When officials of ThedaCare, a four-hospital network in east central Wisconsin, tried to expand its reach to small dairy farm families in rural Shawano County, they realized the problem was much bigger, and tougher, than they thought.
Many of the farmers were loath to seek medical attention, in part because they were too busy trying to keep their operations solvent, and in part because they were in denial that anything medically might be wrong. And many of them were not insured for preventive care, if at all.
So ThedaCare figured out a way to take medical attention to them in the form of personalized care through simple house calls.
"We listened to what these farm families were telling us, especially the wives," said Rhonda Strebel, executive director of Shawano Rural Health Initiative . "They told us, 'Look, everyone comes to us, the veterinarian, or the company that brings tires or fuel. Even the milk that's produced gets picked up at the farm. If you want to see our farmers, you will have to come to them too.'"
So she did.
Strebel, a health professional with credentials in sports medicine, is not a nurse. But she said she's especially qualified to reach this community because she understands the farmer's lifestyle. She herself was born and raised on a dairy farm until she was 18-years-old. "I have a comfort level with these people," she said, adding that she was not averse to "tiptoeing through the manure" to get to these families.
Another provider who is a nurse practitioner works part-time with the initiative.
ThedaCare hired Rhonda in 2004 after ThedaCare had conducted a "plunge," in which teams of community leaders from the area got on a bus to visit these small farmers, explained Paula Morgen, ThedaCare's director of Community Affairs.
Morgen said the system realized many of them were walking around with diabetes or heart conditions or arthritis, but not knowing it.
Many of these farmers are getting older and developing medical problems associated with lifestyle. Some of the men, especially, had developed high blood pressure or had high blood sugar levels, or were getting up frequently at night to use the bathroom, a potential sign of prostate difficulties, Strebel and Morgen said. But much of it went largely undiagnosed.
"If these farmers, the backbone of the region's economy, aren't taking care of their health, what's the chance they'll be able to continue?" Morgen asked.
They just couldn't go to the doctor. "Who would get the work done?" Strebel said.
The plunge team realized "these farmers work extremely long hours, and many of them work alone, with large animals, equipment, and chemicals and no occupational safety and health requirement."
She added, "There was no one there to remind them to wear hearing protection, respiratory masks, goggles, or steel-toed shoes. They could drop heavy equipment, or when milking, a cow might step on their feet," Strebel said. "They'd say their parents and their grandparents never wore protection so they didn't think it was important." In fact, regionally, many providers had seen many such injuries.
"At the end of the day, we realized that we needed to do something in Shawano," Morgen said.
At one focus group meeting to address the problem, one farm woman spoke up. "If you want to see our husbands, you're going to need to come to the farms," Strebel recalled. She said that the initiative does not just target men, but in reality, they're the ones that need it most. Women are just more comfortable with the idea of getting healthcare.
Many farmers had limited health insurance with no coverage for preventive care, added Strebel. In these lean times, she said, it the expense is seen by many farmers as unnecessary.
Strebel said she probably wouldn't get the trust she needs except for how she enters their lives. "I rode out to their homes with the milkman and the veterinarian, and went into the bank to meet them," she said. She became active in Future Farmers of America events such as picnics, and quietly explained the program to many wives she met.
"Can you come out to see my husband? I can't get him to come in to see a doctor," one woman asked Strebel.
When inside the home, Strebel tries to organize a family discussion around the kitchen table. She listens to their questions and draws blood for lipid and blood sugar tests, takes blood pressure, assesses body mass index and body fat, conducts pulmonary function, hearing and skin cancer screenings. She also advises on tetanus shots and views the farm's surroundings.
What she helped launch five years ago has helped deliver needed health interventions to about 300 families, or 670 individuals a year, she said.
The project is, by big city standards, extremely cheap.
The effort has been funded with about $120,000 a year for each of the past five years. Two federal grants provided a total of $192,000, but the rest came from ThedaCare and the Shawano Medical Center, a 25-bed critical access hospital in Shawano.
Strebel advises other community hospitals to make sure that the effort starts with the community.
Strebel said that once alerted that they may have a medical problem, "the first thing they say is 'Oh my gosh. What can I do about this? I don't have time to be sick.'"
And many have been successful following advice to lose weight and eat a better diet.
Ron Hillmann, chairman of the Rural Health Initiative said the program has exceeded all expectations. "It's the old concept of the typical country doctor going out to the patient," he said. "That's what has worked for us, and gained the confidence of the people. Rhonda has done that."
