One More Way To Minimize The Sales Rep?
55 CommentsBy Ed Silverman // June 7th, 2010 // 7:39 am
This may be a way to bypass the sales rep. Pfizer has, apparently, become the first big drugmaker to offer a phone app on iPhones and other mobile devices that is being promoted to physicians. The goal is to encourage docs to send questions directly to the drugmaker or, more specifically, medical liasions. Presumably, adverse events could also be reported this way.
To make this happen, Pfizer struck a deal with Epocrates, which offers doctors access to medical info online and on mobile devices. The “Contact Pfizer” feature is now available in the Epocrates drug profiles of around 40 Pfizer meds and, soon enough, docs will be able to e-mail Pfizer to ask about various drugs. The companies cite a recent poll showing 64 percent of docs own a smart phone and that will rise to 81 percent in two years. Of course, this is no substitute for free samples, but all sorts of info can be pushed through these devices, so why spend face time with a rep?
Mike
Interesting that Pfizer origionally started the mass marketing of reps to providers and now they are trying to end that.
pharmavet
This is an “app” in search of a reason to exists. Most doctors that I know will simply send a text message to a rep if they have an urgent question. A quick call to a company’s Medinfo dept also works. These departments are usually well staffed and quick to respond.
M. Black
The method (i.e.) smart phones, snail mail, heavily equipped Internet services from docs to pharma companies, the relevance of the sample toting suits is seemingly fading out. If and when that happens, they will have great sales experience, and there are hundreds of things out there to sell. They should be fine
My view is not an opinion. But friends that are MD’s talk as if this scenario is becoming more of a truth than not. Device reps have a good chance of surviving. But do we really need to pay for a bag of samples in a suit to “sell” Nexium? No, because after two months of usage, your esophagus will be sprayed so heavily with HCL, bile, and whatever digestive juices, that products such as these will sell themselves. Even without medical insurance. The stoppage of use causes such negative consequences, that it may be considered as addictive as oxycontin.
Perhaps astra will concoct the antidote for nexium just as purdue did so for oxycontin.
Pigs.
Either way, the pharma rep is useless in the betterment of the industry and it’s patients.
I hear ADT has a good sales department…
It puts things into perspective…
~ M. Black
Philosopher in NJ
Epocrates? Wasn’t he a student of Socrates?
Philosopher in NJ
bob
Go ahead and get rid of reps and see what happens. Most Docs actually like seeing reps. It’s a break in the day of seeing sick people all day. And, oh yeah, the reps also can answer questions unlike any other profession in the world and with great respect for the Doctor’s time. They are the only ones paying the medical profession any respect right now.
Frankly, I’m sick of those who think Reps are useless. Grow up. Relationships are everything in all walks of life. Reps are good for our business and provide a quality service. So, why not get off their backs and stop listening to the companies selling email services, web apps and the like tell us the Rep is no longer needed. It serves their best interests… only. Advertising requires multimedia efforts. It’s been that way for years and will continue to be so.
pharmavet
Bob, please update my family doctor’s menu from Pizza Hut. He has an old version and the toppings have changed.
Seriously, what is your scientific training? Can you carry on a conversation with a physician that’s not from a memorized script that lasts more than 30 seconds? Most companies used to have RPh’s as reps that could do this without being scripted. Nowadays they’re too expensive and thus they are gone. You guys do look good, however. Nobody else wearing an off-the-rack suit can make it look like a $2000 Zegna. You might tell your female counterparts that they could make it to more offices if they ditched the four inch stiletto’s for a comfortable pair of flats.
Oh, and BTW, my doctor friend likes his dark roast from Starbucks with two shots of espresso, and his assistant goes for the caramel frappuchino. And please deliver the bagels while they’re still fresh and warm. You might earn an extra minute on your next detail.
The Pigs
M Black, Thank you for your balanced, thoughtful, and meticulously reasoned post, and especially for the careful documentation of your claims and accusations. We all feel we learned a lot from your post.
We all look forward to finding careers doing something as noble as whatever it is you do. We don’t know exactly what this is, will write you care of Mother Theresa’s mission in Calcutta to learn more.
