Unfortunately for many residency graduates, many of the decisions regarding interactions with pharmaceutical and medical device sales forces have been put into policies. These are often parallel to the strictest of parents attempting to shelter their children from what is socially perceived as “evil” or “influential” which in many instances has led to the development of very poor relationships when these residents come out into the real world. Much like the same children that were not allowed to make their own decisions, they either become rebellious and overdo their interactions with drug companies or go the other way and continue to shut them out of their offices. In either case, the results tend to be more to the extremes based on the media bias and fears of scrutiny, which have influenced decisions. Access bans on sales reps in academia, hospital health systems or other settings have become problematic for the development of healthy partnerships with industry. It affects patient care, medical education, and pharma reputation. This may have several outcomes for the long run, including either complete restriction (i.e., no sales rep and no industry support of any kind), or a return to the relationship that helps patients and physician. Unfortunately, these policies are hurting patients’ access to new drugs and those physicians who truly want information. However, a new phenomenon known as “hostage taking” has supplanted the movement of cultivating “thought leaders” because opportunities become a function of support of sales and not of research and teaching merit.
The problem began when a few took advantage of relationships with sales personnel to basically win favor with those in medical affairs…whether it’s the physicians who held their prescriptions hostage (“I won’t write your product unless I serve on an advisory board or speak at an event.”) or the inexperienced sales reps who traded food for prescriptions, the problem led to a more regulated environment for some but created a pathway to make it easy to have doors opened based on “level of support.” Medical Affairs liaisons are taking steps to correct this issue by making sure interested physicians provide their CV, published articles, or presentation slides if they express an interest in speaking. This approach takes the rep out of the discussion and reduces the risk of “jeopardizing” future prescriptions.
In summary, the best approach to developing ethical industry relationships, and becoming more involved in collaborating with industry for medical education as well as research, is to develop a niche of your interest and publishing your work as well as writing your own presentations that are disease and therapy based and not related to products or brands nor containing corporate-sponsored slides. That way your work will stand out as you develop and demonstrate expertise in a chosen field and opportunities will come to you rather than the other way around.
