There is an unseen bond between pharmaceutical companies and doctors.
Pharmaceutical companies need doctors to prescribe their products, and doctors need the financial assistance and marketing capabilities of pharmaceutical companies.
The Malaysian Medical Council (MMC) has a specific guideline on this matter titled Relationship between Doctors and the Pharmaceutical industry (MMC guideline 007/2006), which aims to ensure that doctors are as ethical as possible when dealing with pharmaceutical companies.
It is well accepted that doctors need continuous medical education and that attending healthcare conferences, especially at the International level, will improve their knowledge.
This is 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, as the saying goes, there is no such thing as a free lunch.
There is always something attached to such sponsorship, and that is usage of their products over their competitors.
Quid pro quo
I will share with you my experience with pharmaceutical and medical device companies.
When I was young, I yearned to attend international conferences, but could never afford the expenses involved.
I always questioned the wisdom of pharmaceutical companies in only sponsoring the heads of hospital departments to such meetings.
We young doctors had to solicit them for sponsorship.
Sometimes, a department head would get three or four invitations to the same conference and he would mete out some of these invitations to his favourite lieutenants.
I always thought that pharmaceutical companies should identify promising young doctors and support them when they need the sponsorship the 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 conference, offered one to me.
Unfortunately, I had to decline as I had just started private practice and thought I should not take any leave until I was fairly established in my practice.
Then I started an IVF (in-vitro fertilisation) centre in 1997, and one of the companies selling fertility hormones thought I would be a good future key opinion leader.
As such, they gave me my first travel sponsorship to Sydney, Australia, to attend the World Congress on In Vitro Fertilization and Human Reproductive Genetics in 1999.
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 their rival companies.
IVF was in its infancy in Malaysia in the early 2000s and there were only two big players in the country then.
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 IVF conferences.
However, when I started using the other company’s products as well, I was slowly dropped off the sponsorship list.
Recently, pharmaceutical codes of ethics have become stricter and sponsorships have become more difficult to obtain and more stringent in their conditions.
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 a 3D 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?
Firstly, pharmaceutical companies can assist you in many ways in private practice, so be courteous to them.
They can sponsor you to reputable international meetings and good workshops where you can learn new skills.
Secondly, 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 established your reputation as 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.
Thirdly, try not to abuse the goodwill shown by the pharmaceutical industry.
If they think they are being abused, they will drop you like a hot potato.
Here’s a personal experience of mine in this aspect.
Way back in 1989, when I was green to this sponsorship game, I attended an international conference overseas where all the 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, this representative refused to organise any lavish dinners during conferences and ultimately dropped the senior specialist from his preferred sponsorship list.
Fourthly, be fair to the pharmaceutical companies.
Working with the 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 international conferences to expand your knowledge and catch up on the latest developments in your field.
You might even be invited to be a speaker at the sessions they sponsor.
This will add to your reputation as an expert in your field.
The benefit to the pharmaceutical company is that as a key opinion leader, you may help them promote their products to your colleagues.
Help them, help yourself
As a doctor, you can’t run away from dealing with pharmaceutical companies.
My advice is to make use of their help.
Just like they need you to use and market 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 and/or medical device company.
This could help propel your career as a specialist.
Dr S. Selva is a consultant obstetrician and gynaecologist, and fertility specialist, in private practice in Melaka. This is the 13th article in a weekly series about surviving private practice in Malaysia. For more information, email email@example.com. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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