Thyroid Disorders Community
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393685 tn?1425816122

BEWARE - at your next appointment. Who is this person in here with me?

I had an interesting flight home yesterday and couldn't wait to share this story with you all. Funny how when things go wrong something good certainly can happen too.

Missed an original fight I had booked -  b/c I fell asleep ( literally) at the terminal to get on my  original flight. Had to book a later time to get home and on that flight, LOW and BEHOLD -  I meet an X- Pharmacy Rep from Forest Pharmacuticals, makers of the desiccated thyroid medication - Armour Thyroid.

Well, I am sure you can imagine I am just pumped with questions talking to this guy - who left the company due to the cash-driven - stress he was under working in the sales end for them.

Actually he had no knowledge of their past superior Armour formula orginally and never had it in his black bag of samples to inform the doctor of their alternative product... But did have limited T4 product information and knew about that. So, I enlightened him on how desiccated thyroid users went through a nightmare recently on the shortages and now the backfire with their new formula that is being processed and pushed on thyroid patients.

Since he was no longer an active rep - we just had small talk on the hows and whys Forest probably concluded that changing the product was best - as far as I was concerned after listening to the internal demands he was under - my worst nightmare of why it was changed seemed more true...

Here's the jest on why I am posting this and hense - my title of the post - Beware...

He informed me there is a practice with Pharm reps ( with doctors) , that they are allowed in the examining room as "observers" while patients come in to see there doctor.

Back in the day when I had numberous appointments trying to figure out what was wrong with me I remember some appointments had a third party person in the room but I made the assumption that it was an assistant or  soon-to-be - new medical personnal. - I assume a training was going on.... was it really? -  

and all I was told was "x" was going to be in here with the examination.

Well it could have been a legit training medical staff member, but the reality is - it could be a Pharmacy Rep trying to make a sale on a certain product and seeing the patient activity this doctor has.

As I thought about how distrubing that truly was, I realized the HIPPA agreement we all sign ( and the reps too) now actually covers this practice so the rep and the doctor can not be held in contempt - ditching our privacy needs and expectations.

B E W A R E ... thyroidians... if you have a 3rd party in the room, make sure a formal introduction is made and you really know who else is in your examining room with your doctor. Ask their creditials and why they are present - observing YOU - as the patient.

You never know if its someone just checking to see if you "fit the profile" of their newest selling porducts.

Ironically, most often the daily log of patients is organized so the rep only sees the ones that fits their selling points of their certain meds they want to talk about that day with the doctor.

As the X- rep told me, most often in his case -  it had to do with the abundance of newer anti-depression medication recently approved. As that conversation unfolded - my nightmare of memories of when I was so sick surfaced and remember many times a third party was in there and I walked out with a script to "see if that helps" - when I was so anxiety driven and "depressed" as it was drilled in my head - time and time again.  The concocktion or "depression cocktails" - as I quote from this rep - really distrubed me while we talked.

Seek - search and suprise yourself has been a motto of mine here and my support of thyroid patients globally. That motto really stands out for me today as I write this to male you aware of the practices we may be involved in and really aren't aware of some things happening.

Your appointments with you doctors are difficult enough trying to uncover the real reasons on why you feel so bad.

Better more hormone sensitive tests needed, better or a combination of real meds and not all bandaids to balance your thyroid hormones better, and just your one on one time with your doctor could be invaded.

Ask who this person is while you are in the room and if its not to your approval - say no, its not alright for them to be there.

Your doctor is there to help you with your time you scheduled with them. Your not a numbered "conversation piece" that is talked about at an elaborate dinner paid by the rep after the doctor's day is through.

Good Luck and just make sure you are getting the best care possible at each of these appointments.
13 Responses
649848 tn?1534637300
I did  a quick search and found that this actually "has" happened.  Now, I really wonder about that person in the room with me and my doctor.  Never again, will say it's okay for a 3rd person to be in the room, unless it's my husband or someone who is really needed.
649848 tn?1534637300
Wow -- that's an "eye opener" -- on my last visit to my pcp, there was a 3rd person in the room. He was introduced as a med student; however, I can't help but wonder, now.  