He added that farm women say "I got my husband to listen to her, and he hasn't listened to anyone in more than 20 years."
Hillmann, who also is the president of the Mid-County Cooperative that supplies feed and fuel for the farmers, said that in his years of working in the community, "we tried five other initiatives and every one has failed.
He said the program has also brought patients in to the area medical centers. "There's no question that the health of community is far better today because of this program," he said.
Consumers thinking twice about all but the most critical or emergent care are at the crux of one of the most significant transformations in healthcare today. The rise in consumer driven health plans, economic difficulties, and more have led many patients to carefully consider which healthcare treatments they really need, and which they can delay or avoid altogether.
Once the territory of the un- or underinsured, active decision making based on cost when it comes to healthcare is trending up for everyone. Recently, this trend hit home personally, when I went to a podiatrist to see about having a persistent and annoying wart removed. Seven treatments of liquid nitrogen later, the wart was still there, and my doctor said it was time for the big guns: laser treatment.
To this point, between my office copay and the 20% copay on "surgical treatments," each liquid nitrogen blast was about $60 out of my pocket. Knowing the laser procedure would be more expensive, my physician suggested I call the outside vendor he uses for laser wart removal to determine what my total cost might be. He said, "It's better than calling your insurer—usually they're a little thrown by the term 'laser.'" I was then handed the vendor's bi-fold brochure and told to make an appointment with the receptionist before I left.
Here's where the difference between yesterday and today for healthcare marketers hits like a sledgehammer. Until recently, I would have simply scheduled the laser appointment. I had good insurance coverage, so my exposure was at worst 20% of the procedure cost. I'd already been through seven treatments at $60, and would want to see the treatment through to the end. (No way the wart would win this battle.) Like many others, I would have moved forward with the treatment and paid the bill.
But not today, and maybe not ever again. First off, I've spent $420 to date on this stubborn little hitch hiker. Do I really want to spend another $200, or more? For most people, that's not trivial coin. I've lived with the wart for 10 years, what's a few more? At the very least, I will call the vendor and my insurance company before moving forward.
No more blind healthcare purchases for me, at least not when I have a choice in the matter.
My attitude is not unique. According to a recent Kaiser Family Foundation HealthTracking Poll, 53% of respondents said their households had cut back on healthcare in the previous year due to cost concerns. Retailer CVS recently announced the closing of 90 MinuteClinics for the season, to "align with consumer demand." Many hospitals and health systems are reporting dramatic drops in utilization. Summing it up recently was David Wessner, CEO of Park Nicollet Health Services in Minneapolis, who was quoted in a Minneapolis Star Tribune story on the financial ills of hospitals. Wessner said: "We're seeing that demand is far more elastic than it was in other years."
How does this change things for healthcare marketers? In a nutshell, your customers are becoming a much more challenging sale. No longer will healthcare consumers blindly follow the advice of their physicians to receive further treatment, not when they're own money is at stake, and not when there's a choice in the matter. So not only will it be harder to compel consumers to choose your organization, it will be harder to convert them to additional care even if you do.
What could my physician and his health system have done differently to ensure I took the next step, and went Star Wars on that wart? Here are just a few ideas:
Provide phone or email access to a patient advocate to help me determine the actual cost of the procedure. As it was, I was left to bridge the financial questions myself. I was on my own to contact the vendor and my insurance company to determine the actual cost of the procedure. I have a stake in becoming wart-free, but the health system has a financial stake as well. Why not make it as easy as possible for me to take that step?
Make information about pricing examples and options available via literature or on your web site. Now that I'm spending more of my own money (i.e. "consumerism"), I will be more apt to shop around. Maybe there are better options out there. Maybe cheaper as well. If you can't provide a real, live human advocate to help me figure this out, at least provide me literature that gives some pricing examples. Even better, provide me a link to a page on your web site that provides all the information I need, phone numbers, sample pricing, etc.
Leverage your brand equity when passing consumers off to strategic partners or other vendors. The brochure I was given was from the vendor, with the vendor's brand. But I don't know them, which means I don't trust them. That introduces a whole new player into the mix for me, which makes it harder for me to just take the next step, sight unseen. Remember, as competition heats up, brands matter even more.
Provide educational materials, promotional brochures, etc. that have your brand, even if the service is provided by an outside vendor. It's one less mental hurdle patients have to leap over to take the next step.
Multiply my story across the thousands of services, treatments and procedures you provide, and you can begin to see the impact consumerism will have on healthcare organizations. Healthcare marketers who are still using the old-school equivalent of liquid nitrogen applications as their strategies may want to consider charging up the laser, and consider new and different ways of addressing changing market demands.
