Last Updated: 2001-07-27 18:00:38 EDT (Reuters Health)
מתוך מדיקונטקסט
By Karen Pallarito

NEW YORK (Reuters Health) – A Cincinnati, Ohio, physician group has a message for the dozens of pharmaceutical representatives who vie for face time with its doctors every week: No more free lunch.

Beginning August 1, the Queen City Physicians group will ask drug reps to pay for appointments with doctors. The 50-member physician group has created a separate, limited liability corporation called Physician Access Management to schedule 10-minute appointments between drug reps and docs at $65 a pop.

Over the past 2 years, Queen City has been deluged by drug reps competing for time with its internists, pediatricians and obstetrician/gynecologists. Some weeks as many as 20 to 30 drug reps try to get time with the group's doctors.

"They're certainly competing with my patients for a chair in the waiting room," said Pamela Coyle-Toerner, the group's president and chief operating officer.

Queen's City concocted the unusual plan to clear its clogged waiting room and to counteract the bombardment of free meals and events that drug reps offer as an enticement to get a few minutes with its doctors.

On a recent 90° day, Coyle-Toerner watched one drug rep "schlep" 10 bags of box lunches and three 12-packs of soda to the group's office, which ended up feeding more than 20 people.

"Did my staff enjoy lunch? Absolutely. But what's the value in the long run?" she asked. "What did it cost her and how much meaningful time did she get with the docs as a result of it?"

Medical group and pharmaceutical consultants who spoke with Reuters Health believe that the fee-based appointment plan is unique.

"I think it's a great idea. I think that drug reps truly do make themselves a nuisance to the medical groups," said Darrell L. Schryver, a managing principal with the consulting unit of the Medical Group Management Association.

And, frankly, doctors don't always control the flow of drug reps into the waiting room–their staff does, he said.

"Let's face it, the staff often schedule these appointments based on who's the cutest, who brings the best donuts and what's a good day to have lunch," he told Reuters Health. "If these guys are successful, it will definitely, definitely catch on."

"I think it's probably a reasonable idea from the doctors' point of view because I know that they're plagued with these things," offered Robert N. Zelnio, president and founder of Paragon Research & Consulting in West Chester, Pennsylvania.

The Cincinnati doctors aren't opposed to some one-on-one time with drug industry detailers–the men and women pharmaceutical companies deploy to do drug marketing and education. Far from it.

"You can't just say no. There is a value that they bring to the physicians about the newest products and what they can do," Coyle-Toerner said. Those face-to-face interactions provide something "that you're not going to get in an ad."

Physicians Access Management, created as a buffer between the physician group and the drug reps, will sell blocks of time with members of the medical group, who are technically serving as "consultants" to the new company. The structure is designed to avoid any conflict of interest.

Whether drug companies will buy into the pay-for-appointment scenario remains uncertain.

"A lot of them say, I would never want to pay for physicians' time, and I look at them and say, You already are, guys," Coyle-Toerner said. "You created this beast. You pay," she quipped.

Others are grateful to have a pre-set appointment that guarantees face time and values drug reps as professionals, she said.

Schering-Plough Corporation, for one, has not taken a stance one way or another. "We have a long-term relationship with Queen City and, as such, we will continue to evaluate ways to work with them," Spokesman Ronald Asinari told Reuters Health.

Coyle-Toerner admits that the plan is a risk, but one that she thinks is well worth taking.

-New York Newsroom 212 273 1700