In 2004, the top 40 largest drug companies deployed 100,501 sales reps to call on physicians in the U.S. That number is up from 36,778 in 1995, according to Verispan, as quoted in the article "Drug Sales Calls Wear on Doctors,"? which appeared in the Chicago Tribune on May 8, 2005. Up to five salespeople from the same company may call on the same doctor about the same product. In the late 1990s, Pfizer had up to six Viagra reps making sales calls on the same doctor. Drug makers spend over $7 billion on such calls each year, compared to $4 billion on direct-to-consumer advertising. The pharmaceutical companies often argue such sales visits help educate doctors. However, in the wake of recent safety controversies--such as with Vioxx--reservations are growing. "It is our strong feeling that these people are not educators," said a medical director for one physicians group in the Chicago area. And, in fact, the number of times a doctor agrees to meet with a rep has been flat or has actually fallen in the last three years, according to the market research firm Impact Rx Inc.