The Future of the Doctor-Pharma Relationship


Patient care is increasingly under third party control.  And as a consequence I make fewer decisions regarding the brand of medication used in my patients.

So the role of a pharmaceutical rep comes into question.  If I don’t choose which medication my patients will use, why would a representative call on me?  And as American medicine becomes more centralized and standardized, I wonder how and why industry will connect with treating physicians.  Pharma it seems is asking the same question: Of the core medications I prescribe, I see far fewer reps these days and our relationships are markedly different from a decade ago.

I don’t miss the pitch.  But I find the element of human support to be important.  For example, recently the FDA issued a black box warning for the concomitant use of Remicade and 6-MP.  My representative visited to be sure that I was aware of the changes in the product insert.  Sure the information was in my mailbox – along with 6 inches of pulp spam.  It’s basic attenionomics: I’m more likely to hear a person than a letter.

Going forward I suspect that our future encounters with industry will be more permission-based and contextual.  Pharma and medical device manufacturers will evolve to embrace a more open, social business design that cultivates a supportive rather than sales relationship with physicians.  I suspect that my information about these products will come from digitally facile humans who know me and understand how I get information.  Responsible doctors and industry professionals should open their dialog so that the social public can see that the conversations are properly centered on the patients.

While my political incorrectness may awkwardly quiet the room, I believe that providers should have some kind of balanced, transparent relationship with those who create the stuff that fixes our patients.  As medicine becomes progressively dependent upon advanced diagnostic and therapeutic technology, I might suggest that to avoid the discussion is irresponsible.