Al Rothstein, president of Al Rothstein Media Services Inc., Atlanta
Arnold I. Meyer, EdD, accreditation and education specialist, Temple University School of Medicine, Office of CME, Philadelphia
Anthony M. Iacono, executive director, marketing and sales support, Wyeth Pharmaceuticals, Collegeville, Pa.
Lawrence Sherman, vice president, international healthcare education development, Jobson Education Group, Melville, N.Y., and Bloomfield, N.J.
Taren Grom, editor/partner, PharmaVOICE, Titusville, N.J.
“When Doctors Go to Class, Industry Often Foots the Bill. Lectures Tend to Feature Pills but Drug Firms Deny Influence.” That Wall Street Journal headline exemplifies the type of negative press coverage many CME professionals dread and resent. But no matter how you feel about it, media scrutiny of CME is not going away. Yes, that Wall Street Journal story ran last December, but journalists' investigations of CME have continued and will no doubt keep increasing due to the recent spate of new regulations and lawsuits involving pharmaceutical marketing tactics.
Ironically, some of the attention has been generated by the positive actions taken over the past year by the pharmaceutical and CME industries. When we asked Scott Hensley, the reporter who wrote the above-mentioned article and many others on similar topics, why he focused on CME, he answered, “I became interested in CME after the PhRMA marketing guidelines began to take shape. It seemed to me that pharmaceutical companies might spend more on CME because other activities would be curtailed. It occurred to me that CME would be relatively more important to the companies. I then set out to learn more about CME and to determine if there was a story to be told.”
So, how can the CME and pharmaceutical communities take proactive steps and develop more constructive relationships with the media? We brought together a panel of CME and media experts to discuss the issue at the Center for Business Intelligence's second annual CME conference, held in June in Philadelphia.
Before developing our presentation, we e-mailed participants asking them about their greatest challenges in dealing with the media. Based on their answers, we incorporated role plays into our talk to illustrate effective strategies. Here are excerpts from our presentation.
DON'T BE DEFENSIVE
Rothstein: The key to [dealing effectively with the press] is to prepare. How many of you think you know what a reporter's job is? I see about a dozen hands. The real question is: What does the reporter think his or her job is? The answer — 99.9 percent of the time — is that the reporter's job is to go to bat for their audience. You could even say a reporter acts as a consumer advocate. Once you know the answer, you can start to develop strategy. You can develop your messages to address not the reporter but their audience, and more times than not we have the same audience that they do. We're using the reporter to get to the audience, therefore we have to talk about the benefits of what we're doing instead of being defensive.
THE FRIENDLY REPORTER
Hosansky [as reporter]: Mr. Iacono, I'm calling from Health News Update and I see that your company is funding a series on X disease. I'm doing a story on CME and how it helps people, and I wanted to know if I could interview you about your CME process.
Iacono: I'd provide the telephone number [of the media relations person]. Then I would talk to the media professional to brief them on my perspective. The Wyeth media relations group serves as facilitators, not obstacles. They are fully briefed on these issues and work with internal experts to provide the company perspective.
Hosansky: I'll be happy to go through the media department, but an interview with a public relations person is of no use to me. I need to interview a pharma executive.
Media relations people play a very important role because they can get us to the right people, they can facilitate things, and they can be on the phone during the interview. I have no problem with that — but when you get these canned PR statements you feel like you're being stonewalled and you're really not getting what you want.
Grom: I agree with that point. It's great when media people [listen in] on the conversation because they can record it or take notes, and when the quotes go back for review they can do an internal fact check to see if what was said was correct and present the information to the legal department for approval. This is one tactic to get away from a canned response.
Sherman: What I might do first is turn the interview around. I've never heard of the publication you mentioned, so I'd want to know more about that. You need to know your enemy; you need to know your audience — who's going to be reading [the article]. You need to know the perceptions and misperceptions of the people who will be reading the material. I'm going to offer the best possible insight within the regulations as I know them, and I'm going to say you can't publish [my quotes] until I see the article.
Rothstein: If you're dealing with the general media, dealing with your local TV station, normally they won't let you see [the piece] before they run it. In those instances, after a phone conversation or after a TV interview, you can fax them the points that you made. That way you have it in writing.
NOT SO FRIENDLY
Hosansky [as reporter]: Dr. Meyer, I understand that Dr. X is on the speaker's bureau of XYZ Pharma Company as a promotional speaker. I don't understand how he could be speaking for an independent education program.
