Guest Blogger Dan Ariely on Schmoozing Drug Reps and (Dis)Honesty

[Dan Ariely visited Amazon's campus yesterday to talk about his new book, The (Honest) Truth About Dishonesty. He recently wrote this guest post for our friends at the Kindle Daily Post, and we're happy to share it here. The (Honest) Truth About Dishonesty is a fascinating look at the harmful effects of every-day cheating and lying, and our misperceptions about our own honesty--and dishonesty.]

Janet Schwartz of Tulane University and I once spent an evening with a few former pharmaceutical reps, men who used to be in the business of selling a wide range of drugs to treat all kinds of diseases and conditions. As drug representatives, they visited doctor’s offices and attempt to convince physicians to prescribe their company’s drugs. How? Typically they would start by passing on informative pamphlets and giving out products like pens, clipboards, and notepads advertising their drugs. Later there would be lunches and dinners in nice restaurants where they could discuss the benefits of a therapy or device undisturbed. Little (and sometimes large) acts of ingratiation would work on doctors’ sense of reciprocity, and in this way, nudge them toward prescribing the product in question.

So we tried the pharmaceutical reps at their own game--we took them to a nice dinner and kept the wine flowing. Once we got them a bit sauced, they were ready to tell all. And what we learned was fairly shocking.

One of them--an attractive, charming young man--told us a story about how he was once trying to persuade a reluctant female physician to attend a seminar about a medication he was promoting. After a bit of persuading, she finally decided to attend--but only after he agreed to escort her to a ballroom dancing class. This, according to our new friends, was a typical kind of quid pro quo where the rep does a personal favor for the doctor and the doctor promotes the rep’s product in return.

Even more shocking was that when the reps were in the physician’s office, they were sometimes called into the examination room (as “experts”) to inform the patients about the drug directly, sometimes even selling medical devices in the operating room, while the surgery was going on.

We also learned how well these men understood classic psychological persuasion strategies. One clever tactic they used was to hire physicians to give a brief lecture to other physicians about a drug. They found that after giving a short lecture about the benefits of a drug, the speaker would begin to believe his own words and soon prescribe accordingly. Studies show that people quickly start believing whatever comes out of their own mouths, even when they are paid to say it. This is a clear case of cognitive dissonance at play; doctors reason that if they are touting this drug, they must believe in it themselves--and so their beliefs alter to align with their speech.

So, what do we do? First, we must realize that doctors have conflicts of interest. With this understanding we need to create barriers that prevent this kind of schmoozing, and to keep reps from undue access to physicians or patients. They, of course, have the right to send doctors information, but their interactions should stop there. There should be no more fancy dinners or ballroom dancing their way into the hearts and minds of doctors.

--Dan Ariely