Organizations for the majority population don't always look at the specifics of the particulars of, say, the Hispanic or Native
Indian perspective. Sometimes, they wouldn't necessarily have the understanding or the capacity to do that.
But medicine is generally organized around subspecialities because of this type of thinking. I mean, every subspecialty in
medicine has an organization. There is the American Academy of Pediatrics, the American Academy of Orthopedic Surgeons, and
the Ophthalmology Association, for example.
Do you think pharma is on board with the idea of eliminating health disparities?
It's like everybody's sort of jumped on the idea of health disparities, and are now talking about it. But the prevalence of
health disparties is not anything new. People have been recognizing this since the 1800s. In 1940, Time magazine had an article about that. Then there was the Heckler Report [a landmark report on black and minority health put
forth in 1985 by the Department of Health and Human Services Secretary Margaret Heckler, which prompted the development of
the Office on Minority Health]. It's an ongoing practice.
Where are the health disparities in the African-American community?
There are higher numbers of African Americans that have strokes and are on dialysis as compared with the majority population.
Our key focus areas are heart disease, asthma, cancer, end-stage kidney disease, and diabetes. Not only do we talk with patients,
but we try to educate physicians on the importance of early detection, and conducting particular procedures—what some people
call evidence-based medicine.
We say that colon cancer, for example, is curable. Well, it is only curable if it's discovered in a timely fashion. It's not
curable if it's stage IV, and it's metastatic when it's found. So why is it that in one population these type of things are
commonplace? Some of that is not having access to care or the means to seek out medical care—and so care becomes episodic.
When something catastrophic happens, then one goes to the emergency room as opposed to a clinic or a physician's office.
For us, it's about educating the physician to the need to be cognizant of the fact that, "Hey, this person has a family history
of colon cancer. Therefore, they should have a colonoscopy, regardless of what their age is."
What do you think of pharma's current efforts to target African-American physicians?
The job is good, but it could be better. In terms of marketing, there should be more electronic initiatives. Many physicians
use PDAs, and some of them even have Web-based phones. It's a good tool to use, especially when you are, say, in rounds or
in transit or just need to get some information quickly.
Print media is obviously a good source of information, but I think using the electronic media is probably more effective at
outreach—and it isn't done as often as it could be.
In your experience, how could pharmaceutical companies more effectively use electronic media when communicating with physicians?
I'd like to get more detail, as opposed to just e-mailing me something that says, "Well, this is the new antihypertensive,"
for example. It's more beneficial to have that type of in-depth view as opposed to just constantly bombarding you with e-mails
that don't give a lot of information.
How appropriate is direct-to-consumer advertising for underserved populations?
I'm not totally in favor of that for patients, actually. Unless a patient is very savvy and has a good level of understanding,
sometimes it's hard to decipher what information they should or should not use.
Are there any DTC ads that you see as very effective?
I thought BiDil and Lipitor did a good job of advertising because they used various ethnic groups. I also thought the dialogue
between the physicians and the consumers [in those ads] was very effective.