Respectfully,
The Pigs
Joe
LOL being a drug rep is a 100 % joke left 3 yrs ago and I still kick myself in the head for the many yrs of pharma time when I would have been better off starting out selling copiers,payroll ect. Device for 3 yrs now and it’s night and day. As far as Docs go majority see reps as a disruption of their day since they rarely bring any value except free food !
Pharm D
pharmavet has some deep insecurities. wow, thanks for the constructive comments. were you once a receptionist who now no longer gets krisy kremes?
vet? I doubt it.
pharmavet
Pharm D, see Joe’s comment above. Nuff said. My insecurities only appear if I spot a drug rep that is carrying a cheap pizza warmer that he bought on e-bay that only holds 4 pizzas when I know that the Grand Rounds that his company has bought and paid for requires double that amount. Basically, notwithstanding Bob’s comments, the only docs that see reps these do it for the food or the free trip to Cabo. By feeding the office staff on a daily basis, the doc can keep his salaries in line. A good rep is one who bring the food as ordered. A great rep will scurry back to the Chinese restaurant to exchange the Kung Pao Chicken because the doc said it wasn’t spicy enough.
Contract reps and UPS guys are replacing full time reps quickly. Lower salaries, no food costs and no benefits measns that pharma companies can lower costs from approx $250/rep visit to about $50/visit. Brooks Brothers will take a hit from fewer reps but they will make it up on well-paid consultants such as myself.
Stephany
“well-paid consultants such as myself.”
Nice turn around.
Pharm D
I’m not even sure reps are needed, but they don’t bother me. Some actually bring me outcomes data that is robust enough to fight off payors and well paid consultants.
Bottom line: I am not threatend by reps. I am not jealous of them, nor do I spend 50 post a day on various boards bashing them.
Other bottom line: my index is down to .5 and my putting is on fire!
Carry on.
pharmvet
What rock have you been living under for the last few years. Free trips??? I want in on that. Check out the new pharma guidelines for most companies. You are correct on some levels. Talk about stereo-typing the Pharma Rep. Get your facts straight before you go bashing somebody’s profession. Like I said you are correct on some levels. Advising physicians on when and where to use a certain drug is a high priority from where I come from. No - you will not get warm bagels because I am not a caterer.
Doc
The need for reps has dropped significantly over the last few years. Consider the following.
1. Due to off-label compliance issues, reps can only give a canned answer that parrots the PI.
2. Anything deeper mandates (at most big pharma cos) a Medical liason contact.
3. With reimbursement cuts to MDs, reps “cost” a provider more than ever.
4. Electronics is making instant response to providers questions common place.
5. Samples can be delivered by mail - using reps is costly and being used at this point to force MDs to see reps.
6. The good old days of most MDs “enjoying” reps calls is over - access continues to drop significantly each year.
7. When the first big pharma company learns that a bright high school graduate will gladly drop samples, bring food, spout a canned marketing message, answer common questions with canned responses, fill out medical request forms for off-label questions and have a few basic selling skills for $30,000 a year plus a car, the overpaid reps of today will go the way of the horse and carriage - and not a day too soon. They are a huge financial drain on corp costs.
pharmavet
Thanks, Doc. Pharmvet must be a secret admirer for choosing a handle so close to mine. Point #3 is right on. The average cost of a per rep visit was $250.00 several years ago. If a rep makes 8 calls/day, that’s $2000/day per rep. Since only about 20% of calls result in a face-to-face, the real sunk opportunity cost per rep is about $1600/day, or about $8000/week. A rep who works 50 weeks/year is basically costing his/her company $400,000 to keep him/her in the field with no ROI.
With about 75,000 reps currently, that computes to about $30 billion/year in sunk rep costs, AND THIS DOES NOT INCLUDE THE FOOD BUDGET. With drug sales of about $120 billion last year, sunk rep costs are eating up 25% of that number, hence why they will soon be an extinct species.
M. Black
Ha Ha!!! I think Bob hit his scientific background from the Pigs themselves. According to my personal friends who went through the painstaking process of med school honestly think the rep is an unnecessary side show. At least the good doctors. You know, like the ones always crammed with patients…
Doctors whose offices are empty most of the time may very well have a good ol’ 15 minutes of nonsensical banter. It makes the day go by faster.
From the good ones, reps are ridiculed and laughed at. I can tell you that first hand.
Like it or not, I don’t care. It is what it is.