A healthcare organization's logo represents the all-important first impression, since that is often the first interaction a patient has with a brand. The logo is often a brand's most visible and memorable element, at least at first. After interacting with any business, healthcare or otherwise, all the attributes of that organization are then assigned to the logo, which may or may not reinforce what that visual mark says.
Advertising agencies that used Flash to build deep, immersive sites with intricate animation have in some cases been embracing a low-fi, low-cost approach by tapping out-of-the-box Web software and free tools and platforms. The trend signifies a shift in strategy from the wowing of consumers with an experience driven by tech wizardry to the weaving of brands into the fabric of the Web and an emphasis on content. This means putting a premium on sharing, flexibility and speed.
Shriners Hospitals for Children is facing the same economy, market conditions, and consumer trends as everybody else. With declining fraternal membership and rising healthcare costs putting pressure on its donation-driven revenue model, it needed to raise awareness about its mission and benefits.
Good marketing is all about good storytelling. And the "Defy the Odds" campaign scored such high marks with the 2008 HealthLeaders Media Marketing Award judges on that point that it received a platinum award among large hospitals in the Best Children's Hospital category. They were especially impressed with the 30-second TV spots featuring patient testimonials, calling them compelling, conversational, and effective.
One spot features several children. "I shouldn't be talking to you," says a girl on a swing. "I shouldn't be playing baseball," says a boy at bat. "I shouldn't be doing this," says a girl lacing up a pair of roller skates.
"The success stories were remarkable and heartwarming. Very effective message overall," one judge said. "Seeing and hearing from the children was powerful in this case," said another.
Crystal clear objectives with real numbers qualified the campaign as a success. In the first 11 weeks of airtime, the campaign generated $8,000 in donations, with an average donation of $65. In the first five weeks that the 60-second TV spot ran, 1,768 calls were generated.
Additionally, inquiries and physician referrals are up, and the ads created awareness that led to media exposure and PR opportunities, including mention in a special editorial in the New York Times.
Are you ready to show off your healthcare marketing campaigns? Make sure to enter the 2009 . The deadline for entries is May 29.
This Campaign Spotlight was excerpted from Hospital Campaigns That Work, featuring the winners of the 2008 HealthLeaders Media Marketing Awards. You can order a copy of the book on the HC Marketplace page.
About two years ago I was sitting in the back of a room at a healthcare marketing conference, listening to an executive from a well-known healthcare organization. During her presentation, she casually mentioned the organization's emerging market strategy: to expand beyond its primary, secondary, and even its tertiary market. They were, she said, planning to market to patients in cities and towns all over the country.
The room—which was, of course, full of marketers from cities and towns all over the country—got really quiet. I'm guessing they were thinking the same as me: Holy cow; that's brazen. (They might have been thinking of a word other than "cow," though.)
How are small community hospitals supposed to compete when the big guys come rolling into town to steal away their market share?
Well, it turns out many of them are managing to do just that, thank you very much. And some of them are even turning the tables—small community hospitals are reaching out beyond their own primary, secondary, and tertiary markets to grow revenue, allowing them to continue to serve their own communities at the same time.
Take, for example, the case of Waldo County General Hospital in rural Belfast, ME—about a four-hour drive from the juggernaut of world-class Boston hospitals. It's built a national and international reputation for its speech pathology services, using technology, partnerships, and a laser-like focus on a niche market.
The state of the healthcare market today fairly demands that hospitals look beyond their own neighborhoods for patients. "In our small hospital we're looking at millions of dollars of losses this year," says Michael Towey, a voice specialist/speech language pathologist at Waldo's Voice & Swallowing Center. "We have to become more diverse."
Being small has its advantages—and they can be used to differentiate a hospital. "We're able to provide service that will be extraordinary; because we're small we can be responsive and respond to you in the same day," Towey says.
You can read more about the hospital in my story in this month's HealthLeaders magazine story, The Little Guy Breaks Out. I think you'll be inspired.
Note: You can sign up to receive HealthLeaders Media Marketing, a free weekly e-newsletter that will guide you through the complex and constantly-changing field of healthcare marketing.
By dumping its PBM, WellPoint will zero in on its core business and Express Scripts will provide the insurer's PBM services for the next 10 years.
