Academic Detailing
Early in his medical career, Dr. Avorn established an interdisciplinary research team to study how physicians prescribe drugs, how patients take them, and the clinical and resulting economic outcomes. His studies helped define how pharmaceutical company promotion and scientific information interact to shape doctors’ decisions about which drugs to use, with the former often dominating.
In the 1980s, Dr. Avorn devised a new approach to improve doctors’ ability to make accurate prescribing decisions. He observed that the promotional activities of pharmaceutical companies and their sales representatives (known as “detail men”) used cutting edge strategies to change physician behavior and sell their products. By contrast, medical school faculty may have had a more complete and balanced grasp of the scientific issues, but were much less effective communicators. He devised an approach known as “academic detailing” which took the effective communications strategies of the drug industry and used them to present unbiased, evidence-based education about proper prescribing. In several papers in the New England Journal of Medicine, JAMA, and other medical journals, he and his colleagues showed that such programs could improve prescribing decisions and more than cover their costs through reductions in improper medication expenditures. Today, programs based on this work are in place in the United States, Canada, Europe, Australia, and throughout the developing world.
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