Meyer: I would answer these questions by starting to ask you questions. That way you start to take control. Where are you getting your information from? What's your deadline? Who have you spoken with before? Why are you approaching the story this way? Or, how are you approaching this story?
I'm from a medical school and the way I answer is: We select people based on their credentials. We review [potential speakers] very carefully based on recommendations from ourCME committee to select proper faculty for any particular situation, and we've done so in this situation.
Hosansky [as reporter]: Lawrence, how much is Dr. X being paid for speaking at that program?
Sherman: I think there's a risk that if we're too evasive, we're going to be portrayed negatively. If we answer truthfully, we're going to be portrayed negatively, and if we answer falsely we're going to be portrayed negatively.
I would say: Based on thethat was in place and the letter of agreement, and within all the standards that we typically follow, blah, blah, blah, this is what the speaker was paid. Because that's the truth. I think sometimes it's better to be truthful and be skewered than be evasive and doubly skewered.
Rothstein: You can use a technique that we call a segue or a bridge if you get a question that you're hesitant about answering, such as how much is he being paid. But use it only if you cannot answer the question or you have been instructed not to answer the question. Otherwise, what Lawrence said was 100 percent correct.
An example of a bridge might be: “Thanks for asking me that question, but here's what the issue is…” or “If you're really asking me is this person getting paid for his or her expertise and his or her time…” and rephrase the question and then give the answer that you want to give.
The bridge technique is also good to use for any negative question that you get: “Why are all politicians crooks?” “If you are asking me why I got involved with the field — not as a politician but as a public servant — I'll tell you. It's because we do have a problem in that area and I'm trying to fix it.” Now, you've taken a bad question and given a positive answer. You can use phrases like: “Here's what the issue is …” and “Here's what I think the question should be …” or “Here's what I think is really important …” Watch “Meet the Press;” you'll see [variations of this technique used about] 20 times in one show.
Sherman: There's another risk. If I don't answer the question, who is that reporter going to get the answer from? It may not be one of the people on this panel, and it may not be someone in this room. It may be someone that they randomly pick out of the Alliance for CME directory. Then it's not in your control anymore; then it's in somebody else's control. They're making an interpretation and the people who are going to read [the article] are going to make their own interpretation of something you never commented on. And I think that's why although sometimes “silence is everything” is the best policy, too much silence may not be.
Hosansky: I've had interviewees who have said, “I wish that I could answer that, but I can't,” and it's very nice to say that even if you don't mean it. It helps to establish a good relationship.
Rothstein: [As Meyer said earlier,] one of the other questions to ask is, “Who else are you talking to?” Find out if they just got through talking to Ralph Nader. It's really important to provide context. Try to avoid asking the reporter for the questions upfront unless it's a friendly publication. General media [journalists] are not going to tell you, or even if they do — you prepare for those questions and they will have others they thought about later on.
Hosansky [as reporter]: Tony, your company gave $250,000 to support a CME program. I talked to the accredited CME provider and she told me she felt like she was doing money laundering — taking the money from you and giving it to speakers for their inflated honoraria.
Iacono: Obviously I can't speak to that at all…. [audience laughter] That is a situation where you need to be ardent [and explain] that there are strong standards, regulations, and guidelines in place. If there is an accredited provider behaving in that manner, then obviously some appropriate actions should be taken. But here again, in a case like this, I choose not to respond.
Hosansky: Let's talk about the choice not to respond. Some people have told me they wouldn't respond to journalists' requests; they would stonewall reporters until they disappeared.
Rothstein: Until they disappeared? I would not count on that, especially if it's a Wall Street Journal reporter, or if it's any investigative reporter. The more you stonewall, the more they're going to follow you, and that is a breeding ground for the ambush interview, where they'll jump up from behind a bush or somewhere when you least expect it and start asking you questions with the camera rolling.
As far as stonewalling for a good reason, you simply tell the reporter that you would like to get them the most accurate information, the latest information, you would like to help them and it may not be you [who will do the interview]. Ask them what their deadline is. If they say 15 minutes, say, “I'll do my best, but don't count on it.”
THE AMBUSH INTERVIEW
Hosansky: Speaking of the ambush interview, we've all heard of undercover teams going into. Let's say I did that and I see Dr. Myer in the hall.
“Dr. Meyer, I'm from Exposés ‘R’ Us. I was just in that session and the speaker did disclose that he owns stock in XYZ company, but 99 out of 100 slides were about XYZ company's product. How is that independent?”
