Pharmaceutical drugs sales play a significant role in shaping conventional medical practice. In 2000, pharmaceutical companies spent more than $15.7 billion on the promotion of prescription drugs in the United States. More than $4.8 billion was spent on detailing, the one-on-one promotion of drugs to doctors by drug reps.

In "Following the Script: How Drug Reps Make Friends and Influence Doctors," Adriane Fugh-Berman and Shahram Ahari detail tactics pharmaceutical sales representatives, or drug reps, use to manipulate doctors into prescribing their products:

"Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible. The foundation of this influence is a sales force of 100,000 drug reps that provides rationed doses of samples, gifts, services, and flattery to a subset of physicians..... every word, every courtesy, every gift, and every piece of information provided is carefully crafted, not to assist doctors or patients, but to increase market share for targeted drugs."

Noting that "the essence of pharmaceutical gifting…is 'bribes that aren’t considered bribes,'" the authors conclude, "in the interests of patients, physicians must reject the false friendship provided by reps. Physicians must rely on information on drugs from unconflicted sources."

Bringing to light the the corporate influence pharmaceutical companies have over doctors, this eye-opening, behind-the-scenes article was written as part of a 2004 settlement between Warner-Lambert, a division of Pfizer, and the Attorneys General of 50 states and Washington D.C. With awareness of such pharmaceutical industry practices, we can begin to see how the business of medicine can conflict with patients' best interests.