~ M. Black
M. Black
Doc, well said. Just one correction:
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Bright high school reps are not needed. There are actually reps out there today that could not survive the high school that they originally signed up for, and had to drop out and sign up with a less challenging high school. What do you get? A pharmaceutical sales rep. That says it all.
UPS and electronic media will be the end of reps eventually. Glorified pizza delivery boys and girls are too much a cost for the profession to prosper. Get rid of the reps and start finding better effing cures for Christ’s sake. This topic should even qualify as a debate.
~ M. Black
pharmavet
MB, I’m a firm believer in worker re-training for displaced reps. They can even get a university education at no cost from McDonalds.
http://www.aboutmcdonalds.com/mcd/careers/hamburger_university.html
Stephany
hah hah good one pharmavet
Confused
Those docs who don’t see reps offer the best care from 1978. They are so far behind on the best ways to treat a patient it’s criminal and its sad that you have no idea your care is suffering.
pharmavet
Hi confused. If you’re a doctor you can call up any Big Pharma company and get copies of all of the published controlled clinical trials for a particular drug between 1978 and 2010. They will be happy to oblige, since only the positive ones get published. If you ask for summaries of the negative studies you will only hear silence on the other end of the phone. You can look at the marketing pieces over the past 32 years, realizing that most of them are based on biased protocols that I in fact had a hand in writing (it was a job security thing). If that’s your idea of improving patient care, then maybe you should go back to practicing 1970’s medicine. Having received my doctoral training back then I can tell you that I would be able to teach you, for example, about ganglionic blocking agents for hypertension (pretty much all we had) which helped you if they didn’t stroke you out first.
John
PV, what therapeutic area do you work in?
M. Black
Look - there is absolutely nothing a doctor can gain that he or she wouldn’t be able to learn eslsewhere. I’m not knocking reps, but it’s a negative shortcoming of the fact. The main reason that I’m against the occupation is that it sucks money from more important things such as R&D, QC, & QA.
MB
24 years
So, I got as call about a adverse event, went there the same day. Got an answer from med info for the office and made a real impact in the care of the patient. Why,,because I was asked, I only detail 2 meds right now…know them back and forth. MD and DO and NP’s have thousands to remeber. Me just 2 and I have the latest info. I don’t do lunches…Don’t drop samples….unless of course a patients has a specific need that the gov’t, the INS company and the office can’t handle.
Then we help with PAP too!
pharmavet
Great, Mr. 24 years. You know 2 drugs and the Family Practitioner has to know thousands. So how come he/she probably earns less than you, probably has a clothes closet one third your size, cannot afford your moist almond facial mask you use daily to keep that great looking complexion and doesn’t get a bonus and a President’s Club award to Cabo San Lucas every year. If I only had to know two drugs and how to program my GPS, I would be pretty smart too.
M Helm, MD
24 years, Just so you know, If you were involved in patient care (collecting information about the case and communicating it to your company and back to the office), you (and the practice) very likely violated federal patient privacy laws. Your response should have been to provide the practice with the medical information number (which they could have just as easily looked up on the internet or - heaven forbid - the PDR). Alternatively, you could have directed them to call a drug information center (or if it was bad enough a poison control center), these are typically found in academic institutions and staffed by actual living breathing pharmacists (though admittedly, they have access only to information which is publically available - not all the bad stuff known only to the manufacturer). As I write this though, I wonder if you even have those numbers or are aware of those kinds of resources.
I would be a bit more humble about reporting on a public posting board that you were involved in patient care in ANY fashion. The consequences for you and your company could be more costly than you would want to pay.
ohn
PV you’re just being plain nasty today.what exactly is the point in abusing someone who has tried to explain himself politely and who has done you no harm?
pharmavet
Sorry, ohn. I didn’t mean to slam one person. My intent was to slam an entire group of “professionals” who waste $25 billion dollars/year of YOUR money doing promotion in the guise of “sales”
M Helm, MD
Books could be written about the rise and fall of pharmaceutical promotion, but for brevity, I will offer this.
