Whether doctors and reps are all that different from one another is no longer clear. Doctors know a lot more about medicine, and drug reps dress a lot better, but these days both are Organization Men, small cogs in a vast health-care machine. They are just doing their jobs in a market-driven health-care bureaucracy that Americans have designed, and that we defend vigorously to critics elsewhere in the world. Like anyone else, doctors and reps are responding to the pressures and incentives of the system in which they work.