Physician-Industry Collaboration and the Sunshine Act

2014 was a landmark year for transparency, especially with regard to drug and device manufacturers and their relationships with physicians. Parties on both sides of the equation have been bracing for the effects of disclosures related to the Physician Payments Sunshine Provision of the Affordable Care Act (commonly known as "The Sunshine Act"). Especially due to the wave of media scrutiny and potential damage to hard-earned reputations of key opinion leaders in the medical community, leading to cracks in physician-patient relationships.

Many providers consider industry collaboration central to remaining at the top of their profession. Yet many of these key opinion leaders are questioning the ultimate value of these collaborative endeavors now that the media and public are served imperfect and incomplete "transparency" data, resulting in the potential mischaracterization of this joint work.  For many, the reputational cost may be too great of a threat to their thriving practices and academic mentoring. Thus, they may pause and think that a better way forward is to severely limit, if not completely cease, their interactions with the drug and device industry.

If they pause for just a moment longer, these key opinion leaders may also realize that so much medical innovation across the life sciences depends on these collaborative endeavors. Just as industry needs to work with physicians that have both the scientific acumen and patient access needed for a range of development activities, healthcare professionals must, in turn, look to industry for new treatments that save and improve the lives of greater numbers of patients year after year.

The times in which we all live and work - this "Age of Transparency" - should cause none of us to close-up shop, but rather, forge ahead with practices we know will bring the best work from all parties and best results for patients. Providers can and must continue their work with industry while looking out for their reputations.

With that said, here are four recommendations for those at the forefront of medical innovation:

1. First, key opinion leaders must pay attention to the balance of their activities, which fall within a spectrum defined at one end as product support, and the other as more scientific and consultative in nature. As an example of the former, think of a physician speaking to colleagues at a dinner sponsored by a particular pharmaceutical manufacturer, about a particular drug, using slides prepared by the company. As an example of the latter, picture a doctor approached by a company with a new molecule, seeking the leader's advice for how that molecule might be clinically researched, appropriately dosed, and competitively priced to affect the lives of the greatest number of patients within a therapeutic area.

2. While physicians can and do execute activities on the full range of the spectrum ethically, the Age of Transparency demands that they see these activities through the eyes of the public. Balance of activities communicates to the public - and more importantly, to patients - a willingness to lead others in the profession and put their scientific expertise to work for greater good. In examining public perception, some doctors may realize that they aren't focusing enough on playing scientific roles in product development activities, while others may realize that they aren't doing enough to get the word out to their colleagues regarding these developments.

3. Next, providers should assess the balance of their activities along the spectrum - ranging from product support to scientific consultation - and must spre

ad their work among multiple industry players. The value of transparency is that it ensures objectivity, and in this case, breeds behaviors that ensure objectivity. One of these behaviors is working with more companies, not fewer. Again, by seeing these collaborations through the eyes of the public, key opinion leaders can quickly ascertain that the more companies with which they collaborate, the less likely they will be perceived as "favoring" certain ones or their products.

4. Finally, providers must be proactive and assertive with regard to disclosure, itself, in this Age of Transparency. While payment disclosures remain the onus of manufacturers of drugs and devices, much of the brunt of public perception falls to the provider receiving the payment, not the company making it. 

All-in-all, while the Age of Transparency presents daunting challenges, healthcare professionals have two sound reasons to welcome it and embrace it. The first reason is that transparency can mitigate negative perceptions. The second is that transparency advances the truth: that, through their work together, industry and leaders in the medical community improve patient outcomes and quality of life. Greater transparency educates the public on the incredible benefits brought about by these collaborative relationships, resulting in increased public trust, not to mention a surge in confidence from patients who find themselves honored to be under the care of providers on the leading edge of medical advancement.

Kristen Smithwick, an expert on pharma-physician relationships, serves as a vice president at healthcare consulting firm, Thought Leader Select. Working with over half of the world's top 50 global pharmaceutical, biotechnology, and device companies, her firm uses a proven proprietary system to identify and profile medical experts to ensure that their industry collaborations are ethical, compliant, and justified for the purpose of improving patient outcomes and public health. E-mail her here.