If you are a PhRMA rep you should be able to tell that the model which worked 20 years ago doesn’t make a lot of sense today. PhRMA developed massive sales forces largely because 1) they could (high barriers to real competition, a robust appetite in the market for me-too medicines, and some genuinely poorly met, large market needs - now largely satisfied), 2) PhRMA managment particularly in Marketing was historically dominated by folks who “carried the bag” - “mine’s bigger” became a measuring stick which was (apparently) valued by some, 3) Once upon a time there were many more companies competing for a “share of voice”.
Problem was that when companies started sending more than one set of reps to the same office often pushing overlapping products, docs began to realize that they didn’t actually have to talk to reps to get the samples (or food, or freebies) they wanted. Structural changes in physician compensation and care delivery models changed the pressures on docs (reducing flexibility in product selection and increasing time pressure). Pressures on PhRMA have changed too - maintaining the incredibly high profitability is more important than carrying the costs of oversized sales forces. Technology is cheaper, more convenient, and more controllable.
It is true that there are some reps who are smarter than some of the doctors they call on. It is also true that there are some doctors who are more motivated by money than some of the reps calling on them. If you are a smart rep, and appreciate job security over life-time earning potential, go to medical school (or the health profession of your choice). Otherwise, don’t be surprised or offended by predictions of the demise of your profession.
If you are a patient seeing a physician who you suspect is not as smart as a marketing representative, you should probably ask yourself why you are going to THAT doctor. Instead, try finding one who can keep themselves up to date (without being spoon-fed the marketing message) on what are the best treatments, not just the newest.
If you are always in a rush to use the newest medications, know that you are at higher risk for experiencing an unforseen side effect. From that perspective, creating another way (or facilitating the existing processes) for doctors to exchange information with medical liasons/medical information departments is probably a good thing. A better thing would be to increase transparency on the kinds of calls/questions coming in - but that won’t likely happen voluntarily.
M. Black
PV: “cannot afford an almond facial mask”
That was priceless! One of your best! I literally laughed when I read that.
Knibb High Football Rules!!!
MB
M. Black
M Helm,
Excellent point. I’d first jump off a roof before I find myself calling a sales rep for anything drug, metabolic, or scientifically related.
I’d guess about 50% of reps can’t give a true definition of “metabolic”. And before anyone thinks of throwing that back at me, I once taught Anatomy & Physiology while in college.
MB
pharmavet
MB, I cannot claim full credit for the facial mask line. Every time I see a male drug rep in an office it reminds me of the lead character, Patrick Bareman in “American Psycho”. The full quote is below, as Bateman describes his morning ablutions:
“I live in the American Gardens Building on W. 81st Street on the 11th floor. My name is Patrick Bateman. I’m 27 years old. I believe in taking care of myself and a balanced diet and rigorous exercise routine. In the morning if my face is a little puffy I’ll put on
an ice pack while doing stomach crunches. I can do 1000 now. After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub. Then I apply an herb-mint facial mask which I leave on for 10 minutes while I prepare the rest of my routine. I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older. Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion”
Amazing that these guys find time to work.
M. Black
A final note to The Pigs (yes, the well-spoken Nobel Prize winning Pig). The pigs that I tacked on the lable of “Pigs” alluded to a company that both gets it’s patients physically addicted to a drug, and also produces the drug that is used in it’s treatment of the drug.
As for my reference to Nexium specifically, if you take Nexium for a couple of months then stop doing so, the side effects could be so difficult to swallow (pun very much intended) that patients will run back to their doctors and directly ask for more. What the hell did a suit and a bag do for that patient?
Jack s$&@.
The profession, while it has it’s nice things such as yaking with a doctor who got his medical degree from Guam, and perhaps answering questions that either could be answered otherwise now, or developed and put into use, is a waste of money. Our GDP DOES NOT HAVE ROOM for sucking money to pay for these “services” when they could be obtained much much easier, especially with today’s technology and with the state of our economy that it is in.
We don’t have room for your “niceties” anymore. Our economy is at the level of the great depression. Money is being wasted while R&D suffers.
Then again, many seek professions without regard as to what “noble” things it entails. Some are just happy having a full works day end at 2PM and laughing at society everytime he or she cashes their payroll check.
Respectfully Back,
The Conscientious
Try it some day. You don’t need to involve Mother Theresa.
