Laissez Les Bon Temps Rouler

Posted by KidShrink on Wednesday, February 6, 2008 at 9:04 am

It is Mardi Gras after all, as well as Super Tuesday, so why not chat! Never underestimate the effectiveness of a few well timed, well placed conversations can have. Setting the stage here, I can say that I work in a very interesting health care environment. During the past year, we have had visits from the Queen of England, as well as the First Lady of the United States. In both cases, security is extreme and ceremony becomes the order of the day right down to a ritual changing of blown out light bulbs, the painting of curbs, and cleaning of carpets which I noticed have been stained since my arrival. Security is so tight as to not even allow me to glance upon such royalty without a ticket, when usually I can look out my office door and almost touch where they are seated. So given all of this, it amazed me that such security was not afforded the patients in our outpatient clinics.

It disturbed me that my patient’s information did not receive the same security as the royalty visiting. Yes, I know this is a stretch, but is it? I noticed the infiltration of Big Pharma first hand, as a representative was allowed to enter our clinic unescorted, proceed past our receptionist to the back work area where our mailboxes are as well as those of our residents and fellows, and then proceed to leave doughnuts, coffee, and other freebees. This area also contains patient charts. To get to this area, he also would have to pass several physician offices where patients were being seen. This had disturbed me for quite sometime and I actually asked him to leave. This occurred approximately three months ago. I subsequently brought this up at our faculty meeting. It was frowned upon by some and brushed off by others as me overreacting. Needless to say when I mentioned that this representative also wanted to talk with interviewees for our fellowship, our training director was enraged. Additionally, I commented that given we were due our JACHO survey and they would probably frown upon his being in a area where confidential patient info was as a possible HIPPA violation, the mood of the meeting changed, but not as much as I had like… Our department chair subsequently sent out a less than forceful letter asking that the STAFF ensure that Pharmaceutical representatives be escorted back, but no real enforcement. I somehow thought this should be the responsibility of the physicians, anyways, I took the small victory.

Fast forward to Feb. 5th, 2008, Mardi Gras for all of you who have not kept up!! Given the festive guy that I am, as I was happily giving out beads to my office workers, I noticed that same representative placing “marketing stuff” in our boxes again in the same restricted area. I felt defeated. I returned to my office to eat my King Cake, play my New Orleans jazz, and dream of beads being thrown my way (no sick jokes, please). However, around the 4:40 hour, my department chair pulled me aside to inform me she had noticed that the boxes were stuffed with Pharma marketing and she had personally sent a letter to said representative reprimanding him and reminding him of our policies and cc’d all the other researchers, training director, attendings, etc and expressed her displeasure. She said it was due to my efforts to remind the department to be mindful of such interactions. I felt vindicated and empowered. Curiously enough, I did not receive the gifts in my box that I noticed all the other docs did, so I guess they are not only detailing our prescribing habits, but also which docs are in “in the know” about their marketing tools. I guess I was on another list and was being put in a Pharma induced “time out.” I can honestly say that I notice the representatives when they visit, but do not get detailed by any, although most of the other do on a regular basis. That works for me.

I tell this long story to remind us all that sometimes, just a few words are just as good as a speech, and sometimes setting the personal example creates an impression. Never underestimate the power of small conversations and the impact one can have on many!

So I returned to my office, grabbed my briefcase, frowned at the prescription pad with all it advertisements on its cover, threw on some Mardi Gras beads and headed out the door towards home. The ride home was especially gratifying as I blasted the New Orleans Jazz!! I had made a difference, a small one, but no less another step towards cultural change!

Laissez Les Bon Temps Rouler…Let the Good Times Roll!!

-Kid Shrink

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Category: Uncategorized,a day in the life of a practicing physician

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