Drug reps - the end is nigh!

Benjamin Brewer, an FP in Forrest, IL, turned up the heat on pharmaceutical representatives by framing a simple question: Are their visits worth the patient encounters they cost a doctor?

In 2005, Brewer decided that the 15 or so drug reps—also known as detailers—who visited his office each week distracted him from patient care. So he went cold turkey, refusing to meet with them or accept their samples. Life without reps, as he recently wrote in his online column for The Wall Street Journal, has allowed him to treat a few more patients each week, and earn an extra $6,300 a year.

"I didn't think rep visits cut into my time with patients, but a few minutes here and a few minutes there added up," says Brewer.

It's not just the money or the productivity at issue; it's the overall value of detailing visits, which have faced increasing criticism in recent years. Doctors like Brewer, who find them expendable, view the samples they leave behind as an attempt to lock patients into new medications.
Not everyone sees it that way. Most of the doctors we informally surveyed welcome the attractive men and women who show up with pizzas and meds. But many have nevertheless tried to rein them in, only meeting with them during lunch hour, for example, or limiting how many can come to the office on a given day. Here's a closer look at how some doctors deal with detailer visits.


Nationwide, there are an estimated 90,000 to 100,000 reps; each calls on eight to 10 physician offices a day. Some practices may get only two to four visits a week. However, in 2005 and 2006, primary care physicians deemed as "heavy prescribers" were called on by an average of 29 reps a week, according to Health Strategies Group, a research firm that tracks the pharmaceutical industry.

How those visits break down hints at the possible strain on physician practice: In 2005, 85 percent were drop-ins, 5 percent were appointments, and 10 percent were lunch dates.

Hearing a drug spiel over a fajita wrap may not disrupt the schedule, but drop-ins and appointments eat up roughly 60 minutes a week, Health Strategies Group reports. If you used that extra time to see four established Medicare patients, using CPT code 99213 for an intermediate visit, you'd collect roughly $60 per visit, $240 per week, and $12,000 over 50 weeks. Subtract 50 percent for overhead, and you'd net an extra $6,000 a year—just a hair under what Brewer cleared after dropping rep visits.


More

Imagine