M. Black
PV,
Its not amazing, it’s just plain wasteful and unnecessary. If Pharma companies bitch about not having funds to ensure a safe and effective product, in a matter of a year be able to replace the function. I’m surprised it hasn’t happened yet. Then again, Ed’s article about Pfizer may be the jolt it needed to
get the rock rolling a bit faster.
MB
Stephany
Which brand of almond facial mask is what I want to know!
M. Black
Now THATS a service that a rep could provide. But for Christ’s sake do it at a Tupperware party or an Amway meeting…
MB
M. Black
PV - It is Dominoes that has the new menu. They have also changed their recipie on their pizzas themselves. Their new sandwiches are quite tasty too, and don’t deny yourself of their new pasta bowl. Because nothing says “excessive” like a handfull of ziti in a bowl made of dough that you ear.
Bob - Please tell us what you say “would happen if all drug reps disappear” that can’t be problem solved and filled (probably in a more quality manner) in about a year or two.
I would absolutely LOVE to hear this.
MB
pharmavet
MB I like the new Domino’s too, although most doctors still refer to them as the old “Domino’s Death Discs”. I think that the reps prefer the generic pizza boxes that don’t reveal the franchise, and thin enough that they can carry 4-5 in the warming boxes that they buy on e-bay.
Stephany, you can find a selection of facial masks on Herbalfacial.com. Just slather it on and you’ll feel like a rep in no time.
M. Black
Bob,
I wish I realized the utter field of mulch that it is. You say “the rep could answer any question better than anyone in the world”. Is that really a valid response?
I personally (I’m assing your earlier statement was in at least part directed to me) don’t need to grow up. I fact, I could due tomorrow knowing that I myself has successfully lessened the risk of products that you and perhaps your loved ones may use. If not your family, others. And I’ve done so absorbing the eventual cost.
So go ahead. Tell me what kind of catastrophe would happen if all reps disappeared?
Relationships are in needed everywhere. However in this case, the relationship is unnecessary, costly, and misallocates funds that should be put towards R&D. I know sales reps in med devise and pharma otherwise. That doesn’t mean I want them to lose their jobs, and as I posted earlier, they will be fine once a major number of them leave. Sales experience is a good thing.
But I sure as hell as one whose mother died of cancer, sure as hell can’t not speak about fund allocation in the industry. No starbucks, no yearly trips, no WAY overpaid suits with bags suck the life of ANY company that could put those funds to better use such as development, and quality. Reps are playing in a sandbox, while a tsunami is on it’s way to the shores, but they are too blind to see it. I do my best in at least telling them that this is a very viable likelihood, considering the state of pharma. Understand, that in order to put those samples in your bag, that a major number of things need to happen, such as manufacturing and Quality related functions (I’m certainly not go into those here).
~ M. Black
pharmavet
MB, the catastrophe would be layoffs at Starbucks and Panera Bread. These folks would join the reps on the unemployment line and our tax dollars would pay them unemployment compensation while they are sitting in their parents’ basement in their underwear, drinking beer and playing video games while texting their college binge drinking buddies.
M. Black
24 years,
Could you prove immediately what the side effects are for your two whole products, and why and how? Can you describe the
mechanism the illnesses of “your” patients, as well
as the mechanisms by which they work? What
side effects may trigger other side effects? If it’s bacterial or fungal, will you be able to give the best information?
I would ask a microbiolost from any company about a bacterial or fungal issue before asking the magical shammy rep.
But you could do what you like.
God bless America!
MB
pharmavet
MB, if these guys have a science degree, it’s probably in “General Science”, which you can get an Associate’s degree in at any community college. If it’s a four year college then it’s probably marketing or communications. Don’t even assume that the rep even knows the difference between a bacteria and a fungus. All his company needs for him to know is that they are “bugs”.
M. Black
PV,
I’m more of a Dunkins Donuts fan myself. Im just not into that whole thing they have going over there with their whole “status” thing. I
just want coffee and perhaps a kruller or something. Also for you reps out there, Subway as of recent have been putting more meat, and less lettuce. So if you bring Blimpie’s, you may very well build a relationship.
With a GD sandwich…
Nice. Very Nice…
~ M. Black
M. Black
PV,
A weakly obtained high school diploma, and a BS in pretty much anything if a candadate has that certain “bling.” suffices to be a pharma sales rep.
