Pharmaceuticals Anonymous

Saturday, September 12, 2009

Haldol... and an elderly patient - by Gwen Olsen, author of Confessions of an Rx Pusher

Written by a former top drug company representative - drug seller.
It was the end of the third quarter, and I was behind in my sales quota for Haldol. That meant forfeiting a significant amount of money from the bonus pool if I didn't make quota. My territory was at somewhat of a disadvantage because I didn't have the large number of psychiatrists the reps in other metropolitan areas such as Dallas, Houston, and Austin had. It occurred to me that the most common drawback/objection I received from the general practitioners I called on with this product was patient compliance. (Patients would frequently discontinue the medication because of its side effects.) So, I determined the best way to build my Haldol business would be to campaign for the institutionalized patient. These patients were not only encouraged to take the medication; they were actually given the drug. This completely eliminated the compliance issue.

I set about scheduling training in-services in the local nursing homes and mental health and mental retardation (MHMR) facilities. I increased my call frequency on physicians whom I knew to have nursing home relationships and directorship responsibilities. I littered these offices and institutions with every type of marketing tool known to man. You could not look anywhere in my territory that there wasn't a clock, coffee mug, calendar, candy dish, scratch pad, or pen displaying the Haldol name.

During my so-called "Haldol Blitz," I made weekly visits to my nursing homes. The nursing staff was very supportive and appreciated being the recipients of all the goodies and attention that was rarely placed on them. (Reps notoriously do not like to call on nursing homes or abortion clinics.) They began to eagerly recommend to doctors that patients be placed on Haldol and actually kept track of patients who were put on the drug to report to me on subsequent visits. I rewarded these facilities and staffs with catered-in lunches and gift certificatesto local restaurants.

In my routine visits to one particular nursing home, I met Mrs. Ida Smith. (I have changed her name to protect her privacy.) Mrs. Smith was a petite, fragilelooking woman in her late eighties. Her snow-white hair was always neatly coiffed. She also wore a bright red lipstick that contrasted starkly with her delicate, pale complexion. Ida was a whirlwind of activity in her motorized wheelchair. She was frequently seen motoring from room to room, checking on and visiting with other residents. It was apparent the nursing staff was put out with Mrs. Smith's meddling. Ida often complained to staff about patients who were not properly being cared for. She was the self-appointed hall monitor and was not afraid to let people know she was watching. I got a kick out of observing the nurses' reactions when Mrs. Smith would demand someone change a bedpan or IV bag that had been left unattended. She could definitely hold her own in a debate.

Mrs. Smith became a bright spot in my visits to an otherwise gloomy, depressing facility that reeked with the stench of urine and disinfectant. However, I called on the home one day, and Mrs. Smith was nowhere to be seen. Before departing, I questioned the head nurse about her. "Oh, Mrs. Smith, she's had a bad patch lately," she said. "Her friend in 17B died, and it really upset her. She hadn't been sleeping well and seemed a little disoriented, so we recommended her doctor put her on Haldol. She's doing a lot better now...sleeping through the night...not combative and quarrelsome like she used to be." She concluded, smiling.(It was obvious she thought she was making brownie points with me.)

As I rounded the corner to the front door, I saw an attendant pushing Mrs. Smith in her wheelchair into her room. Her head was hung, and she was drooling on her pretty, pink gown. Mrs. Smith looked like a zombie. She was in complete disarray. Her hair was uncombed, and her signature red lipstick was missing. I felt a pang in the pit of my stomach. Had I been responsible for this turn of events? Surely, Mrs. Smith was not the patient-type for whom I had promoted Haldol. Or was she?

I exceeded my quota in all four of my products that sales quarter. Shortly thereafter, I was promoted to a hospital rep's position in Houston for the Baylor College of Medicine. I would never see Mrs. Smith again. However, my last memory of her would stay fresh in my mind and on my conscience for many years to come.