Meyer: You cannot possibly get into that situation. That's why you have advisory committees. If you don't know the [speaker], you find out who does in the planning stages. I'd never be trapped with that.
Hosansky: I also think it's OK to admit, yes, there are people in the industry who don't follow the rules. We all know that and when we try to say everything is rosy, reporters know that it is not.
Rothstein: Before you admit something though, there's always a legal [consideration]. I think generally it's OK to admit things. Again it's a matter of controlling the message. People know everybody makes mistakes. We're human. If you admit something, offer a solution as well: “Here's what we're doing about it.”
Iacono: I'd just like to make an editorial comment. If we were having this discussion three years ago, these questions would be actually very relevant. I think one of the good things post-PhRMA code is there is a great deal more integrity and independence of CME; the lines between CME and promotion are more clearly defined.
Hosansky: That would be a good point to make to reporters. But even if the reality is changing, the questions are going to be out there. I just read last week in the San Francisco Chronicle an article about the American Psychiatric Association annual meeting. [“Psychiatry Convention Begins in San Francisco. Virtual Reality Tours of Schizophrenic Mind,” San Francisco Chronicle, May 19, 2003] The article said that now that the PhRMA code doesn't allow for lavish parties, guess what? The exhibitors are putting on lavish exhibits. One of the exhibits takes [attendees] through a virtual reality experience to help them understand the life of a mentally ill person. It sounds like great education, but that's not what the article was about. One of the doctors was quoted as saying, “This is like Disneyland.”
Rothstein: Let's demonstrate the ambush interview, because one of the dangers is trying to answer questions during ambush.
Hosansky [as reporter]: I just saw the virtual reality exhibit where you go through a schizophrenic experience. It must have cost a fortune for companies to bring that in. How can you possibly allow that?
Rothstein [as CME provider]: I would like very much to help you. Let's go up to my office.
Hosansky [as reporter]: I've got to get this on the 6 o'clock news. A doctor told me, on the record, that the exhibit was like Disneyland….
Rothstein: Repeat what you said. If you have to stand there for a half an hour, that's what you have to do in an ambush. You don't want to give them emotional responses. Stick to your answers no matter what they ask.
I CAN'T BELIEVE I SAID THAT!
Hosansky: Suppose you did everything right. You got permission to do the interview, you established a good relationship with the reporter. The article comes out and you can't believe you said any of those things. What do you do next?
Grom: You can write a letter to the editor, and if they refuse to print it, you can write another one. If you're still unsatisfied, you can go to the higher ups — find out who owns the publication — to see what type of resolution you can get. Reporters are responsible to report accurately and they are responsible to their bosses, so if they misrepresented or misquoted you, they should be held accountable.
GETTING POSITIVE COVERAGE
Hosansky: [One of you asked in your e-mail] “How can we get reporters to cover positive scientific developments? How can we get them to really understand our industry?” Educate them. You're all in the educational area. I would suggest setting up a media education panel if you have a meeting and you know journalists are coming. Or even holding [a stand-alone media education session] organized by the pharma industry. Go out there and be proactive. That really can help.
Grom: There is a lot of education that needs to be done on both sides. The industry is facing a lot of scrutiny now, so it's really [incumbent] on pharmaceutical executives to make sure they're putting on the best face possible when dealing with the media. Be truthful, be forthright. If you don't know the answer, defer the question and say you will get back to them. Work with your media department. [Your press relations staff] are a great resource and they really will help you.
Sherman: When reporters, especially ones who are not familiar with CME, do their research, what is it they are going to come up with? They're going to come up with the bad stories and that goes to your point about being able to educate them. [Except for] articles in certain publications that are represented on this panel, you are not going to find great CME stories. We know the story. We can write the story — it's up to us.
NO Comment? No Way
Saying “no comment” is the best way to look like you have something to hide. It shows disdain for the news reporter and the public. There are many times when speaking to the media is inappropriate. However, saying “no comment” will increase your chances of not only making the news, but being the news. Here are better ways to respond:
“I'd like to respond to your excellent questions. But I have decided that the proper thing to do is to keep my opinions to myself.”
“It's not the appropriate time for me to respond, however, your questions are of concern to me as well. I'd like time to assemble the facts in order to get you the latest, most accurate information.”
“Your questions certainly deserve the correct response. Allow me to refer you to someone who can give you more accurate information.”
What did you think of this article? Please send your comments/suggestions to Tamar Hosansky, and include the article's headline in the subject line of your email.