Pharmaceutical / Medical Device Companies and the Private Practitioner

There is an unseen bond between pharmaceutical companies and doctors. Pharmaceutical companies need the doctors to promote their products and doctors need the financial assistance and marketing capabilities of pharmaceutical companies. The Malaysian Medical Council has a specific guideline entitled “Relationship between doctors and the Pharmaceutical industry” (MMC guideline 007/2006), which aims to ensure, that doctors be as ethical as possible when dealing with pharmaceutical companies.

It is well accepted that doctors need continuous medical education and attending conferences especially at International level will improve their knowledge. This has  even been acknowledged in the MMC guidelines.  Pharmaceutical companies are usually big sponsors of these meetings. They want doctors to attend these meetings so that they can showcase their latest products and studies. As such, they are ever happy to sponsor doctors to such meetings. However, there is no such thing as a “free lunch”. There is always something attached to such sponsorship and that is, more usage of their products over their competitors.

I will give you my experience with pharmaceutical and medical device companies. When I was young, I yearned to attend international meetings but could never afford the expenses involved. I always questioned the wisdom of pharmaceutical companies only sponsoring the heads of departments to conferences. We young doctors had to solicit them for sponsorship. Sometimes, a HOD may get 3 or 4 invitations to the same conference and he will mete out some of these invitations to his favourite lieutenants. I always thought that pharmaceutical companies should identify potential young doctors and support them when they need the sponsorship most, rather than only sponsoring senior, well established doctors.

My very first offer was to go to Canada for a big international meeting. My boss, who had received several offers to travel to this meeting, offered one to me. Unfortunately, I had to decline because I had just started private practice in Melaka in 1994, and thought I should not take any leave till I was fairly established in my practice.

I started an IVF centre in 1997 and one of the companies selling fertility hormones thought that I would be a good future key opinion leader and gave me my first sponsorship to travel to Sydney, Australia to attend the World Congress in IVF. I was indeed grateful for this sponsorship. In return for their kind gesture I used that company’ s product for a long time. One problem being a key opinion leader for one company is that you immediately become an “enemy” of the rival competitor company. IVF was in its infancy in Malaysia in the early 2000 and there were only 2 big players in the country. I was happy to be associated with one and was able to secure sponsorship at least once every year to travel to different parts of Europe to attend the IVF meetings.

However, when I started using other company’s products as well, I was slowly “dropped off” the sponsorship list. Recently, the pharmaceutical codes of ethics have become stricter and sponsorships have become more difficult and stringent.

Similarly, I was using a certain company’s camera and laparoscopic surgery instruments for many years. I received sponsorship from this company to travel to different parts of he world to learn laparoscopic surgery. I also had their support when I organised numerous laparoscopic surgery workshops. However when I bought the 3 D camera system from another company, the first company dropped me as their key opinion leader.

So what can I teach you as a new specialist in private practice?

1. Pharmaceutical companies can assist you in many ways in Private Practice. Be courteous to them. They can sponsor you to good international meetings and good workshops where you can learn new skills.
2. Be good in one aspect of your work. Become so good that pharmaceutical companies will want you to be their key opinion leader. Once you have become one, then you need to make the difficult decision as to which company you want to support. In my experience, when you become a “friend” of one, the rest will become your “foe”. This is the unfortunate truth. So choose wisely.
3. Try not to abuse the goodwill shown by the pharmaceutical industry. If they think they are being abused they will drop you like “hot potatoes”. I can give you a personal experience. Way back in 1989, when I was green in this sponsorship game, while attending an international conference overseas, all Malaysian delegates were invited to a dinner at a fancy restaurant. One of my senior colleagues went overboard and ordered the most expensive food and wine during the dinner. The cost of the dinner became so high that the pharmaceutical representative’s credit card was overdrawn. From then onwards he refused to have any lavish dinners during conferences and ultimately dropped the senior specialist from his preferred sponsorship list.
4. Be fair to pharmaceutical companies. Working with a pharmaceutical industry is a symbiosis. They should get as much from engaging you, as you are getting out of them. The benefits that you get will be to attend meetings and even be a speaker at their meeting. This will propel you as an expert in your field leading to more fame to your practice. The benefit to the pharmaceutical company is that as a key opinion leader you may help them promote their products to your colleagues.

Conclusion

You can’t run away from dealing with pharmaceutical companies. My advice is to make use of their help. Just like they need you for the marketing of their products, you need them to market yourself. If you plan your private practice well, you can become a key opinion leader to at least one pharmaceutical/ medical device company. This can help you propel your career as a specialist.