiotic)

    14. My prize - a computer mouse labeled "Paxil CR" (an antidepressant). The end that fits under your palm is clear plastic and has two layers of fluid in it, along with a little person in a kayak that floats on the lower layer of fluid. I'm sure you've seen the sort of thing I'm talking about previously, as a paperweight or a travel souvenir. Well, here the point is that no matter which way you turn the mouse, the kayak will always remain upright and stabilized - just like Paxil keeps you stabilized! Or something.

    I showed #14 to one of our pharmacists recently to see what her reaction would be. First she laughed, and then she began to look disgusted:

    "Drug companies have money to spend on stuff like this, and meanwhile all our senior patients are scrambling to pay for their drugs?"

    "You're right," I said. "You're absolutely right."



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