Prometheus 6   

Drug firms increasingly barred from exam rooms

By Liz Kowalczyk, Globe Staff, 7/28/2003

Azucena Sanchez-Scott had just finished chemotherapy treatment for breast cancer, and she was worried about the side effects. Her nails and hair were falling out, hot flashes plagued her, even sleep was difficult. So she went to her oncologist for reassurance. As she undressed in the exam room, he looked on.

So did someone else: a salesman from Alza Pharmaceuticals.

Sanchez-Scott's doctor didn't say who the man was, only that he was ''observing my work,'' she said. At one point, when a hot flash hit, the doctor asked the salesman to operate Sanchez-Scott's pocket fan so she could lie down for the exam. She grew increasingly uncomfortable about the stranger's presence, but it wasn't until she questioned the receptionist afterward that she discovered the visitor was a drug company representative. Eventually, she sued the doctor and Alza for invasion of privacy, a suit that was settled in 2001. Executives at Alza, now a subsidiary of Johnson & Johnson, would not comment on the case. The doctor could not be reached.

''I still feel hurt,'' said Sanchez-Scott, now 50, a family and marriage therapist who lives in Los Angeles. ''The drug rep didn't have anything to do with me or my care, and he was allowed to come into my exam room. I felt violated.''

Sanchez-Scott's lawsuit was one of the first public challenges to a standard, long-term practice that has come under growing fire in the past year: Pharmaceutical companies paying doctors a fee of several hundred dollars a day to allow salespeople to shadow them as they see patients, a practice called a preceptorship. Drug companies and some doctors say it is an important educational tool, but others believe it is an invasion of patients' privacy and a ploy by drug companies to promote their products.