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A Piece of My Mind
January 24/31, 2017

Academic Detailing: “Marketing” the Best Evidence to Clinicians

Author Affiliations
  • 1Harvard Medical School; and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA. 2017;317(4):361-362. doi:10.1001/jama.2016.16036

Thirty-eight years ago, a US federal research agency issued a request for proposals on “Improving the Quality and Economy of Prescription Drug Use.” Recently out of my residency and concerned about the mismatch I was seeing between the best evidence and prevailing patterns of prescribing, I suspected that the problem might result in part from an imbalance in the effectiveness of communication coming from commercial vs academic sources. The pharmaceutical industry was impressively adept at sending well-trained change agents (drug “detailers”) to provide information about company products engagingly and interactively to physicians in their offices, in order to increase product sales. Academics, by contrast, who may have had a more impartial and thorough understanding of the evidence, tended to be passive and inelegant communicators, standing behind podiums in optional continuing education courses, delivering one-way didactic presentations in darkened rooms, often doing little to change actual practice.