The Second World War brought about a pharmaceutical revolution in Britain, heralded by the introduction of penicillin and other drugs that changed medical practice for ever; the problem was, how could manufacturers impart knowledge of changing medicine to pill rolling doctors without undermining the latter’s self-esteem? Modern medicines allowed even a bog-standard doctor to treat anything from infections to heart failure more effectively than a teaching hospital specialist could have done 20 years earlier.

The challenge was: how to instruct doctors trained in an earlier age? The pharmaceutical industry responded by recruiting highly skilled, early to middle-aged former male nurses and service medical orderlies, together with rather jollier, but less medically educated wartime officers, and medical school dropouts — and, in Norfolk, even a retired colonial governor. They introduced the older doctors to the latest advances in medicine.

In the 1960s doctors became busier, and an increasing number had been trained in modern medicine and worked in hospitals before going into practice. As the older sales representatives retired, their replacements tended to be selected more for their sales potential than for past experience. I recall an attractive young female rep who arrived on the Norfolk circuit

to introduce second-generation antihistamines to GPs. Her fame spread as rapidly as a flu epidemic, but as she was also a highly trained pharmacist, the doctors could assuage any guilty feelings by saying that it was all in the service of medicine.

I had left general practice by the time (if it has ever come here) when reps began to be chosen for their looks. But recalling the effect that that woman had on my colleagues, I see why Americans pick educated cheerleaders as reps. Doctors will happily see them.