Confessions of a counter-detailer, part 2: Tchotchkes

If you want to lose weight, you have to consume fewer calories or burn more calories through exercise or increased physical activity. Both tactics involve changing behaviors or habits. The same is true for prescribing practices, which are behaviors or habits developed over time. Physicians develop prescribing behaviors based upon various factors.

Conditioned behaviors

These folks were conditioned to go to the display tables and look for the "goodies" before moving on to the food. At the display tables, the drug reps would engage the physicians in brief conversations about their latest brand products. Sure enough, the physicians would start using the new brand medications, and the use of "older" and non-promoted brand medications would decrease.

"Leave-behind" envy

Back in the summer of 2007, I began meeting with physicians to discuss the preferential use of generic medications over brands. Usually we met in their office lunchrooms. As I sat and waited, I'd look at the various items in the room. The clock on the wall bore a brand-medication logo. So did the salt and pepper shakers. On the refrigerator door, magnets sporting brand-medication logos held various restaurant take-out menus in place. Looking more closely, I'd see cups, letter openers, pens, sticky notes, and examination-room table-liners, all bearing promotional logos. The office staff seemed oblivious to all this brand information. I wasn't.

"Wow!" I thought, "Lots of stuff!" I felt inadequate. I felt a sort of "leave-behind" envy; I didn't have anything to leave for the doctors. I thought to myself, "I need some 'leave-behinds' - some tchotchkes."

Wikipedia describes tchotchke (typically pronounced "CHACH-kee") as a Yiddish word meaning "small toys, gewgaws, knickknacks, baubles, lagniappes, trinkets, or kitsch. The term has a connotation of worthlessness or disposability, as well as tackiness, and has long been used by Jewish-Americans and in the regional speech of New York City."

I like to refer to tchotchkes as "agents of behavioral change."

Now that the pharmaceutical industry no longer provides such items, a void has been created. I decided to fill that void.