More Texas clinics are saying no to pharmaceutical salespersons because of ethical concerns

As sales representatives for pharmaceutical companies brought doughnuts and lunch over the years to physicians at the 20 Kelsey-Seybold medical clinics in the Houston area, Patrick Carter worked to limit their presence.

Carter, a family physician and managing director of care coordination for Kelsey-Seybold, said he wanted to remove the appearance that drug representatives influenced the decisions made by doctors when writing prescriptions. Since 2012, pharmaceutical representatives cannot stop by Kelsey-Seybold clinics or meet with its 370 doctors unless the physicians request an appointment for guidance in prescribing certain drugs. 

“It eliminated the idea that the drug rep is there every day bringing breakfast or lunch for everybody in the clinic,” Carter said.
While the rule banning drug representatives from visiting with doctors has been embraced at the Houston clinics, it is not standard procedure at most medical practices in Texas.

But advocates for improving medical ethics say that it is a step in the right direction and that more doctors and medical facilities are imposing a ban throughout the state and across the nation. And it has some support from the pharmaceutical industry, which is looking to help improve ethical standards in health care while maintaining some aspects of the physician-drug representative relationship.

Since Kelsey-Seybold instituted the rule, Carter said he had heard from other doctors, particularly those who work at academic medical facilities, who are considering similar action.

Stephen Brotherton, a Fort Worth physician and outgoing president of the Texas Medical Association, said no specific figures exist on how many Texas practices have approved such bans. But he said that the direct physician-drug representative relationship is becoming less common because medical practices are trying to reduce disruptions to patient care while emphasizing the need to obtain medical information on pharmaceutical drugs from scientific sources instead of “trade sources.”

“It’s probably a little more unusual for a clinic or group to say ‘Don’t come at all unless we call you,’ but it’s quite common for people to be saying we’re going to reduce our contact with the pharmaceutical reps,” Brotherton said.