It’s scary (true story) that a rep from of the biggest has no idea of the difference a peer reviewed study, Ths was after at least a few years in this industry.
So, you reps that are whining “no fair!!!”, shut up.
MB
M. Black
Have you ever put rotten banana peels in your garden? You will have a more robust outcome.
Is the value of what is provided by reps to the doctors as inane as this? Because I have a special place for the inane.
Kinda like Phil Rizzuto giving watchers an excellent up to
date report on the history of brown turtles, as the camera finds one scurrying around the fence?
MB
pharmavet
MB I prefer DD also. However, I think that a Caramel Macchiato Latte from SB’s has more cache than a Box of Joe from DD’s.
Funny about the bling. One day I was on my way to a Phi Beta Kappa reunion and was wearing my key pin in my lapel when a drug rep spotted it and asked me if I had ever also pledged his fraternity. I smiled politely and said “I don’t think so”. He thought he was Mr. Cool because he had landed an ex Chi Omega cheerleader, now female drug rep, but I have a feeling that she was not attracted to his intelligence.
Josh
Funny thing is I actually tried to be a sales rep for a pharma company in my younger years. I don’t think they thought my background in zoology and years doing pre-clinical pharma work was actually worthwhile. Happy to say I got passed up as that part of the industry is a wreck.
M. Black
True story,
Way back I was working in a non pharma environment as a temp and worked closely with internal sales rep. On a whim, I interviewed for a sales rep position. I did not get the job. In speaking with the internal reps that were familiar with the person that had interviewed me, the main reason I didn’t get the job was the answer to one question. I was asked if I would lie to clients. I really didn’t know what to say, but more or less said “no”. That was the sole reason. If I were gung-ho about pissing on the legs of customers and convincing them that it was rain, I would have gotten the job offer.
It was an a-ha! moment for me. The products they sold weren’t health related, but I got a feeling for why these reps were able to buy new cars with their end of year bonus.
There are a number of morals of this story that you probably already know.
MB
M. Black
Bob,
Where did you go? We have so many questions for you. I need to add another. You said “reps can answer any question better than any profession in the world”. The question in and of itself is flawed. There is absolutely nothing “new” or groundbreaking that someone else or a piece of technology couldn’t answer. Unless of course you were one of the engineers that developed the product. And if you were one of those, there’s no way in hell you would go
from that to being a “sales” rep.
PV, I agree with you. Domino’s boxes are pretty thick. You know, a “good” sales rep would, after the end of his or her day, drive around the areas they are responsible for, and order a pizza from each one. Then, measure the sizes of the boxes in order to determine the max number of boxes they can tote in their delivery bag from eBay. Now THAT’S customer service!!!
MB
MB
British Marmalade
Greetings Bob Chap!
I think MB has a good point. Perhaps give three questions as examples that you would receive, that no one else would be able to answer.
All reps, help Bob chappy out.
BM
pharmavet
MB, the correct question should have been would you lie and still be able to keep a straight face. Only good reps are ones can beat a human lie detector. The good ones learn how to control their facial microexpressions (there are over 200 of them according to FBI testers) by using appropriate biofeedback techniques so that their lies will go undetected. Honest folks like you and I wouldn’t stand a chance.
M. Black
I hear you PV. Back then, that may have just been the case. Right now, with the experience that I have earned, even in the rough economy, there are several reasons why I would not want to be a sales rep. I have quite a good deal of pharma experience that would make being a rep a step down, albeit not necessarily on the annual $ earning side. At this point in my life, I can lie with the best of them. But in general, I live an honest life, and throw an occasional handfull of grapes and tomatos with the hope that they get it. Some can’t. Some do, but choose not to. Some don’t think - at all.
I’ve done more morally fibrous things than most in my age bracket, and if I had a chance to go back and do them again, I would - without a thought.
MB
M. Black
Ground control to major Bob, there are good questions out there to substantuate your ……. ::stuff:: that you’ve ignored. Come on now and put your claims to the challenge…
MB
pharmavet
MB, that’s why role-playing is such a major prep tool for reps, so that they can practice lying with a straight face.
M. Black
Yeah, but most of them don’t have the mental capacity to understand even Dungeons & Dragons. I don’t think they would function in Real Life Roleplaying. (if you’ve heard of that…). Nothing adult related, but there is such a thing…
MB