The drug rep and our illusory superiority

The attitude of doctors towards pharmaceutical sales representatives (‘drug reps’) is influenced by a complex psychological phenomenon, and we seem to be blissfully oblivious.

About twenty years ago I briefly studied psychology at the University of Amsterdam. It’s a long time ago, but two things I still remember. One: the psychological experiments we had to submit ourselves to as first year students to get enough points to pass – so senior students and scientists would have sufficient study participants. And two: the Milgram experiment.

Shocked by Milgram

This well-known experiment shocked the world in 1963. Yale university psychologist Stanley Milgram showed that many study participants obeyed an authority figure in a white coat, even if this meant they had to administer dangerously high shocks to other participants.

I still recall watching the film at the university, in horror. I couldn’t believe that the poor participants would follow a request to these extremes. I was certain that I would have disobeyed the experimenter.

The Milgram experiment was replicated in 2006 – with some changes to satisfy the research ethics committee – and guess what: The results were similar. Most participants agreed to administer increasingly painful shocks when asked to by a professor.

I was probably wrong in thinking that I would have disobeyed. Yet at the same time I wasn’t, because most people believe they would not follow the order to administer the shocks.

The psychological phenomenon of self-deception

So why are we fooling ourselves? It’s called illusory superiority: an illusion of personal strength. This phenomenon has been demonstrated in countless experiments. For example, a study asking people to rate their own driving skills demonstrated that eighty per cent of drivers rate themselves above-average.

Illusory superiority occurs in a variety of circumstances:

• We tend to think we’re more likely to perform altruistic deeds than our peers
• We think we’re good at certain cognitive tasks, such as problem solving, even when we’re not
• We believe we’re more creative, thoughtful, or sophisticated than we really are.

In an article titled Shallow thoughts about the self, a group of authors argues that we tend to mistake our good intentions for our actual behaviour.

Our inability to recognise bias

Similarly most people think they are less susceptible to bias than others. This failure to recognise our own bias is caused by the bias blind spot.

One study found that 52% of doctors agreed doctors were influenced by the pharmaceutical industry, but 40% believed this was not the case for them personally.

So, when the friendly drug company representative comes along, serves lunch, and gives us little gifts to make us prescribe their product, we may think we’re not susceptible to their influence and strong enough to form our own opinion – but are we really?

The no advertising please campaign encourages doctors not to use drug reps as a source of education. I have signed the pledge not to see drug reps in the next 12 months.