Danny Jones

The reality of the matter is you have a lot of...

expense accounts and budgets and that clinicians reaching for a tool in their tool belt and the tool available to them is what's covered by the insurance and what have i been educated on okay well when you're the device rep or the drug rep that is in that clinic every week and you're the person bringing the lunches and the dinners and taking that clinician out i became really good friends with most of my doctors

And then I'm being educated by the corporation and the corporation's telling me we have to stop depression in its tracks.

We have to stop depression in its tracks.

And they bring in psychologists and psychiatrists that are funded by the company that educate you and help you grow a market.

You do.

It's not that all these reps are thinking, oh, I'm going to do a bad thing.

And so one of the examples of one of the most evil things I saw

is they talk about off-label and you do training as a 20-year-old kid and you do all these online modules that say, I will not promote off-label.

I will never promote off-label.

And all this is documented at the company level.

Then they would bring in a super charismatic neurologist from some university like Stanford that'll come in there and start telling you where all they're using the medication off-label in their practice.

and they'll go you know we've this is indicated for depression but where we saw a lot of benefit is in this subset population and this is a big population in america and then you're at dinner with your doctor drinking wine on a tuesday night and you're like they're asking brigham i want to write more of this but i just don't know where i don't really see the patient you've laid out for me and you go do i do i tell them about what that psychologist said or that psychiatrist do i tell them what that professor from stanford said maybe i'll just tell them and let them decide

They can do what they want with it, right?

And those seeds are planted everywhere and then they're watered and nourished and then that leads to more prescriptions.

And right or wrong, that's just the nature of the beast of that ecosystem that you're living in.

And then you go to the other players.

So if we were to break it down by players, there's the doctor who in all honesty is in a captured system doing the best they can to navigate that system, right?

If I'm a clinician and I went from, I have six minutes with you,

I literally have got to get out of that room as fast as I can.