Pills, Power, and Policy by Dominique A. Tobbell

Author:Dominique A. Tobbell
Language: eng
Format: epub
Publisher: University of California Press
Published: 2012-01-23T00:00:00+00:00

The Therapeutic Consultants Program and the Effort to Create Expert Educators

In October 1964, the DRB created the Committee on Continuing Education. Chaired by Carl F. Schmidt, the research director of the U.S. Naval Air Development Center and a former professor of pharmacology at the University of Pennsylvania School of Medicine, the committee was charged with exploring what the DRB’s role should be in expanding and improving physicians’ access to pharmaceutical information. The committee was particularly troubled that medical schools were systematically reducing and in some cases discontinuing the teaching of therapeutics within the medical school curriculum just when that instruction was needed most. Therapeutics refers specifically to the practice of treating disease. Amid the rapid pace of pharmaceutical innovation, physicians were struggling to keep abreast of the latest developments in therapeutic practice. Without sufficient training in therapeutics and without access to accurate and reliable sources of pharmaceutical information, it was no wonder, the committee held, that physicians relied on the pharmaceutical industry for their information.

Despite the intellectual relationship of therapeutics to clinical pharmacology (which referred to the study of drug actions in humans and not to practice), the DRB realized that increasing the number of clinical pharmacologists and the amount of clinical pharmacology being taught to medical students would not be sufficient to provide all physicians with authoritative information on how to incorporate the wealth of new drugs into practice. Rather, what the nation’s practicing physicians needed was access to accurate, up-to-date, and regularly available continuing pharmaceutical education.

Within eighteen months, the Committee on Continuing Education had determined that all existing methods of disseminating drug information to physicians—whether newsletters, workshops and conferences, or editorials—offered little hope of competing with the methods of pharmaceutical detailing. Acknowledging the “success of the face to face approach,” the committee instead resolved to tackle the drug information problem by establishing an education program modeled on the work of pharmaceutical sales representatives.

To this end, the committee proposed a therapeutic consultants program in which medical schools (ten to begin with) would hire an academic physician or pharmacologist with expertise in therapeutics to serve on a full-time basis at the medical school. This therapeutic consultant would be responsible for bringing to physicians in the region “a wide range of authoritative information on the uses and limitations of new drugs.”86 The therapeutic consultants’ educational efforts would be two-pronged. First, therapeutic consultants would offer regular seminars and workshops on specific aspects of pharmaceutical practice, which would be available to all physicians in the region. In this way, the work of the therapeutic consultants was to be modeled on the work of medical schools’ existing continuing medical education programs. Second, therapeutic consultants would visit physicians in their offices and clinics, providing them with up-to-date and face-to-face information on prescription drugs. This, the most innovative aspect of the therapeutic consultants program, was modeled on the work of pharmaceutical detail men and the farmer education provided by states’ agricultural extension officers.

To ensure their continued access to high-quality and authoritative drug information and preserve their

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