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Stepping out of her car, Sally Pharmrep glanced again at her watch.  If she was late, it would not be well received.  Reaching into the back seat of her white, four-door Camry, she pulled out the large sheet cake and, of course, the balloons.  After all, it was Dr. ThoughtLeader’s birthday and he loved balloons. . .

Cake and colorful balloons birthday background (1)This is neither a law school case study nor a piece of ancient compliance history.  Rather it is something that happened in the parking lot of a Maryland doctor this month. It is a typical situation that I dealt with every day as a pharmaceutical compliance officer, but that was before 2003.  After 15 years of having detailed guidance from PhRMA and the OIG, this is not something I’d expect to see in 2018. Especially in this environment where John Oliver and others justifiably ridicule the industry for these practices that are self-inflicted wounds.[1] This is the very definition of a “predictable failure.”

In this climate, where patients struggle to pay for their medicines, this is not the time to bring cake and balloons into a doctor’s office, no matter how good a “friend of pharma” he or she is.  This is not the time to behave this way in front of regulators faced with drug prices rising faster than inflation and who look upon the industry in general with skepticism and suspicion.  For compliance professionals, it is a time to step back and take stock of exactly what have we managed to accomplish.  It is time to go back to basics and take an independent look at all those codes and policies and training and frequent reminders.  Because after 15 years we are still talking about meals, gifts, entertainment and speakers’ programs.  Now is the time to get serious about curtailing this behavior or we can simply decide to just continue being a source of jokes; cake anyone?

[1] See John Oliver, Marketing to Doctors, HBO (2015) at