The chief executives of the two companies, predictably, are promoting the sale as a partnership that will help both entities. It will give WellPoint the benefit of Express Scripts' trend management tools, including generics, home delivery, and specialty pharmacy, allowing the insurer to concentrate on integrating health benefits. This combination will save money and deliver significant value to shareholders, according WellPoint. The deal will also move Express Scripts into the second spot in managed prescriptions, beyond only Medco Health Solutions.
Though WellPoint is selling its PBM, this isn't necessarily a signal for other plans to follow suit. George Van Antwerp, vice president of solutions strategy at Silverlink Communications, Inc., in Burlington, MA, says health plans can reap benefits in owning their own PBM if they manage them properly and do such things as integrate data and lower medical cost ratio. Large insurers Aetna and UnitedHealth continue to provide PBM services in-house, but one wonders if WellPoint's decision will cause them to rethink their offerings.
The WellPoint decision comes as no surprise. In this difficult economic environment with employers dropping health coverage, insurers are reviewing their programs to see what can be outsourced. One such program is disease management. Blue Cross Blue Shield of Minnesota severed ties with DM company Healthways and began offering in-house DM programs in January. Insurers that are insourcing DM programs trumpet benefits such as having more control over their members, the ability to provide faster outreach to at-risk and chronic disease members, and a greater opportunity to collaborate with physicians.
Whether to insource or outsource DM services is not clear cut, according to the HeatlhLeaders Media Industry Survey 2009. In the health plan section of the survey, half of the respondents said they plan to insource all DM and wellness programs within three years. One-quarter said they planned to outsource some DM and wellness programs in that timeframe.
As health plans debate these issues internally, the decision whether to outsource or insource services is certainly influenced by external pressures from employers. Businesses want health plans to help them reduce health costs and improve employee health. They are also demanding ROI information to make sure their programs are working.
For health insurers exploring whether to bring services in-house or move them to an outside vendor, here are questions to ask yourself:
What is our core business? For example, is it plan administration, claims payments, and member outreach? If so, do we want to re-focus our attention on those areas?
What programs do we offer that could be provided more effectively by a third party?
Will dropping our in-house PBM mean that we will lose a valuable revenue stream? Will cutting in-house PBM staff and services balance lost revenue?
Does tracking members via pharmacy claims data and reaching out to members for health coaching actually improve member outcomes and reduce costs in the long run?
Would a third-party DM company that specializes in chronic disease effectively reach our member population or is in-house a better model?
Would moving PBM services to a standalone PBM reduce drug costs due to the third-party vendor's ability to negotiate lower prices? Is our PBM effectively maximizing its mail order business or would a third-party PBM perform those functions better?
Health plans are understandably concerned about their present and future. Layoffs and employer benefit cuts are causing much consternation in health plans. Add to that potential healthcare reforms that could soon create public competition for health plans and it's clear why private insurers are looking for ways to streamline services and reduce costs.
In the near future, these private insurers may have to go head-to-head against a lower-cost public option. In order to prepare for that day and survive in the current climate, health plans need to perform this soul-searching now.
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The new 15-member Federal Coordinating Council for Comparative Effectiveness Research, authorized under the American Recovery and Reinvestment Act (ARRA) to assist federal agencies in coordinating and comparing the effectiveness of health services research, heard suggestions from the public April 14 in Washington on where to focus its efforts.
The goal of comparative effectiveness research (CER) is to provide information on the relative strengths and weakness of various medical interventions. Individuals participating in the listening session—representing provider, patient, research, medical education and other healthcare organizations—urged the panel to consider a variety of options.
John Martin, director of Premier Research Services, a research group owned by nearly 200 not-for-profit hospitals and healthcare organizations, urged the council to make sure that CER be aimed at "true research"—not administrative activities—and that the research be patient-focused.
Rather than just rely on findings from clinical trials, attention should be focused on whether a treatment "provides the greatest benefit to the patient in a real-world healthcare environment," Martin said. To that end, he suggested that results for CER "should be used as a guide for the best available treatment based on quality, safety, and efficiency—but not as a substitute for provider judgment."
"The care provider and the patient should have the opportunity to fully weigh each measure in selecting the best pathway for care," Martin added.
Collaboration also will be important. "Our experience has shown that involvement of stakeholders such as hospitals and healthcare systems early in the process—if it's considered in the development of research priorities—more likely will lead to the transition from research practice to use in acute healthcare facilities."
Harold Miller, president and CEO of the Network for Regional Healthcare Improvement (NRHI), a nationwide coalition of regional collaboratives, said it is difficult to "do good comparative effectiveness research if you don't have good data on the use of treatments and outcomes that result."
