More than a decade ago, the job of pharmaceutical rep was enviable. Direct-to-consumer advertising pre-sold many drugs so doctors already knew about them. Medical offices welcomed the reps who were usually physically attractive and brought lunch. In fact, reps sometimes had their own reception rooms in medical offices and seemed to see doctors before waiting patients. 

By 2011 thanks to drug safety scandals and new methods of marketing, the bloom had fallen off the Pharma reps’ roses. The number of prescribers willing to see most reps fell almost 20 percent, the number refusing to see all reps increased by half, and eight million sales calls “could not be completed” at all, reported ZS Associates.

Some doctors did not hide their antipathy. Salt Lake City family doctor Ross Brunetti estimated six reps called on his office every morning and six more in the afternoon. “In a week, I might see three people trying to sell me the same thing,” he complained. “There are more drug reps than patients. It’s like a minefield.”

While some medical offices tolerated reps for the drug samples they left behind, even that began to change. The samples began to be viewed as nothing but inducements to prescribe more expensive drugs. Nor were they usually going to needy patients but rather to staff members themselves and their families and a move to refuse free samples started.

In 2007, the 62,000-member American Medical Student Association (AMSA) rolled out a “scorecard” program that graded the nation’s 150 medical schools on their policies toward Pharma gifts, consulting and speaker fees and financial disclosures.