TIME - "Attack of the Pharma Babes!"

From TIME:

It's the click of high heels that gets our attention.

The hospital is a place of aching feet in wide, thick rubber-bottomed, stand-all-day-long shoes. And our good women thus shod can't compete; in the weary, unaesthetic world of sick people they work too hard at tasks that are too unglamorous.

Those good women were the first to warn us about the young lovelies in high heels. But the pharma babes still get to us, and the good women just role their eyes.

Younger and prettier — or at least better coiffed than anybody taking actual care of the sick — drug reps are a feature of medical life that few outsiders see. Known as "detail" people or (behind closed doors) "pharma babes," they are basically salespeople. They generally work on commission. Despite all the patient information confidentiality laws, they somehow find out which doctors write how many prescriptions for what.

More by Dr Scott Haig.

Perhaps Dr Haig (an orthopod) reveals more about himself than he intended in this piece?

Today's doctor is far less in-charge than was Marcus Welby. Patients tell us what to prescribe. They see prescription drugs advertised on TV. "Ask your doctor" means "go tell your doctor you want this pill." The tactic must work; I see more TV drug ads every time I turn the thing on.

HMOs tell us what to prescribe. They have lists of (cheap) drugs for which we don't have to spend hours filling out forms, and lists of (less cheap) drugs we can only get with forms, and lists of (not cheap) drugs they won't pay for no matter what.

Hospitals tell us what to prescribe. They have formulary lists, somewhat like the HMOs, and contracts with equipment suppliers whose implants they force us to use. It is perhaps because of these strong voices that the reps are more effective.

While those stern voices tell, the friendly pharma babe, just asking, is often a more forceful persuader.