"Moreover, what matters is the effectiveness of treatments in the real world—not in the laboratory," Miller said. The "fastest and most cost effective way to get real world data" is to build on the "extensive quality measurement and data collection" that are already being developed around the country—such as through the health collaboratives, he said.
Jeff Allen, executive director of Friends of Cancer Research, noted that CER historically has used data and evidence obtained through literature reviews of individual trials. These reviews generally cannot "create new knowledge" and "provide little insight into the effectiveness of healthcare interventions outside of clinical trials," he said.
Instead, he called for new ways of thinking—such as linking public and private healthcare databases (such as insurance claims)—which would have the potential to "generate an unprecedented amount of information for a variety of research activities."
Myrl Weinberg, president of the National Health Council, which represents the interests of individuals with chronic diseases and disabilities, noted that efforts should be made to "disentangle the findings of good comparative effectiveness research" from insurance coverage and reimbursement decisions.
"We need to break the immediacy of that relationship in order to avoid denial of appropriate care," Weinberg said. Weinberg noted that patients' greatest concern was that CER will be used "inappropriately to deny access or to funnel them into a one-size-fits-all mode of care."
Elena Rios, MD, president and CEO of the National Hispanic Medical Association, which represents Hispanic physicians, said that CER could add to the body of knowledge to assist in reducing healthcare disparities. It also could help promoting effective ways of communicating with Hispanic patients and their families.
Earlier this year, the Recovery Act appropriated $300 million for the Agency for Healthcare Research and Quality, $400 million for the National Institutes of Health, and $400 million for allocation at the discretion of the Secretary of Health and Human Services to support CER. The council will make its recommendations in June.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached atjsimmons@healthleadersmedia.com.
Feeling neglected and marginalized in the debate over healthcare reform, nearly 400 emergency physicians from across the nation will head to Washington, DC, next week to make a case for improving patient access to emergency medical care and pushing Congress and the White House for a greater role in how healthcare is restructured.
"In all the discussions about healthcare reform, there has not been any discussion about emergency care. Not having a seat at the table is absolutely wrong," says Nick Jouriles, MD, an emergency physician at Akron (OH) General Medical Center and president of the American College of Emergency Physicians, which is hosting the April 19-22 meetings. "There has been absolutely no funding for emergency medicine. There has been no discussion about improving emergency care, or providing the resources that we need to provide the care that we've been providing."
Jouriles says the nation's emergency physicians treat 120 million people each year, yet account for only 3% of the cost of the $1.5 trillion spent on healthcare annually in the United States.
Emergency physicians are still stinging from a presidential snub last month when they weren't invited to a White House summit on healthcare. Jouriles says it is shortsighted and counterproductive for the people setting the debate over healthcare reform to exclude the physicians who are doing more than anyone else to hold together a crumbling healthcare infrastructure. Beyond providing healthcare to the estimated 47 million or so people in the United States who don't have health insurance, Jouriles says emergency physicians have become the de facto personal physicians of people with insurance but who can't access a primary care physician, including millions of Medicare and Medicaid patients.
"Most Americans have no access to care," Jouriles says. "No matter how we slice and dice the national need for healthcare, there is a certain amount of illness that we are going to have in this country and right now it's not being taken care of. Emergency care by default becomes the safety net for the entire infrastructure."
David H. Newman, MD, director of clinical research and an emergency physician at St. Luke's-Roosevelt Hospital Center in New York City, says the problems facing emergency departments are among the worst-kept secrets in healthcare.
"Everybody thinks these issues haven't been examined. But it's much worse. These issues have been examined and nobody cares," says Newman, author of Hippocrates' Shadow: Secrets from the House of Medicine—What Doctors Don't Know, Don't Tell You, and How Truth Can Repair the Patient-Doctor Breach.
"It's always a money thing. It's not about the greatest good for the greatest number. It's about whatever is going to get your biggest piece of the pie because that is what a hospital needs to survive," he says. "It doesn't make sense to fund your emergency department if you can do an outpatient plastic surgery procedure instead."
Lynn Massingale, MD, a board-certified emergency physician and the executive chairman of Knoxville, TN-base TeamHealth physician staffing service, says the nation doesn't have the primary care infrastructure in place to support universal healthcare. "Nobody talks about that," he says. "There is not primary care capacity for 47 million uninsured people in the United States. Even if you fund healthcare, who's going to take care of them? And it's going to take a long time for that capacity to materialize."