The only thing "out of the ordinary" is that my cholesterol was high again and my doctor mentioned that I should be put on cholesterol med; I refused, saying that my thyroid levels were lower than I need them to be and as soon as I get an increase in med to bring them up, my cholesterol should come down, as it usually does.  The doctor insisted that there was nothing wrong with my thyroid levels -- after all, they were "in range", even if rock bottom.  

I refused to budge on the issue, knowing that I would see my endo in a few days and get the increase in thyroid med that I needed; the doctor also refused to budge, so we ended the appt rather abruptly.  

Now, I have to wonder if that "med student" might have been selling cholesterol med.....hmmm.  

219241 tn?1413541365
You asked this guy for his business card, right? You did actually check he said who he said he was, right?  Sorry but my alarm bells go off when 'strangers' tell me stuff incidentally.  Call it my investigative hat still sitting on my head from my former career!

  Sounds a bit Conspiracy Theory to me!
Not to make light of what you say, though. I have been seeing doctors since the day I was born for many ongoing issues, (non thyroid related) and I have never had a third person in the room...ok I lie....when I was going for my Pap smear Test, in the late 1990's they ordered female nurses in the room if the male doc was taking the test, since some women had cried rape or molestation or whatever.

   I have serious doubts that a Pharmaceutical representative would be allowed in to 'view' doctor/patient relationship in order to see if the patient 'fits' a medication to be dispensed. I do know that doctor's are asked to fill in questionnaires for pharmaceutical companies to advise what range of ages, illnesses, how often they prescribed etc. They often get kick backs, meaning say $5 for every Lipitor prescription as opposed to a Crestor one (both are anti-cholesterol medications)
It makes no sense to me as to why a Pharma rep would be in the room in the first place.

This guy you met had no knowledge of a product he was selling? I presume he was selling something else then? I mean the company makes alot  of products so for sure he may not have been one of the people toting Armour, but perhaps Savella. Not all the reps promote the full range of the companies products.

  I think the point here is; If you are introduced to Joe/Joan Bloggs as being a 'Med Student' or Medical Observer, then say, 'Sorry, I am not comfortable with you being here, I would prefer you leave.'  By law they have to leave. No if, buts, or maybes. End of story, end of paranoia. You then deal with the doctor in question and you leave hopefully in better  spirits than when you arrived.

Avatar universal
My cholesterol was up when my TSH was high, and came down in just a month when my TSH came down, and my PCP's comment was, "That's interesting, your cholesterol came down." Scary that the PCP's don't know this important connection, as well as how many other issues the thyroid can cause.

What's even scarier is that some endros don't know either ! I went to my endro, whom I have had good luck with in the past, with a complete list of symptoms I had been having, most of which I verified online were thyroid symptoms, including blurry vision and red eyes, and he actually told me they all looked like menopausal symptoms and to see my GYN, which I immedietely did the same day.  When I read her the same exact list, she said it did not fit typical menopause symptoms, although she did test me and I am in menopause!  The endro also told me that menopause should not cause any issues with my thyroid meds...
Avatar universal
Call me paranoid (I HEARD that!  LOL), but I've gone one step further.  My husband and I never go to doctors' appointments alone any more.  Our original thought was that it's best to have more than one pair of ears listening to what the doctor has to say.  However, on at least one very important occassion, my husband was also able to serve as "witness" when the doctor and I remembered very differently what he had said to me.  If my husband hadn't been with me, I'd have thought I was going out of my mind, and I'd have had to incur a lot of expense reconciling our (the doctor's and my) memories.

Nothing would surprise me as far as the extent to which the pharmaceutical companies will go in promoting their products.  Just look at the very successful smear campaign they have run against dessicated.

