May 21, 2013--The "Patient Experience"

As I have been hobbling from doctor to doctor to MRI to doctor the past couple of weeks, I assumed that the only one keeping track of me was Rona.

Assume again.

From what I've been reading, the drug companies are hot on my trail.  From a report in the New York Times, here's how it works--

There are data-mining companies that specialize in tracking patients' encounters with doctors, the tests that are prescribed, how patients' insurance works and reimburses, and what drugs are recommended. Also, using other data-gathering techniques, these companies can learn if patients are taking the drugs they bought and if they refill prescriptions on time. Perhaps most chilling, they gather information about what doctors talk about with each other and how they collaborate, including which doctors in a geographic area are most influential among their colleagues. From this "influence mapping" they are able to develop an "index" and do all they can to influence the influencers.

In effect, as the CEO of one of these marketing companies claims, they are able to monitor all aspects of the "patient experience."

The information gathered is in turn sold to pharmaceutical companies who use it to target-market their drugs to doctors and other medical professionals. If they discover that a particular physician has many patients with high cholesterol but is not prescribing their latest statin, they do what they can to reach out to that doctor in an attempt to convince him or her that theirs is the most effective medication.

The drug marketing people say that by engaging in these quasi-ethical practices they can help doctors by "providing information that is customized to their needs."

For example, German drug maker Boehringer Ingelheim uses insurance and prescription data to focus on doctors who have many patients with chronic respiratory disease but do not prescribe long-acting drugs such as BI's Spiriva. Of course, to get patients as well to think Spiriva, they run endless TV commercials on those channels that appeal primarily to middle-age women.

In the words of BI's USA chief executive, "You start analyzing what [doctors are] doing and you can find out if, through a combination of factors, you can intervene."

I can remember the time when that intervention was by young (and very attractive) pharmaceutical sales reps who made the rounds of doctors' offices, leaving sacks of free samples that physicians then passed along to their patients. To further predispose doctors they also paid for sumptuous lunches and dinners for all who worked in the office.

But wouldn't you know it, as a result of  the data-mining, Big Pharma has been able to cut way back on this in-person salesforce. Thus far thousands have been laid off.

And all along I thought this information about me and my doctors was strictly confidential. The research companies claim that their work is accomplished anonymously, without identifying individual patients. Forgive me for being skeptical. I wouldn't be surprised if ZS Associates already knows the results of my recent MRI. On the other hand, I am still waiting to hear about it from my surgeon.