Marketing Medical Faith

There are so many factors involved in the campaign of encouraging the use of new (and even old) drugs in the medical community that one can really make a career out of it. I've never been under any illusion as to the intricacy and complexity of the management that goes into promoting a single drug and I have no doubt that it takes a great deal of money involved, but it would take constant updates and reinvention to lead a successful campaign.

Given that  I've been privy to the thought process behind it recently, I just think that, although there still are too many factors to possibly ever have under control, it would help people in this business to take into account certain things into consideration.

DOCTORS: When it comes to approaching the use of new drugs, there is no greater avenue for promotion than to those that prescribe and practice medicine. But unfortunately, doctors are not created equal.

When it comes to brushing up on new drugs and new medical information, there are doctors that diligently read and keep up with medical breakthroughs and whatnot through established medical journals (no, not the ones that routinely pop up on your regular Wikipedia searches), know how to critically appraise articles, and know what the terms RRR (relative risk reduction), ARR (absolute risk reduction), hard and soft endpoints mean. You see, it's never just about what they point out in the conclusion sections of articles that counts. One has to look at how the trials are conducted, any underlying agendas and whether they are statistically hazy or statistically potent.

On the other end of the spectrum, there are doctors who are content with what they know and do not read quite as much. There are subsets of this group that become the hook, line and sinker types that believe everything medical representatives pitch to them at their clinics or those that think sponsored scientific "eatings" are law and incorporate them into their practice.

If you strategize, you'd have to wow the first group with a great medical trial to influence the inclusion of new drugs into their well-established arsenal of therapeutics. The second group will take a little bit more wining and dining, maybe a few more side offers, and you're all set. Not to make this sound all shady and unethical, but people have to know that these are drugs with trials about them having proven their effect with their target disease. In reality, use is largely a matter of marketing, and benefit takes a backseat, but if you can get both, everybody comes out a winner.

PHARMACISTS: Pharmacists in the Philippines play a unique role in the sales of medicines. And I largely suspect, not only here but all over the world. Patients would often bypass doctor consultations and go directly to pharmacies and ask for medications. I'm sure that they all know their stuff and exercise vigilant and compassionate dispensing of drugs, but somewhere out there is an argument that they should refer to doctors regarding drug prescription but that is the reality. Marketing-wise, it's a whole new avenue to cover.

MEDICAL REPRESENTATIVES: These individuals go into doctors clinics and make cases for their assigned drugs and have to keep smiles on their faces doing so. Imagine how hard that job will be if you have to drive doctors and hospital bigwigs around at their whim. But marketing drugs have to be launched off somewhere and for companies to have the perfect representatives will go a long way. They have to know how to play doctor types and personalities and know the intricacies of promoting drugs, when to play off humor, who needs the extra push, who responds to flattery, and who needs it straight up. So for those in the market of selling to doctors, make sure you have the best of them.

PATIENTS: The most important market for drugs are the people who actually use them. In this day and age, the information superhighway is a busy busy one and patients are not as uninformed as they used to be. They come into clinics armed with information, albeit a hodgepodge of medical jargon and not necessarily knowledge, but giving them information, guided and unbiased, for them to digest as they see fit, would go a long way. Just don't forget to add those words at the end "if symptoms persist, consult your doctor." Creating groups online of patients with similar experiences, quick drug study guides, and nearby support systems will go a long way in showing that your drug cares for patients and at the same time, promoting its use among people who actually know what it is like using them.

Selling people on to medications has never been as straightforward as it seemed. Through the ages, people have found ways to get around stipulations, advertising, succumbed to some degree of corruption, but it has always been about getting drugs to people that need them, given by people that actually know stuff about it. With that, you need belief in your drug, some medical faith. So if you are in the drug marketing biz, and you think that traditional folk healers are a way to get people to believe in your drug, go that way.

Sell the drug, not your soul.

