It's anybody's guess how many thousands of pharma sales reps might have visited internist Lucien Wilkins, MD, during his 30-year
career as a practicing physician in Wil-mington, North Carolina. Whatever the number, those visits seem to have fueled his
drive to galvanize the medical community into remembering their ultimate responsibility to patient care wheninteracting with
pharma companies. He recently co-founded a new organization, the American Physician Partners Association (APPA), a clearinghouse
for matching industry's messages to doctors' needs for information and continuing education-on doctors' terms.
APPA's launch coincides with PhRMA's recent adoption of a new voluntary marketing code intended to help pharma self-police
its relations with healthcare pro-viders. Although the code's guidelines address growing FDA Division of Drug Marketing and
Communications (DDMAC) scrutiny of pharma sales reps' exchanges with doctors-in their offices, at medical meetings, at dinner
programs, and through what DDMAC describes as "quid pro quo" gifts-Wilkins believes the only real change will come from persistent
moral and ethical behavior by individuals on both sides of the relationship.
"Time will tell whether PhRMA's code will lead to a greater emphasis on educating physicians or more perceived mischief,"
says Wil-kins. "In the meantime, we should all watch to see whether the relationship between physicians and the pharma industry
changes as a result. As the next chapter in pharma marketing unfolds, industry insiders should maximize their contributions
to the health and well being of patients and their families."
He characterizes physicians and pharma companies as partners, rather than adversaries, in healthcare. He also advocates the
practice of ethical marketing that doesn't disrupt delivery of patient care-a view in agreement with the guidelines. But Wilkins
questions some of PhRMA's valuation of meals and definitions of accommodations. He also takes issue with the implication that
good judgment, ethics, and morality are enforceable.
"It is unlikely that competent physicians will abandon their missions, scruples, and reputations for golf balls or fancy dinners,"
says Wilkins. "It is just as unlikely that pharma would abandon its patient-centered mission or scruples simply for market
share or ROI alone. Simply put, we will all be appropriately rewarded as we benefit patients."
The new code may give rise to a greater level of mutual respect between both parties involved in the pharma marketing relationship.
In the meantime, Wilkins has a relatively sophisticated-and ambitious-business plan for growing APPA to include 30,000 physician
members by the end of 2002 and 80,000 by the end of 2003. His marketing plan includes medical journal advertising, a public
relations campaign, and internal market research.