"In a perfect world, there would be no need for drug reps," writes Jamie Reidy in _Hard Sell: The Evolution of a Viagra Salesman_ (Andrews McMeel Publishing). Of course, in a perfect world there would be no need for medicine or doctors, much less the representatives of the big pharmacy companies whose job it is to influence doctors to prescribe their particular medications. As a physician, I myself don't look at drug reps as a necessary evil. Each does, after all, have detailed knowledge of one or two drugs that I am responsible for prescribing. More importantly, reps provide samples, and for my patients, who are generally indigent, the samples represent a lifeline for those not yet on, say, Medicaid. I got lots of insights from Reidy's rollicking book, one of which is that other doctors find samples important as well, not for the poor but rather as starters for patients who will buy their own prescriptions if the supply of samples works. The larger revelations in Reidy's hugely entertaining book are not really complimentary to him or to Pfizer, the company about which he writes, or to drug reps in general, or to the medical profession. I know what drug reps do from my role in the system, but for other readers, there will be even more revelations of secrets here than there were for me. In the capitalist economy, we have not figured out the paradoxes of buying and selling health, and Reidy's book gives a small, detailed picture of some of the problems, with no suggestions for answers.
Reidy graduated from Notre Dame, with a degree in English, not pharmacology or even any other science. He did a spell in the military, and then he slacked. He was eventually invited to consider working in pharmaceutical sales, and went to Pfizer's "boot camp," learning that Pfizer's drugs were far better than those of any competing manufacturer. He was posted to a sales territory in Indiana, and began to make his rounds, using free food as a way of getting into the doctor's office behind the office staff. He learned which doctors like to be chatted up on sports, Pfizer's stock values, or his dating experiences. Reidy was simply good at his job. He also learned to be good at faking being good at his job. He learned how to fudge his visit books and sample signatures to make it seem he was making far more calls than he really was. Most of Reidy's book is about becoming and being a drug rep, and just getting by as a slacker. It is only toward the end of the book that Reidy starts telling his often ribald Viagra ("Vitamin V") tales. Being a seller of Viagra came with the unexpected benefit that everyone was curious about his work and proud of the fine job he was doing; one doctor even introduced him to a waiting room full of men as "The Viagra Guy," which resulted in all the patients standing up and clapping.
Reidy left Pfizer after five years when he didn't get the promotion he wanted, and his book ends there. He thereupon did four years with another big pharmaceutical company, which fired him when its officials got to see the galleys of his book. Given the slacker techniques he describes here, that's probably good for the company's bottom line. Reidy, former English major, is going to try writing for a living, in California. He's good at it; _Hard Sell_ is frequently laugh-out-loud funny, and he comes off as a lively, personable guy, just the sort of slap-on-the-back, elbow-in-the-ribs fellow that would make a good salesman. In many ways, however, his book is an unpleasant reminder of the wrongs of our system of providing medicine to sick people. It reveals a pharmaceutical giant over-paying a salesman for under-work. Americans who already know that they pay more than the rest of the world for name-brand drugs ought to remember that a lot of that extra price goes to this sort of marketing.
