Thanks for your post. I personally see this as 2 issues that sometimes get inappropriately (IMHO) combined into 1.
1) Is it appropriate that prescribing data is available to pharmaceutical companies?
This is a very complex issue to be sure. I will say that I do feel that it is inappropriate that the American Medical Association facilitates the process even for the prescriptions of physicians who are not members. As many of you already know, the American Medical Association has an identifying number for every physician, not just its members. Check my facts on this, as this is only my understanding of the process in general - the physician information from the AMA's masterfile is licensed to Health Information Organizations (HIOs) who use it to connect physician data with prescription data they get from pharmacies. This combined information is sold to pharmaceutical companies.
Opting out does not change what I just described; it changes whether a field rep can see the data. Consequently, I do not see opting out as an effective way to undermine the selling of our data. Cynically, I feel the offer to opt out is a bit manipulative - it gives the some physicians the good feeling that goes along with taking action on an issue. However, if the issue is the selling of the data, the action doesn't pertain to it in any meaningful sense.
If physicians in general feel that the selling of the data is inappropriate, we could lobby for legislation to prevent it. But who is our major lobbying organization? The AMA, which discourages opting out. Consequently, I would think the next approach would be for AMA members to threaten to leave if the AMA's masterfile continues to be used for this purpose.
I'm skeptical that refusing to see reps on a grand scale would result in the end of prescription datamining. I'm sure the information is so valuable in so manay other ways, pharmaceutical companies will continue to buy it as long as they can.
Once again, don't take the above as gospel - please correct me if I have any of those facts wrong.
2) Should reps see individual prescribing data?
If this is the only concern, opting out does solve this problem on an individual basis. I feel that as long as my data is being sold, I would like to have the opportunity to use that information. I don't personally mind discussing this data directly or indirectly with a rep. However, I recognize that others feel differently, and if a physician finds interacting with reps unpleasant, I can understand why s/he would stop.
Over time, my "system" has evolved as follows: I do not see every rep that drops by. If a rep has a new or unfamiliar product in a disease state that's relevant to my population, I will see them at least once, research the product and determine if there is any likely long term value in seeing them regularly. If there is a rep who has a product I use regularly in a disease state I see commonly, assuming I find him/her pleasant and professional, I will generally continue to see them over time.
I realize that what works for me may not work for others. I also realize that discussing my prescribing habits with reps is comfortable for me but may not be for others. I enjoy asking questions about my prescribing habits - e.g., "I perceive I prescribe more X than Y - does that appear to be correct?" Obviously, I don't get a 100% straight answer every time, but I generally get a sense. Of course, that's not the only reason I see them. I find updated formulary information, PI updates, new indications, etc. valuable for products I use regularly. Once again, that's me, not everyone.
Once again, thanks for your post! Definitely a complex, charged issue.