Educated by Sales Reps…

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How do doctors get educated once they leave medical school? You would be surprised to learn the answer. Most people would say medical conferences and courses. In fact, in my experience, many physicians get a good chunk of their continuing medical education via sales reps. That, of course, is like the fox that guards the henhouse teaching the hens about home security. Let me explain.

Medical Education Is Always a Moving Target

What do I mean? When I began medical school, our dean told us that half of what they would teach us would later be confirmed to be wrong. Hence, there is a need to constantly update medical education for new discoveries and trends. The problem is that for physicians in private practice, time away from the office disrupts patient care and can be financially difficult.

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How Industry Influences Medicine

The consumer group ProPublica has been sounding the alarm for years that some doctors are bought and paid for, especially in academia. The issue is that pharma and device companies have figured out how to use “influencer” physicians to push their products at medical conferences or through white papers. It’s frankly not all that different than a pop singer endorsing a company’s products on Instagram. However, in medicine, there is supposed to be a firewall between industry and medical decisions; otherwise, what gets offered to the patient isn’t necessarily the best option. If you want to see if a specific physician you know is on the dole, check out the ProPublica Dollars for Docs website.

The Most Consistent Education Machines in Medicine Are Sales Reps

You would think that doctors get most of their continuing medical education via universities, medical conferences, and courses. However, while for some physicians that’s true, for others, in my experience, an awful lot of it happens in interactions with sales reps about products. For example, this is why Pharma hires attractive people to go into doctor’s offices to push product. Let’s explore that a bit.

The concept of a pharma sales rep is almost a meme at this point. This used to be almost always women who could have easily won a beauty contest, but now that there are many more female physicians, men have joined the ranks. Sometimes these salespeople can have a deep, but narrow, knowledge of a specific topic. In that one area of knowledge, they can know more than the doctor. Other times, they’re as clueless as the physician and worse, their job is to push the product:

Educating Doctors

In regenerative medicine, we have a sales rep problem. Take what happens in other areas of medicine and magnify it times 10. Why? Because doctors have never been taught anything about this field in medical school. They commonly know enough to be dangerous. So when a sales rep walks in and discusses what sounds like common-knowledge facts, these physicians often add this slanted and inaccurate knowledge to their education.

For example, it should be common knowledge to any physician that you can’t thaw living cells at the bedside and have many of them survive. Why? Because in culture expansion and storage facilities, cells need to be recovered from a frozen state via controlled-rate thaw, via a specialized recovery media, and over days of incubation. In fact, this is common knowledge to any four-year-degree cell biologist who freezes, stores, and recovers cells. So why doesn’t your doctor, who went through a decade-plus of school, know this? He or she was never taught anything like this in medical school, residency, or fellowship. Hence, when a sales rep tries to convince your doctor that all he or she needs to do is to warm a frozen vial of cells in the hand and then inject those and the cells will all magically live, that doctor tends to believe what he or she is told.

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How You Can Protect Yourself

I spent the better part of the last two weeks and then this past weekend reformatting our education system for Regenexx network physicians. All I can say is that at the end of that process, we continue to have the world’s most intensive educational process in regen med. Why? Not only do these doctors have to have a certain base level of training in interventional procedures before we accept them, but they also have to progress their way through more than a dozen courses offered through the Interventional Orthopedics Foundation (IOF). Each of those involves didactic lectures, cadaver training (where they have to demonstrate that they know how to perform the procedure being taught), and also a written test. They then need to make it through the educational gauntlet I upgraded this weekend. This is eight Regenexx-specific didactic lectures and then a 132-question online test and then an observation period in the clinic or at a mentor site.

The upshot? At the end of the day, physicians being educated by drug or device reps in regenerative medicine is irresponsible at best and dangerous at worst. The good news is that there are nonprofits out there to educate doctors with noncommercial messages. The bad news? There’s still an army of sales reps trying to use their own spin on “education” to convince doctors that the sky is red. The physicians can, of course, look up and verify the inaccuracy of that information, but most keep their heads down.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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