Medical Education and Communication Companies: How Ideal a Fit for Pharmacists?

Maryam R. Mohassel, Pharm.D.

Am J Health Syst Pharm. 2003;60(18) 

A few years ago, I left a career in academia to accept a position with a medical education and communication company (MECC). I had never worked for an MECC before, but I had spoken with friends and colleagues who had taken similar jobs and seemed happy with their choices. I worked for the company as a medical writer for about a year, when I departed to join AJHP's editorial staff.

Given this experience, I was particularly interested in the commentaries in this issue written by pharmacists employed by MECCs.[1,2,3,4] The authors appear content with their jobs and believe that MECCs offer pharmacists a rewarding environment.[1] MECCs certainly extend a variety of job opportunities to pharmacists and others with advanced professional degrees. In fact, some of the brightest people I know work in such companies. However, there are challenges and occasional compromises associated with working in such settings.

Most MECCs are for-profit companies whose primary revenue source is the pharmaceutical industry. MECCs are very forthcoming about their business goals. During its sales pitch to potential clients, one MECC says it "never loses sight of the strategic value of its programs to enhance its client's corporate image and to strengthen brands."[5] Another company promotes itself as "putting the science of medicine to work for you. Preparing and building the market through professional education."

According to Relman and Angell,[6] medical education "requires an unbiased analysis of all the available evidence, led by experts who have no vested interest in the drugs that they are discussing." Yet an employee of an MECC works for clients with a decidedly vested interest in the prescription drug market. I was often reminded of this as a medical writer when I was asked to cast clients' products in a favorable light. This was easy to achieve for novel products with distinct advantages over other agents, but it became a struggle when the assignment involved a "me-too" drug with no apparent additional benefits beyond the competition.

Then there are the controversies surrounding ghost authorship, which is a service provided by most MECCs. Medical writers ghostwrite scientific articles, yet their act of writing is completely detached from their claim to authorship. When preparing a drug review, the medical writer conducts the literature search, retrieves and reviews the essential articles, organizes the relevant information, and drafts the entire manuscript. The authors listed in the byline are merely prominent clinicians who are paid an honorarium for the insertion of their names. In most cases they do little more than take a last-minute look at the completed manuscript. The real author's contributions are rarely acknowledged. As an editor, I have had the occasional experience of contacting the person listed as the corresponding author, only to be referred to the anonymous medical writer who actually wrote the paper.

Some pharmacists may feel that such misappropriation of authorship undermines the integrity of the biomedical literature. Why hide the medical writer's contributions, especially if he or she is commissioned by a company with a commercial interest in the paper? After all, aren't the editors and readers of biomedical journals entitled to honesty in medical writing?

More than 100 MECCs operate in the United States today.[1] Most of them offer pharmacists interesting opportunities and competitive salaries and benefits. However, working for an MECC may not be an ideal fit for every pharmacist. Some will become disillusioned once they learn about the challenges and compromises involved.