In a previous life, I served as a personal safety consultant to a major pharmaceutical company, traveling around the country training female sales reps in self-defense skills. Their biggest concern was handling doctors who tried to harass them during their sales calls. How could they dissuade the doctor without sacrificing the client relationship and losing business? The company had sexual harassment guidelines and training in place, but none of that helped much once the women got out in the field and faced complex and sensitive situations.

I remembered that experience when I listened to a Health Care Compliance Association audioconference about the predicaments that reps encounter today. The conference focused on the ramifications of the TAP Pharmaceutical Products case, in which sales execs were accused of bribing doctors with phony educational grants to prescribe their drugs. (See news story, page 8.) Presenters emphasized that sales personnel need training throughout their careers in regulations regarding gifts and inducements, training that explains the reasons behind the rules and the consequences of noncompliance.

I also think that training needs to go beyond the rules and get at the emotions underlying the violations. As CME providers observe, underpaid, overworked doctors feel entitled to pharma perks. And reps are under incredible pressure to make their quotas. A combustible mix. How can a rep effectively answer the doctor who says, “The competition gave me $500. What can you do for me?” In the workshops I gave, women shared their coping strategies — my favorite was the woman who, when a doctor touched her behind, told him, “We're not giving out samples of that today.” Through role-plays and brainstorming, they came up with options that would really work for them.

An assistant U.S. attorney speaking at the audioconference stressed that most reps do not see themselves as bearers of bribes; they believe their products will help patients. That was my experience as well. When I think back to the women I had the privilege of training, I am re-inspired by their gutsiness and humor — and their inventiveness in problem-solving. Given the opportunity, I would imagine reps would generate and share “best practices” for tackling these tough situations. (I think that approach would work for doctors, too.) As adult learning principles teach us, if trainees participate in developing solutions, they are more likely to implement them.

P.S. Excellent venues enhance training. See page 79 for readers' picks for the best medical meeting venues of 2001. Cast your vote for our 2002 awards using the ballot on page 24.