We believe Modern Healthcare's 2006 list of the 50 most powerful physician-executives in healthcare overlooks the importance of physicians in the pharmaceutical industry. Pharmaceutical physician-executives are the Rodney Dangerfields of the healthcare system.
Although the contributions of physician-executives in hospitals, government, HMOs and other health-related businesses are undeniable, physicians engaged in pharmaceutical medicine and clinical investigation deserve recognition, too. The sampling bias inherent in the procedures used to identify the most powerful physician-executives'-a survey of readers of Modern Healthcare who voted online at modernphysician.com -only partly explains the omission of pharmaceutical physicians from the list.
The fact is that most people, including those in healthcare, have a poor understanding of the diverse roles of physicians in the pharmaceutical industry. It is generally not appreciated that pharmaceutical physicians provide responsible leadership through clinical trials and other activities that promote pharmaceutical innovation, improve quality of life and safeguard patient safety.
The majority of physicians in the pharmaceutical industry work in drug development, designing and managing clinical trials to bring new drugs to market or to gain approval for new indications. Physicians working in drug development also devise clinical strategies to fulfill unmet medical needs of patients, for example, through educational and care-management programs. These types of activities are similar to those performed by physician-executives in disease-management companies. Indeed, the pharmaceutical industry recognized the value of disease management long before the disease-management industry existed.
Another area in which pharmaceutical physicians demonstrate leadership is medical affairs by serving as liaisons between their companies and key thought leaders in medicine. Pharmaceutical physicians often excel in peer-to-peer negotiations and at influencing other physician-executives, including some executives who appeared in the top 50 list.
Not all pharmaceutical physicians are focused on the external environment, but they are just as effective in advancing science, for example, through teamwork in their companies. These pharmaceutical physicians are consultants to their own legal and regulatory departments, where they lend their expertise to manufacturing and product quality, new drug labeling, and risk management and surveillance.
The strategic use of pharmaceutical physicians in advertising and promotion provides medical, therapeutic and disease expertise, which may enhance the creative process and improve the quality of promotional material. Pharmaceutical promotional material may contain inaccuracies or present very selective accounts of the results from clinical trials. Pharmaceutical physicians may contribute to improved accuracy and balance by providing medical and scientific review of promotional material before it reaches the market.
Many career pathways are available to physicians in the pharmaceutical industry, and there are significant opportunities for advancement within any given company and across the industry.
In contrast, physician-executives in nonpharmaceutical sectors of the healthcare industry are threatened by hospital mergers, the continued consolidation of the managed-care industry and government infighting and stakeholder unrest. Of 620 members of the American College of Physician Executives who responded to an unscientific poll, 290 (47%) said they had been "involuntarily terminated" from a medical management job. Personnel conflicts, organizational insolvency, and downsizing or re-engineering were common reasons for being fired.
Even though the drug industry develops medicines that benefit millions of people, it has ranked among the least-trusted industries in consumer opinion polls. But therein lies the power of the pharmaceutical physician-executive-to help restore the public trust.
Arthur Lazarus, M.D., M.B.A., is senior director of clinical research at AstraZeneca. Barry K. Herman, M.D., M.M.M., is senior director and regional medical and research specialist at Pfizer. Lazarus and Herman co-lead the American College of Physician Executives' online network for pharmaceutical physician executives at acpe.org.
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