Sales reps are 'shadowing' doctors


Published: Saturday, January 18, 2003 at 6:01 a.m.
Last Modified: Saturday, January 18, 2003 at 12:41 a.m.

CHICAGO - Some doctors are letting drug company sales representatives sit in while they treat patients - a practice called ``shadowing'' that is being questioned by at least one professional group.

An organization of psychiatrists says it intends to ask the American Medical Association to review the ethics of the practice.

Sales reps have been known to sit in doctors' offices and examining rooms and observe routine checkups, various treatments and diagnostic tests, even child psychiatric therapy. Some doctors are paid hundreds of dollars in return.

Some, if not all, of the pharmaceutical companies require the doctors to obtain the patient's consent.

The companies say these programs are purely educational, allowing sales reps to learn more about doctors' jobs and better serve physicians who use their products. But critics see the efforts as an unethical marketing attempt that violates the privacy of the doctor-patient relationship.

It is unclear how widespread the practice is, but the players include major pharmaceutical companies such as Eli Lilly and Co.

Critics say confidentiality and consent are especially problematic when psychiatric patients and children are involved. Some question whether parents can adequately represent their children's wishes.

The American Academy of Child and Adolescent Psychiatry plans to raise the issue at the AMA's annual meeting in June in Chicago.

Dr. David Fassler, a Vermont psychiatrist and member of the academy's governing council, said he wants the AMA to come out against the practice unless patients have ``full knowledge and informed consent.''

``It seems quite inappropriate to have non-clinical personnel present during therapy sessions,'' Fassler said in an interview this week. ``I'm also concerned that patients may not always feel free to say no when asked by their doctor if something like this would be OK.''

The AMA does not have policy on shadowing, but one is needed - especially if doctors are being paid, said Dr. J. Edward Hill, chairman of the AMA board of trustees.

``I would be extremely concerned about that being an ethical behavior,'' he said.

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