FAQ

Why do you speak for pharmaceutical products?

i am as passionate about teaching as i am about caring for and advocating for my patients. I've been teaching in some way or another since i was in high school. Speaking for pharmaceutical companies combines my two passions in a manner that i find very satisfying & compelling & makes the taxing travel & resulting fatigue worthwhile. Long after the program is over & my compensation has been handed out i stand by my word to maintain contact with fellow physicians at my programs who contact me to consult on a challenging patient or have follow up questions about medications i spoke about.

Aren't payments for speaking excessive?

When travel time is taken into consideration it is seldom "worth" it from a purely financial perapective. But that's not at all why i speak and money isn't at all why i went into medicine & then psychiatry.  That being said i am happy that educating my peers does pay me so that i can keep my practice small enough to devote extra time, attention & care to my patients. A recent study found that when primary care doctors switched to practice styles that allowed them to dramatically reduce the size of their patient panel they began to spend more time with each patient & their diagnosis of psychiatric illness in their patients increased by over 70%. i spend up to two hours for an initial psychiatric visit & 30 minutes for medication follow up visits and 50 minutes for psychotherapy with or wthout medication management.

In an age of dwindling physician reimbursement and therefore dwindling face time with their doctors patients are often left frustrated with unanswered questions because their doctors must cut patient visit duration in order to break even. Supplementing my clinical activities with paid peer education allows me to enhance the care i give my patients & actually reduce their costs.


Isn't speaking for drug companies a kickback for prescribing their medication?

Kickbacks of this sort are not only unethical but against federal law & carry stiff penalties. i only speak on medications that i am very familiar with & only do so when i believe that I'm able to teach my colleagues about their safe & effective use. i have said no on more than one occasion when approached by a company to speak & their are frustrated company reps out there who can attest to that :-)

Furthermore, i have "opted out" through the AMA from allowing pharmaceutical companies access to my prescribing data. Therefore when i am asked by a pharmaceutical company to speak on behalf of their product the request is made without their having any data regarding whether i have even prescribed their particular product.

When you speak on behalf of a pharmaceutical company to other doctors about a drug aren't you just "pushing" that particular drug?

Promotional educational events sponsored by a pharmaceutical company are highly regulated affairs with all aspects tightly controlled by the FDA. After all from the FDA's perspective such events are the MD equivalent to direct-to-consumer advertsiements on TV or in print. All peer to peer educational events are required to highlight the risks associated with a medication using presentation materials reviewed and approved by the FDA. i describe these cautionary aspects of any medication I'm speaking about with as much enthusiasm as i describe the potential benefits. My credibility with peers depends just as much on how i prepare them for the side effects of a medication as its therapeutic effects. After all the goal of peer education for me is ultimately to improve patient care.

i see that you speak for many products in the same therapeutic class. Isn't that a conflict of interest?

Au contraire. i believe strongly that credibility is enhanced rather than dimished when a physician speaks for more than 1 product in the same class. The reasons are legion:  knowing that i could be in front of the very same group a month later speaking about a "competitor" keeps me focused, on task & honest without engaging in "bashing" other products; i believe that especially with psychiatric medication, where we know so little about actual mechanism of therapeutic action, each molecule available for prescription by us has something positive & unique to offer. As such we have a rich pharmacotherapeutic toolbox & i thoroughly enjoying educating my peers about different aspects of each tool & sharing best practices with them.

Any given pharmaceutical company's reps may joke & "wish" that i spoke only for "their" drug but when they take off their sales hat even they understand that patient well being takes priority over corporate sales & so called brand "loyalty". Many sales reps have shared unhesitatingly with me stories of their own loved ones' being treated successfully with a "competitor's" product without the least bit of shame or disdain.  Brand loyalty for pharmaceutical products stops respectfully well before the doctor-patient relationship begins.