Challenging Pharma towards Patient Centered Studies

Pharma effectively trains a "Challenger" Salesforce, as described in Harvard Business Review. We recently met with Dr. Molony to discuss the development of a short lunch lecture series at UT-Houston which would better prepare medical students to deal with this type of salesforce. In the long run, pharma will deliver only the evidence that doctors demand. As we begin to demand patient centered studies, leading Pharmas will react by funding more appropriate studies. Then, patient centered evidence becomes a competitive advantage.

Collaborative :: Silos

Recently, our leadership team has been developing a plan to study and improve the ability of our teaching hospital to comply with best practices in the blood pressure management of acute stroke patients. Coincidentally, we will be working with the hospital to implement findings from studies our neurologists acted as reviewers, contributors, or even lead authors.

UT Houston and Memorial Hermann have recognized that it’s not enough to be a thought leader; ideas must be transformed into clinical practice. This goal isn’t accomplished by establishing a separate “Translational” organization, furthered by flashy rhetoric, or supported by a partnership with a neighboring business school. Rather than discuss the need for “bench to bedside” initiatives, quality transformation has been fully integrated into the culture of UT Houston medical school and its main teaching hospitals. The initiative has been championed by our dean, and its vision accomplished through the leadership of our faculty mentor, Dr. Eric Thomas. Today, Quality Improvement physicians are in place as distinct leaders in most clinical departments. In this way, Patient Safety benefits from direct accountability of named individuals and by delegation through well structured responsibilities.

We engaged the QI leader of the neurology department to help us refine our project proposal. He identified several flaws. Additionally, in his role, he had the credibility to request that our proposal be reviewed by the Chief of Neurology and several Stroke Neurologists. Our collaborative effort was further strengthened by his engagement of nursing staff who noted our project required an understanding of admission criteria. We were promptly supplied with that documentation and the nursing Stroke Coordinator was available for follow-up questions. Within a few days we had received constructive comments from several organizational facets. Many we immediately integrated into our proposal; others we sidelined to discuss with our mentors how additional study metrics may overextend our scope.

What’s unique in these efforts is not that medical students are engaged in clinical research. That’s common in any medical school. Fortunately, we attend the rare medical school in which a group of students is able to organize and be counseled by these experts. It is a unique structure that wholeheartedly supports quality improvement. A culture sufficiently pervasive that even its student’s perspective of clinical problems may initiate change.