There Was A Line On The Floor

Here’s the key anecdote (to my mind, anyway) to a fascinating article on the power of Key Opinion Leaders (KOL) in the pharmaceutical industry. The article is at the Chronicle of Higher Education, and worth checking out. Thanks to Will Baum, LCSW, who sent me the article with the comment, “may be up your alley.” Indeed.

My brother Hal, a psychiatrist at Wake Forest University, used to work as a KOL for GlaxoSmithKline. The event that drove him away from the business came one day when he was giving a lunch lecture at a local primary-care clinic. To his irritation, none of the doctors in attendance paid any attention to the lecture. They were answering pages, talking loudly with one another, helping themselves to the lunch that Glaxo had brought in—anything, it seemed, to avoid listening to him talk. Eventually Hal got so frustrated that he cut the lecture short. As he was packing up his laptop to leave, however, the Glaxo rep asked him a favor. The director of the clinic had been unable to attend the lecture. Would Hal mind sticking around a few more minutes to say hello? Reluctantly, Hal agreed, and the rep took him to a small room adjoining the clinic, where he said they would wait until the director appeared.

Hal calls this his moment of understanding, after which he never gave another industry-funded talk. Up to that point, he had imagined himself as a high-powered academic physician bringing the latest university research to doctors out in the community. Standing next to the drug rep, however, Hal understood how the community of doctors saw him. To them, Hal was a drug-company shill. “I was literally standing in the drug-rep spot begging for a minute of this doctor’s time, like a cocker spaniel begging for a leftover piece of meat from the table,” he says. It was no wonder the doctors saw little difference between Hal and the rep. “It was like I had become a psychiatric call boy,” he says. “I might as well have just said, ‘Hi, I’m Hal. The company sent me to make sure you all have a good time.'”

“There was a line on the floor,” Hal says. He had never seen such a thing before. “The rep told me that we weren’t supposed to step past that line unless a doctor said it was okay.” They stood behind the line, waiting patiently. After a few minutes, the director walked down the hall toward them. “I sort of looked at him hoping to make eye contact and speak, but he wouldn’t even look at us,” Hal says. “This rep just stood there with a big smile on his face, and the doctor stopped in front of the treatment room five feet away from us, and stood there for several minutes reading a chart. Then he walked away into the treatment room like we were not even there.”

And while we’re posting large excerpts, here’s the opener to the article:

In the early 1970s, a group of medical researchers decided to study an unusual question. How would a medical audience respond to a lecture that was completely devoid of content, yet delivered with authority by a convincing phony? To find out, the authors hired a distinguished-looking actor and gave him the name Dr. Myron L. Fox. They fabricated an impressive CV for Dr. Fox and billed him as an expert in mathematics and human behavior. Finally, they provided him with a fake lecture composed largely of impressive-sounding gibberish, and had him deliver the lecture wearing a white coat to three medical audiences under the title “Mathematical Game Theory as Applied to Physician Education.” At the end of the lecture, the audience members filled out a questionnaire.

The responses were overwhelmingly positive. The audience members described Dr. Fox as “extremely articulate” and “captivating.” One said he delivered “a very dramatic presentation.” After one lecture, 90 percent of the audience members said they had found the lecture by Dr. Fox “stimulating.” Over all, almost every member of every audience loved Dr. Fox’s lecture, despite the fact that, as the authors write, it was delivered by an actor “programmed to teach charismatically and nonsubstantively on a topic about which he knew nothing.”

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