Your tone is a bit inflammatory, but I can't help but agree a bit. If someone who is selling you something is doing so by trying to convince you of a medical phenomenon that you (as a doctor) aren't familiar with, it's the height of irresponsibility to just accept that at face value. It shouldn't be a secret in the medical community that big pharma sales can be... unsavory.

As someone who has worked in the pharma industry, most doctors are very skeptical of anything a drug rep says, not in the sense that they're lying, but more that they're trying their best to make their products look good.

One shouldn't underestimate other factors in opioid prescribing: 1) the idea that pain is the "fifth sign" and should be aggressively treated and 2) that good pain control leads to positive customer experience.

It's not as simple to say "jesus those docs are stupid to believe Purdue". Some maybe are, but most probably never even saw their rep.

I talked to a retired Doctor about this the other day and he dismissed out of hand the narrative that doctors were fooled by pharma reps.

His read on this was: doctors by and large knew exactly what they were doing.

Perhaps they were irresponsible. Perhaps they just didn’t want to let people be in pain.

But his take was that laying this on the pharma reps is a silly idea.

He would say that. Nobody likes to feel like a dupe, and there’s safety in numbers. I doubt he had a Purdue rep in his office change his mind about prescribing habits.

Still, you go to conferences and there are often a few Gladwell-caliber speakers at the big ones who get your head bobbing up and down for an hour. It’s very much in the drug companies’ interest to convince those speakers. Then the whole thing feels very organic, everyone’s new opinion feels like a reasoned medical choice.

It's also distressing that through undergrad, medschool, residency they never learned that opioids are fucking addicting as fuck and how to think for themselves.

I mean, this opioid crisis didn't just begin this year, or last, but it's been decades in the making. So imo doctors happen to be just as part of the problem as big pharma.

Give me a break.

Also, and more importantly, fuck those drug reps - and if they were ignorant then fuck our society that has come to accept CYOAism so widely. It is your job as an employee to be aware of the effects your labour is having on others - if you're working in a paper mill that is dumping chemicals into a river it's not enough to hope folks downstream don't get sick.