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A Critic's Advice For Doctors In Search Of Industry Work

Over in the U.K. there's a set of principles being floated in support of collaboration between the drug industry and doctors.

A sample of the dos and don'ts for doctors reads a little like dating advice:

"Don't establish blanket policies denying interaction with industry or regard it merely as a source of funding.

Do look for opportunities to get involved: in clinical trials, in joint working and/or with opportunities provided by industry for medical education."

Yes, there have been problems in the past. But the document suggests not letting those issues scare doctors off:

"Opportunities may be missed or even rejected because of misconceptions stemming from historical practices that are no longer acceptable, or the actions of a few individuals that are not typical of the working relationship between healthcare professionals and the industry."

Go ahead and see sales reps, the document counsels, and help drugmakers by serving on their advisory boards. And look for ways to take advantage of industry-sponsored education.

I'd overlooked the guidelines until today, when Australian journalist Ray Moynihan, a frequent critic of financial conflicts in medicine, made me take notice with a piece in BMJ, the British Medical Journal.

He makes quick (and footnoted) work of them. In his own tongue-in-cheek way, he advises would-be collaborators with some more dos and don'ts. A sample:

  • Don't read a review that found no evidence that doctors who saw drug reps were any better off when it came to prescribing medicines well.
  • Don't read an analysis that found doctors who had positive views of the controversial diabetes drug Avandia were more likely to have financial conflicts involving drug companies.
  • Don't read a proposal to control conflicts of interest in medicine by reducing the sway industry has on continuing medical education.

Moynihan takes a hard line. But it's not that hard to see why. Recent history provides plenty of cautionary tales.

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