In addition to the 47 million or so uninsured, Massingale says there are another 25 million people who are underinsured with lousy coverage or too-high deductibles and another 10 million or 11 million illegal immigrants. "Nobody has said anything about coverage for those folks and nobody will," Massingale says.
Newman says emergency department volumes have increased dramatically over the last 20 years as the rest of the healthcare infrastructure has crumbled. "It's not a coincidence," he says. "It's like the financial crisis. There is money to be made here and people are willing to play the Russian roulette game of not funding their emergency department, because they are willing to lay their bets, 30-to-1, that they aren't the ones who are going to wind up there."
A key item on the agenda of next week's 2009 Leadership and Advocacy Conference of the ACEP will be the effort to push Congress to enact the Access to Emergency Medical Services Act (S468), which would strengthen access to emergency care.
Massingale says emergency physicians need to rally around the bill. "That bill primarily would provide for some additional payments for both emergency physicians and more importantly, for the specialists who take call in the emergency departments," he says. "One of the biggest problems we have in the emergency department now is getting physicians on the medical staff to take call at the hospital. We have to have a mechanism to try to entice them to want to take call for the emergency room. This specifically calls for increased funding for all those people who take call in the emergency department. It's not just about getting emergency doctors paid to offset their losses on the uninsured."
When Massachusetts health system Partners Healthcare announced new industry interaction recommendations for doctors on Friday, it was just the latest piece of erosion in the changing landscape of the healthcare-pharma relationship. The recommendations came days after a similar announcement from Johns Hopkins and one month after Partner's home state set statewide rules limiting pharma gifts to physicians.
Although these new policies may seem like an onslaught on the pharmaceutical industry, Partners says they put their policy in place to make the symbiotic relationship stronger.
“I think there are many important aspects of the relationships between academia and industries that we need to preserve and protect," says Peter Slavin, MD, the president of Massachusetts General Hospital, who is leading the implementation efforts across Partners. “It's in our interest and in the public's interest that we focus our relationship with these issues and try to eliminated some of the noise that cause some people to call into question the value of the [pharma-healthcare] relationship. I think it will make the relationships stronger and by working together it will help the people we're trying to serve."
Extravagant dinners and ghostwritten articles are unnecessary distractions, while drug research and trials are paramount, he says.
Similarly, the Johns Hopkins policies were written to prevent any aspects of marketing from getting involved with drug research and physician interaction.
"This policy is designed to try to put the emphasis on relationship with industry—where many people believe it should be," says Julie Gottlieb, assistant dean for policy coordination at Johns Hopkins University School of Medicine. "That [focus] is on science and medicine exchanges that will advance patient care—and not on marketing."
Ideally, these conflict-of-interest policies will create strong ties that better facilitate the exchange of ideas between healthcare organizations and pharma researchers, she says.
“Ultimately none of us want to see a situation were our medical care is compromised because of a financial relationship between pharmaceutical company and that doctor," says Retta M. Riordan, president of Riordan Consulting in Mountainside, NJ and former compliance officer for Organon BioSciences. “Similarly we don't want to see the results of a research doctor being swayed as a result of the relationship. It would be horrendous from a research standpoint, a patient standpoint, and a company standpoint."
But the most recent regulations, like those implemented by Partners and Johns Hopkins, have gone too far, Riordan says.
“What has happened is these conflict-of-interest policies have been morphing into much more," she says. “They basically have been looking at every contact with pharma as being bad. I think these extremely restrictive policies don't benefit anyone, least of all the patient."
Slavin admits that the new Partners policy has caused dissent in the pharmaceutical industry and even within the organization itself, but they are prepared to deal with the consequences.
“We really feel very strongly that relationship between Partners and industry is critical to us achieving our mission," he says. “By restricting certain things they will liberate us to focus more energy on the important things between our organization and industry."
The next step for Partners will be to turn broad recommendations into specific policies ready for implementation.
“I hope by working together we can develop new agents that can help the lives of our patients and the public in general," he says. “I hope in five years from now this is less of a concern to public policy members, the media, and the public at large."
Johns Hopkins is less optimistic about the future of the healthcare-pharma relationship, and it will adjust its policies as the environment changes, Gottlieb says. "If industry decides to find new and different ways to market their products that also undermine independent decision making by physicians and researchers, then we have to address those," she says. "I hope that's not the case."
Riordan, too, is thinking about the future.
“We may see some more of these restrictive policies coming on board," she says. “What we don't want to see is a total restriction on interactions between physician and drug companies. I think people have stepped over a little too far in one direction, but I'm hoping that the pendulum will swing back."