Flash Drive Movie Moments

I recently browsed through my collection of downloaded movies after a friend asked to copy them for her own. I'm a bit organized, so every movie was filed under their genre -- action, comedy, rom-coms, adventure, etc -- and I wondered if, after all this time, I'd be considered a movie critic. After all, I do love watching movies, and as a moviegoer, my opinion should count right?

What could be great for me, may not be good for you. What constitutes a movie worth sharing a laugh over, or shedding a tear for for me could be rubbish for everyone else. But I like to look at movies on moments and stories, and if they resonate with me, touch me, or entertain me in any sort of way, they can take their place in my external drive for replays anytime in the future.

Just looking through my collection brings back several of these movie moments.

I remember the beginning silent sequence of Pixar's "Up" which I think sold the movie itself. No words, just images and music yet nothing evoked emotions of happiness, grief and the beauty of life and love like Carl and Ellie's love story in a nutshell.

I laugh and sing in my head to "...Jamaica we have a bobsled team" and relive going to the Winter Olympics with the Jamaican bobsled team in "Cool Runnings." That movie had me dreaming I could start the bobsledding dreams of Filipinos everywhere. It was when they fell over during their last run and saw their medal hopes dashed, that they literally got up and carried their sled over the finish line to respect that I nearly stood up and applauded myself.

I have a lot of sports movie moments in my flash drive. Like when Gary Bertier and Julius Campbell finally yell, "Strong Side! Weak Side!" in putting it all together for their team in "Remember the Titans,"  when Keanu Reeves runs out onto the field his last day as quarterback Shane Falco in "The Replacements," feeling goosebumps as I listen and watch USA Hockey as they defeat Russia in "Miracle" with Kurt Russell pacing on the sidelines as the radio commentator shouts, "Do you believe in miracles?" or when Dennis Quaid throws his first pitch in "The Rookie" and Kevin Costner throws his last in "For The Love Of The Game."

Though I have a whole slew of sports movies, I have all the other genres too.

The rom-coms have their own category with the usual Julia Roberts, Meg Ryan, Tom Hanks fare. After all those are the cuddle movies -- the Harry Met Sallys, the You've Got Mails, the Runaway Brides, the Sleepless in Seattles -- that will have us saying all those "You had me at hello," "You complete me," "Love means never having to say you're sorry" lines that we all love to whisper in our loved ones' ears. But moments that got me are best exemplified in "Love Actually," where the all the types of love we share  are showcased and that by the end you realize truly that in a world where we think that caring for others has lost its luster, "Love, Actually Is All Around."

I remember all my "Lethal Weapon" movies and "Back To The Future" made me believe time travel was possible with a car and a flux capaciter. I loved the face-off between Samuel L. Jackson and Kevin Spacey in "The Negotiator" and the literal face-off in "Face Off" between John Travolta and Nicolas Cage. Feeling like I was sliding that endless water slide in "The Goonies" and cracking my whip with Indiana Jones on his adventures -- what a rush! Oh, and like James Bond, I ended up with the mission completed and the girl in the end.

I guess that appeal of bringing us stories that we can believe to be true for us has always been a prevailing pull to movies for me. I firmly believe that should The Sorting Hat be placed on my head that I'd be ushered into Gryffindor and that I'd give Harry Potter a run for his money. Perhaps that whole series could be about me instead! Or that I'd discover that I had mutant powers and join the X-Men.

So many movies so little time. Maybe one day when my kids are off to the futuristic 10D cinemas I'd say, "Oh, that's a remake kiddo!" I pull out this old dust-laden flash drive, "You should see the original!"

And they'd roll their eyes and I'd smile. What are we without our moments?

Changing The World, Eventually

A while ago, I came across an article published in the Philippine Star about twentysomethings and their continued education in the classroom of life. It struck a chord not simply just because I can relate to it somewhat, but because I came across it at this time in my life where I lose sight of things sometimes.

But I disagree.  Somewhat.

Let the record show that I've played both the jaded, depressed angry-at-the-world guy and the naive, heart-on-a-sleeve idealist at several times in my life.

