Dr Gillian Riley

Started in a couple of new places recently so I’ve been laying out my rules/beliefs and thought it might be handy to have it written down for patients to see too.

when I was but a baby gp some time ago (don’t make me put a number on it) it was routine in the practice I worked in for the gps to see drug company reps and they had somewhat of a free reign in the practice.

General practice training is in part an apprenticeship model. You move between various practices so you see how different gps work, and so initially I did what the senior gps did – I spoke to the drug reps.

But I it was kind of. Annoying. They always wanted to interrupt me when I had patients to see. They had glossy pamphlets but no actual data, by which I mean, primary research papers that weren’t heavily edited, or studies that hadn’t been sponsored by the company. They’d argue with me when I’d point out flaws in the pamphlets (some in particular were quite aggressive and there was one guy who really didn’t like being questioned, and I was younger? Yes? But still a high school and college award winning debater – dude. No.). It just never sat well with me

I don’t even remember where it came up. It may have been in gp registrar training. I might have just come across it reading. I read widely, then and now, and I read a lot of medical journals. Obviously. That’s my job. But I came on an article about doctors prescribing habits and how they were influenced by drug reps.

Being me – I read further. And further. And well. Wasn’t really… happy about what I was seeing.

Because the data on this one is pretty clear. Drug companies are absolutely trying to influence our prescribing habits. Overtly. It was nascent data when I was first training as a gp way back in 2010. I think it’s overtly clear now.

I’d life to say that I immediately cut off all contact but.. I was a registrar. I was very junior in practices I worked at, and I had very limited power. I did immediately stop seeing reps. I stopped taking freebies and samples, and I got a lot more bolshie when they tried to do a sales pitch in the tea room. A lot of the events I was expected to attend, I had no wiggle room on.

I do now, though, and once I was fellowed, independent employed and in charge of my own destiny, so to speak, I’ve drawn a pretty hard line on this one.

I don’t see reps.

I don’t attend educational activities if they have drug company sponsorship.

I check conference sponsorships before I attend. (Difficult, but thankfully most conferences are no longer taking drug company money. It is getting a little more complex now around the ethics of the big gp corporations and the tech/ai companies who are all sponsoring events – I have a lot of thinking to do on that one and thankfully not enough time or money for conferences at the moment so I can just sit with it).

I pay upfront for pretty much all of my ongoing education and continuing professional development courses and training. Expensive. (And at times irritating). But at least then I know the biases I’m carrying in are the ones I’m carrying already (and there are *lots* of those let’s be real haha, and I’m so verbose I’m sure we’ll discuss them at some point. I am human!).

Anyway here’s a picture of the one freebie I still have – it’s chicken with chickenpox. This was for varilrix. I have justified my one lapse because it’s cute, the vaccine name isn’t anywhere advertised on the toy, it ended up on the immunisation schedule anyway, and this one wasn’t going to really influence my prescribing habits much because promoting it is a government recommendation .

But I am prepared to accept judgement for the chook if I must.

peace out,

dr. Gillian and the poxy chook,