But now, there are new, slightly more staid competitors for doctors’ attention. “Academic” reps, with a different message than the drug reps I’m used to seeing.

Drug sales are big business, and companies are energetic in the tactics they use to promote their products.

The New York Times made the point with a racy article (“Gimme an Rx! Cheerleaders pump up Drug Sales”), noting that drug companies were recruiting former college cheerleaders to provide—if not well-informed intellectual salespeople—at least a commodity that will get the doctors’ attention. And I was no exception.

At the private practice office where I worked for many years before joining the Lloyd F. Moss Free Clinic, the clamor was such that we had to impose a quota—three drug rep visits in the morning, three in the afternoon. The early mornings before the office door was unlocked were a bit like Walmart at Thanksgiving. A jostling crowd—such was our popularity.

Dare I say it, the pharmaceutical company representatives I saw tended toward a certain unscrupulousness: overemphasizing the benefits, playing down the adverse effects and fandangling the whole business of clinical trials and “educating” doctors. I particularly like the statistic quoted in Family Practice journal that shows the more reps a doctor sees, the worse is his or her prescribing habit.

But they are, of course, only doing what every industry does—trying to promote sales, which they’re pretty successful at. Drug companies on the whole are twice as profitable as the average Fortune 500 company.

The trouble is, busy doctors often don’t have the time, the energy or the inclination to go looking for objective sources of information on medicines. Such sources do exist, like the drab but scholarly Medical Letter, or the repository of evidence-based medicine, the Cochrane Reviews.

But it’s been all too easy to fall back on information that comes right to your door—often with coffee or donuts and a little flirtation on the side.

ENTER DAVID