To the ex-fresh graduate, I have been you too. After a bachelor's degree, a medical degree, a post-graduate internship, and an Internal Medicine residency training, I can definitely say I've played the part of fresh graduate a couple times over, and each time these had opportunities opened up for me to change the world. But I chose to toil even more in books and training, so as to be able to make my mark in the world -- specifically, make a difference with the future patients that will come knocking on my clinic.

Now a few months removed from graduating from IM residency and even passing the diplomate examinations, I find myself back at square one. Granted I'm waiting and wavering over and over again on the subspecialty that I want to go into, I've had the misfortune of not even being called for interviews to apply for junior consultancy in the hospitals I've applied to, and the clinics I attempted to see patients in. At this time, I work at a small diagnostic clinic in a mall that does employment medical clearances and physicals, and some consultation with patients coming in, malingering to get a medical certificate more than anything else. I've even accepted shifts at call centers in the city to augment my income. Heck, even some of my friends think I'm just suited for medical practice in the city and can't cut the rural/provincial hospital scene or that they think I don't like doing duties at hospitals.

It's my first real shot in the working world and I don't think I'm doing as great as I had planned. I have a memorized dialogue for my PE interviews, get frustrated daily with those that pretend to be sick just to get excused from work when I haven't missed a day of work since, well, I really don't know the last time I missed work. After a few hours of clinic duty, I go out to nearby call center to do a few more hours there.

Not exactly world-changing.

After reading that article, not exactly a difference-maker for the nurses I work with in the clinic as well. Those spiffy, twangy, sassy and young call center agents, did not have tedious graveyard shifts in mind when they wanted the chance to earn their first millions. Anybody who is not anywhere they want to be, or feel like they are owed more, will not have expected dealing with all this frustration and obstacles. Anybody who has had to settle, will want to be somewhere else. Somebody who has had to change themselves for something they do not want, will seek other more fulfilling things to ultimately satisfy them.

I wanted to touch people's lives and be an instrument of His healing -- to make difference, to change the world.

And I still want to.

The passion never really goes away -- it just gets lost sometimes.

Though the cases that have legitimate illnesses that come into the clinic I work for are few far in between malingering patients, there is the palpable spark of curiosity and the pure intention of helping them achieve a cure when they sit down and tell me their stories. The drive goes back on to scrounge up every rusty bit of knowledge that I have been hanging on to since finishing training and actually bring the patient back to health.

The key is always finding a reason to be happy where you are -- finding something that drives you. Whether it be money, fame, or the chance to change the world, for family, for love, for that extra bonus -- to each his own.

I remember Sanjiv Chopra's talk at the Philippine College of Physicians' Annual Convention this year admiring the work done by Paul Farmer (recounted in his book "Mountains Beyond Mountains") where he brought cure to an HIV-infected African man. He did it by never giving in. The big names in this world have somehow made their marks, because passion never really went away. So it can hold true for all of us as well. We hold it in our hands when we go out into the world from graduation and when we set it down to throw back the crap the world is slinging at us, we end up losing it. We'd have to go through the muck surrounding us, get dirty and find it again, and somehow just manage to survive.

I still believe I can change the world. I've never been the whole get-up guy in the spiffy suit so I don't have to worry about looking like a fresh graduate all the time. I say to young people everywhere, get your suits dirty, and so what if you got it off a rack at SM. At times, it takes the hardened, seasoned, weather-beaten, oft-insulted, underestimated individual to get the job done.

It takes passion to dream, fail and get up again. It takes passion to be able to get up in the morning, go to a job you don't totally like or dislike and work for something better. Such is life, and misconstruing hard work and its slow, deliberate toil as failure and irrelevance, is just so wrong. So I urge you to find passion wherever you can. It is normal to lose it at times, but for you to have any semblance of happiness and satisfaction, there has to be that drive to just go a little bit more.

Always remember that happiness and success are relative. It is not where you start nor where you end up, but, as a wise and good friend of mine put it, "when someday, you look around with satisfaction that you're exactly where you're meant to be," you got it made.