Meeting professionals who work in the pharmaceutical, bio, or medical device field need to know how today’s challenges and changes affect the healthcare professionals who attend their events. But how often do they get candid feedback from HCPs that they can use to improve their meetings?
They had just that opportunity at the 4th Annual West Coast Life Sciences Meeting Management Forum. The forum, held in December in San Diego and co-organized annually by and The Center for Business Intelligence, kicked off with a panel of practicing physicians who shared their perspectives on the life sciences industry. The panel, which was moderated by Benjamin Comer, senior editor with Pharmaceutical Executive magazine, included David Bazzo, MD, clinical professor of family medicine with the University of California San Diego; Enoch Choi, MD, partner, Palo Alto Medical Foundation; and John Kusske, MD, professor emeritus and interim chair, neurological surgery, University of California Irvine School of Medicine.
Here’s how they said federal, state, industry, and corporate compliance issues are affecting their ability to meet their educational needs, how technology is driving change in their meeting habits, and what motivates them to participate in pharmaceutical company meetings.
Healthcare Reform and Practicing Physicians
Comer began by quizzing the docs on how they expect the Patient Protection and Affordable Care Act, signed into law by President Obama in 2010, will affect their practices.
Bazzo, whose background is in primary care, said those in his field generally view healthcare reform as positive, because “it will help enable patients to come in for preventive care, rather than wait until they’re in critical need of care.” This, he said, should help to bring down the still-soaring cost of healthcare in the U.S. However, he said, “Some of the things that come with the healthcare reform act are a bit of a black box for us.”
Choi, who is a provider in a multispecialty outpatient physician group, said, “We’re hopeful it will be beneficial.” Kusske said that neurosurgeons, too, generally welcome the healthcare reform act. “We hope it will cover patients who hadn’t previously had coverage,” he said.
However, they said, when it comes to the Physician Payment Sunshine Act provision of the act, things look a bit murkier. The so-called Sunshine Act, which calls for pharmaceutical companies to report what they spend per physician—including their meetings where HCPs are present—starting in 2013, may mean less pharma involvement in physician education, said Choi. As Krusske said, after having listened to the pharma meeting managers talk about the Sunshine Act during his time at the conference, he couldn’t help but conclude, “You’re all in for a bumpy ride.” As will be medical education as a whole, he added, predicting that “Medical education will take a huge cut, and payment for graduate education will disappear. This will be a huge issue for GME in 2014.”
Transparency and the Press
Comer also asked the docs about the recent Dollars for Docs reports published by nonprofit news organization ProPublica recently and picked up by newspapers and other media outlets. Twelve pharma companies are already required to publicly publish their physician spend by corporate integrity agreements; ProPublica took this information and aggregated it into a database that made it easy for journalists and the public to track which companies have spent what on specific doctors. Will physicians think twice about becoming paid speakers or participating in peer-to-peer programs once the Sunshine Act goes into effect and every company is required to post this type of information? Has there been a “ProPublica/Dollars for Docs” effect in the physician community, or a hesitancy to be seen by the public as an industry shill?
“Like others, doctors love positive press and hate negative press,” said Bazzo. “If there’s any perception that a doc is a money grubber, that could kill a practice.” He compared the situation to when his system created a policy six years ago to not allow pharma sales reps on campus. “This split our people,” he said. “Some thought their presence was improper because we’re a teaching institution. Others didn’t.” He sees the same scenario playing out when it comes to attending pharma-sponsored meetings once the Sunshine Act goes fully into effect. Those who see nothing wrong with attending dinner meetings may still attend, but “those who go to three or four pharma-sponsored dinner meetings per week may stand out.”
While Choi said his organization doesn’t have an overt ban, it is highly influenced by neighboring Stanford University Medical Center, which six years ago instituted a policy that prohibits its physicians from accepting gifts or compensation from representatives of pharmaceutical companies, medical device manufacturers, biotechnology companies, and medical supply companies. The ban includes drug samples as well as pharma-sponsored dinners or lunches. “They can’t accept even a pen from pharma,” he said, adding “We try to encourage all in our group to follow similar rules. Those who don’t are not representing the organization.”
When asked, “What would make you come to a promotional meeting?” Bazzo said that, since patient education materials are still allowed, he would be more inclined to go to a non-CME meeting that included tools he could bring to his practice. While he does not go to many non-CME events these days, Choi said he may make an exception if the activity covers a new method of practice his colleagues at Stanford are using that he would like to learn more about.
“If I have limited time, a dinner meeting with no CME credit might not be so attractive,” Bazzo added. But for physicians who enjoy face-to-face interactions, “They will still come to dinner meetings,” he predicted.
Thinking Outside the Lunch Box
The pharma and medical device meeting managers in the audience had more than promotional luncheons or dinner meetings on their minds. One asked, “What do you see for the future of investigator meetings? Will pharma companies have to look more outside of the U.S. now that the Sunshine Act reporting rules may make more U.S. physicians wary of participating?”
Maybe, said Brazzo, adding that it would be bad for everyone if that were the case because “you would lose the U.S. perspective, which is vital.” While those who were wavering might drop out of the investigator pool, he predicted that there would always be U.S. docs willing to participate in investigator meetings. “We’ll see when the first wave goes out. Some people may drop out, but that may level out as [the reporting process] becomes more normalized.”
Will these new transparency rules dissuade docs from working on the clinical trials pharma companies need to get their drugs through the Food and Drug Administration approval process?
Kusske said he thought most would still be willing to participate in studies sponsored by industry, as long as they could report all the results and as long as how the money was spent also is transparent to the public, the way it is with National Institutes of Health grants. “I think that’ll be a positive moving forward,” he said.
Online Versus Face-to-Face Learning
When it comes to getting their certified continuing medical education, Choi said that, while residents and new practitioners tend to attend a lot of national conferences, “I’ve evolved more into doing what’s convenient.” He added, “Those who have little kids like to do a couple hours of online CME after tucking the kids into bed. Now with transparency about paying for costs related to meetings, you’ll see even more [physician education] moving online.”
Bazzo added, “As adults we have different learning styles—some strictly like face-to-face meetings, others online learning, and others like to read journals. I think you’re still going to get the full gamut. In California, you have to have at least 25 hours of CME per year—for those in specialties, that number generally doubles.” Large national meetings keep the issue of financial relationships at arm’s length, he said, because “You can’t tie an individual’s name to an exhibitor or unrestricted educational grant.”
In terms of transparency and CME, he said the Accreditation Council for CME already requires full disclosure and resolution of any potential conflicts of interest involving financial relationships with pharmaceutical companies. “So reporting isn’t a problem as long as the conflicts are resolved,” said Bazzo. Kusske added that, now that the is raising the fee providers must pay to be accredited, “Many smaller hospitals are no longer providing accredited CME. This will shift the burden—you’ll see more people in these environments going to Web presentations.”
Whether it’s CME, promotional events, or investigator meetings, the era of transparency in financial relationships has arrived, and none of the physicians believed this trend would reverse direction any time soon. Does this mean that docs might be willing to pay for their education in order to make the whole point moot?
In a word, no. Bazzo said that there would be a big drop-off if physicians had to pay for their education. “You’re paying for their time,” he said. “If the benefit doesn’t equal their satisfaction rate, they won’t go.”
Choi was even more direct: “No one’s going to go if they have to pay!”
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