There's a very interesting expose' of pharmaceutical companies' tactics in a book called "Our Daily Meds" written by Melody Petersen, a NY Times reporter who wrote about the pharmaceutical industry for several years.  I think pharmaceutical companies will probably stop at nothing to sell their products.  Interesting reading...
393685 tn?1425816122
It was on the up and up Red.. This guy was for real.
393685 tn?1425816122
and I certainly wouldn't post a thread like this without knowing the facts.

It is something and suprising. You're right Barb. I almost fell out of my seat on the plane when this guy was filling me in.
219241 tn?1413541365
Ok, maybe it is different in USA. But our laws here are incredibly tight when it comes to 3rd persons in the room with a patient. Our privacy laws are very strict.  I actually rang around different companies and doctor surgeries and they all agreed it is a huge no-no here in Australia to allow pharma reps in with a patient. They have to make an appointment and talk to the medical officer in charge of the clinic. USA pharmaceutical companies must be very arrogant and the whole system is obviously very lax in its attitude to patient confidentiality. It frightens me to think you guys allow this to happen.

I suggest all US thyroid ( and non thyroid!) patients write to their practitioners and state;
I, (insert name here, date of birth and current address) refuse to allow any other person other than the doctor or nurse who is treating me to be in the room with me other than in an absolute emergency, being a paramedic or likewise to assist me.  Sign and date it, keep a copy and hand it to the doctor.
  This is a legal request and they cannot deny you this!
  You guys need to stand up for your rights, and not be walked all over!

649848 tn?1534637300
redhead -- this not something that we "know" about ahead of time.  As when I went for my appt, the doctor came in with another person in tow, introduced him as a "medical student" and we went on from there.  Had I had any inkling at the time, that this might have been something other than that, I would have refused to allow him in the room. Next time, I won't take a chance.

Our system is not "lax".  We, too, have very strict privacy laws; it's just that sometimes people will do whatever it takes to get around the law.  
Avatar universal
I'm afraid Barb is right here...we do have the laws in place, but although the laws may be well-intentioned, they are often totally ineffective.  With electronic medical records (EMR), I'm afraid the situation just becomes scarier.  All of our medical records (locally) are in a patient database so that any of our doctors can see the results of any of our tests, etc.  What I find amazing is that any system user (doctor, nurse, receptionist, etc.) can see the records for ANYONE.  No, you do not have to furnish your doctor with a password to get into your records.  He can see them just by being on the system, and he can also see the records of anyone NOT his patient.  

So, as always, we depend on the discretion of medical personnel.  However, confidentiality laws only apply between a doctor and HIS patient.  If you have not been treated by a doctor, but he has access to your information, confidentiality does not apply.  Please spare me the argument that this information is not being "leaked".

The absurdity is that privacy laws force our doctors to make us sign a "release" in order to get our own test results, and even then the doctors offices are always concerned about violating HIPPA (patient privacy act).  However, meanwhile, those results are in EMR for anyone who works in a doctor's office (ANY doctor's office, not just your doctor's) to see.

The profits in the pharmaceutical industry make the profits in oil look like loose change.  I'm quite sure that Big Pharma knows whatever they want to know about us.  I'm sure they're not beyond placing a drug rep in a doctor's office to "coach" him on the most effective ways to get patients on their product.

In my local pharmacy, in order to meet HIPPA requirements, they have installed a "booth" in which they can give you further information and answer your questions about prescriptions.  Sound proof, you say?...nah, the "booth" has two sides and a top (a top???), but no front or back.  Any "privacy" it creates is the same privacy an ostrich gets by sticking its head in the sand.  However, it puts the pharmacy in compliance with HIPPA.

The absurdities go on and on...
649848 tn?1534637300
Anything to make the sale, huh??
393685 tn?1425816122
I guess the reason why I posted this was because I was shocked at this practice with the reps.

I just never imagined a pharmacy rep would be allowed in the room when a patient was being examined by their doctor.

Live and learn......
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649848 tn?1534637300
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1756321 tn?1547098925
Queensland, Australia
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