Paying Doctors and Nurses – Can be a GOOD Thing #Change My Mind

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An Inside Look into Pharma Sales and Marketing

Let’s start with the caveat that I’m specifically talking about Pharma/Biotech marketing after 2010 (and the implementation of the Sunshine Act*). I am not talking about the days of fully paid trips to the Bahamas or Suite tickets to Yankees. Sadly enough I started my support of Marketing just prior to this, so I ended up being too late to the party. Although, aren’t you supposed to show up fashionably late?

Quick background – there were articles from Newsweek, Forbes, USA Today, NY Times and JAMA in 2006-2007** that called out the doctor / Medical Product Company relationship. This included promotional items (not medical related) and extravagant gifts from marketing teams. Soon after, legislation passed limiting amounts and tracking these transactions.

Since I am directly involved with this type of category spend or event, I feel like I have an inside look to share. Even if it is an unpopular opinion. I’m also always one for a healthy and civil debate, so let’s get this party started!

Advisory Boards. Speaker Programs. Round Tables. Key Opinion Leaders (KOLs). Speaker Training. Lunch and Learns. Scientific Summits. Symposium. Nurse Advisory Panels. Master classes. No matter what you call them, they all have the same underlying theme. Seeking information from or providing Continuing Medical Education (CME) to doctor, nurse practitioners, nurses and everyone in the healthcare field.

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So what are YOU getting (if anything) from this exchange between company and doctor? Good question. Here’s the naked truth:

Ever wonder how your doctor knows about the latest and greatest drug? You know the one that has fewer side effects and would be better (more effective) for you? What if there are five different drugs that do the same thing? How does he know which one to use?

How does your doctor stay current on industry standards – like which drug to try first and what combination? What is called the “standards of care” are and how she should follow them? Does she have another 12 hours a night to read through all the medical journals and articles that have been published in the past six months?

If there are financial issues for accessing the drug, where does the doctor get the free samples from and pharmacy co-pay cards to ensure you can get it? What about the office staff – who educates them on how to get your insurance to pay for your medications?

If you show up in the ER, would you want your doctor to be well versed on adverse interactions if you were already on blood pressure drugs and they needed to give you pain killers? What about the quickest identification techniques or the latest medical devices that could be the difference between life and death?

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What if your child had a rare disease and there was only a single drug and could take years to identify? Would you want them enrolled in the latest clinical trials for the most advanced therapies and cutting edge technologies? Or would you want to wait five to ten years until it was released?

My argument is simple. We’d be worse off if they didn’t. The exchange of knowledge and information is powerful and necessary.

At my current company, we deal with ultra-rare diseases. Not only are they hard to pronounce, but even harder to diagnose (Phenylketonuria or Mucopolysaccharidoses anyone?). We have to not only educate, but help find these patients. Yet our company still does this with absolutely NO competition. It’s not profitable when your potential patient population is smaller than the number of company employees. Can you say, Where’s Waldo?

Now lets for a minute consider the alternative. Medical education to all types of healthcare providers – doctors, nurses stop. What are the implications? The slowing or stopping altogether the sharing of knowledge, information, and ideas. No more discussing best practices and new standards of care. No more feedback to go back to the companies to improve upon their drugs. Now begin the endless task of reading hundreds of publications instead. Sound like a fun and quick endeavor – think again. Especially since there aren’t the cliff notes version lying around.

If perks are given to healthcare workers, I would suggest we all become just a little bit more comfortable with it – even if we don’t agree with it.

To support this, let’s go back to the beginning of this article and remind ourselves that this is a highly regulated environment. Slide decks and sponsored events must all be approved from a compliance team PRIOR to happening. And don’t forget, ALL of these interactions, payments, conferences, etc. are reported to the government and limited on how much they can receive per year. So this isn’t an endless supply of cash or perks for doctors.

There is still one variable left in the equation (since I’m done defending Big Bad Pharma for now). It’s taking a look at the person who is taking care of you.

Evaluating your doctor can be effective. Ask them what relationships they have with which companies, or who they consult for. Come prepared for the conversation by looking it up ahead of time HERE. – Hive five! Then if they refuse to talk to you about it or brush you off, you can start an evaluation of their priorities.

If you believe they would prescribe something unethically because of a dinner or conference – then get a second opinion and find a new doctor. STAT! No need to put your health at risk, for ANY reason.

So please try to cut Pharmaceutical / Biotechnology companies some slack. They really are well intended in trying to do what’s right for the patient. And I promise, there really isn’t a conspiracy to withhold the cure for cancer (spoiler alert – it may be closer than you think – click HERE).

I’m sure you can think of a few counter-arguments to this, so, by all means, say your peace. I have a pretty thick skin, and won’t cry myself to sleep over it. I’m always open to hearing new and fresh perspectives from others. Especially if they are constructive ideas on improving the current situation!

*The Physician Payments Sunshine Act (PPSA)–also known as section 6002 of the Affordable Care Act (ACA) of 2010–requires medical product manufacturers to disclose to the Centers for Medicare and Medicaid Services (CMS) any payments or other transfers of value made to physicians or teaching hospitals. Source: Health Policy Brief: The Physician Payments Sunshine Act,” Health Affairs, October 2, 2014.

**Sources for articles: Karen Springen, Saying No to Big Pharma, NEWSWEEK (Oct. 5, 2006).; Doctors’ Ties to Drug Companies Called Commonplace, FORBES (Apr. 25, 2007);R. Rubin, Most Doctors Get Money and Gifts from Industry, USA TODAY (Apr. 25, 2007); A. Berenson & A. Pollack, Doctors Reap Millions for Anemia Drugs, N.Y. TIMES (May 9, 2007); T. Brennan et al., Health Industry Practices That Create Conflicts of Interest, 295 JAMA 429 (Jan. 25, 2006).

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