Getting to the Right Relationship Between Doctors and Drug Companies

There is a way to cultivate, not demonize, collaboration between physicians and pharma.
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The pharmaceutical industry is held in remarkably low esteem right now. It's seen as a bunch of nefarious pushers who pay off vulnerable doctors to prescribe their latest expensive, mediocre product. Physicians who work with pharma companies are considered especially suspect, routinely described as "cozy," "in bed with industry," and "on the take."

Wanting to develop important new medicines that improve health and save lives is what gets every industry researcher I know up in the morning.

CEO of Kaiser Permanente Robert Pearl wrote last month in a Wall Street Journal commentary, "Patients will continue to be at risk for potential harm until physicians themselves stop participating in these relationships [with industry]." He added that Kaiser, a managed care consortium of almost 15,000 physicians and 9 million patients, prohibits physicians from "being paid to 'consult' with drug and device companies."

I think they have it backwards, though. Drug companies -- at least every one that I've worked for or consulted with -- would like to develop important new medicines that improve health and save lives. That's what gets every industry researcher I know up in the morning, and what keeps them going through the many highs and lows that characterize the scientific process.

While the biological foundation that enables most contemporary drug discovery was largely built in academic labs, moving from research publication to validated drug is long, difficult, expensive, and very tricky -- not least because many academic findings turn out not to be robust enough to support new drug development.

To advance even a solid idea requires, ideally, close communication between industry and outside experts: university researchers, who often developed the science and understand it the best; practicing clinicians, who can describe where the medical needs are the greatest, and what properties an ideal therapeutic would have; and patients, of course, who understand better than anyone else what they need, and where existing approaches may fall short.

We should strive to cultivate, not demonize, these sorts of interactions.

The signaling problem that's developed is especially unfortunate: we're taught to distrust the physicians and university researchers who consult the most with industry, yet it's often these experts who are the smartest scientists or the most experienced clinicians -- that's why companies seek them out. In essence, we're stigmatizing (and increasingly, seeking to exclude) experts who are arguably the most worthy of our admiration.

It's true that industry has seen its share of bad actors; so has academia; yet in both cases, we should be careful about generalizing from sensationalized examples to condemn everyone who works in pharma -- or in universities, for that matter.

We're taught to distrust the physicians and university researchers who consult the most with industry, yet it's often these experts who are the smartest scientists or the most experienced clinicians

It's also true that drug companies seek to turn profits, which many seem to regard as fundamentally incompatible with wanting to do good. But Whole Foods CEO and "Conscious Capitalism" champion John Mackey has it right when he explains , "Making high profits is the means to the end of fulfilling Whole Foods' core business mission. We want to improve the health and well-being of everyone on the planet though higher quality food and better nutrition, and we can't fulfill this mission unless we are highly profitable." I enjoy farm-raised salmon and oven-roasted kale as much as any Californian, but I'd like to think that the pursuit of new medicines represents at least as worthy an endeavor.

Presented by

David A. Shaywitz, MD, PhD, is a director of strategic and commercial planning at a biopharmaceutical company based in San Francisco, and the co-author of Tech Tonics: Can Passionate Entrepreneurs Heal Healthcare With Technology? More

Trained as a physician-scientist and management consultant, Dr. Shaywitz has experience in clinical drug development and strategic and commercial planning. Dr. Shaywitz is co-founder of the Center for Assessment Technology and Continuous Health (CATCH), a Boston-based initiative to use improved real-world measurement to improve care and drive science. He also is co-founder of the Harvard PASTEUR program, a translational research initiative at Harvard Medical School, and a founding advisor of Sage Bionetworks, a non-for-profit medical research initiative focused on open innovation. He works at a biopharmaceutical company in San Francisco; the views expressed in his postings are his own and do not represent the views of his employer. Dr. Shaywitz is an adjunct scholar at the American Enterprise Institute. His personal website is: http://davidshaywitz.wordpress.com.

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