Thursday, May 14, 2009

Need for certification of Medical Representatives

EDITORIAL for NetRUM ©
Need for independent national certification for medical representatives
Dr Vijay Thawani, Group Owner, NetRUM
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Market forces always dictate the change and stimulate development. For the existing staff in specialized services, the impetus brings in new era of improvements, continuing education, and training. Every change is initially resisted because we fear the uncertainty of the unknown. Sound justification with good understandable reasoning catalyses acceptance of the change.
Medical representatives (MRs) are important stake holders in the delivery of health care to society. In our part of the world, unfortunately they have not received due position of respect and are relegated to be mere “agents” of the pharma companies, trying to “push” the products.
The MRs in the past were popularly known as “human parrots” who were taught limited knowledge about the company’s products, made to memorize, then recall it for medical doctors to influence their prescription. The medical directors of the pharma companies turned these detailers into polite glib talkers, likable personalities who were easy to talk to, who always “agreed to agree”, to appease the prescribers. They were considered as “couriers” of medicine samples and company gifts. The era of modern management converted them into human tool to effectively impress the prescribers.
Critics have often objected to the impact of MRs on medicine prescription and making buffoons out of intelligent doctors. The MRs can sway the opinion of doctors in favor of their products in minutes, a claim which is so true but yet denied by the medical professionals.

The advantages of certification
Pharma industry is facing tough times, fierce competition, bad name, and hence there is need to enhance its standards, establish better image and improve credibility. Hence the need for setting up a national standard for certifying medical and pharmaceutical sales representatives, who can perform the good work of ethical and rational promotion of medicines.
It is felt that certification of MRs will usher in requisite basic knowledge base, improve work ethics and impart good name to the industry they work for. By voluntarily elevating the level of knowledge, MRs will demonstrate greater commitment and accountability. Ultimately they will become better professionals, who will perform better in improving the health of populations through the medics with whom they interact.
The standardization brought in through the certification will ensure more focused, better versed and trained MRs, capable to talk about the technical things and answering the questions of medical fraternity. Medical doctors will certainly like to interact more with a MR who is certified. A tremendous potential remains to be harnessed in bringing in the change, the way MRs interact with medical doctors. With the certification the quality of the information flow will improve which will be more consistent. It will also make the MRs more marketable for their careers.

What all will come in with certification
The certification program will succeed if it is managed by a single, national autonomous council with absolute powers and total independence. This institution should not use tax payers’ money and also not receive funds from the industry. It should be self sufficient to earn through registrations, training, CMEs, examinations and certification. Once the exams for certifying MRs get going, it will be self-sustaining.
This council will conduct activities and programmes to educate and train the MRs to bring them up to the set uniform standard, so that they can be groomed. Need based changes can be introduced in the curriculum to keep the MRs updated with current trends. Such trained manpower with acquired skill set can then be examined for the certification meant for representatives of medical, pharmaceutical and biotech companies. The certification process must focus on measuring competency in science, medicine, pharmacology, disease state management, evidence-based medicine, ethics and compliance, rational promotion of medicines.
In addition to establishing the initial certification examination, the council must establish procedures for periodic renewal of the certification and requirements for CME. It should be alike international certification programs for other health care industry workers. The goal is to have a voluntary certification and examination system in place.
The in-service employees enrolled for such educational courses can be sponsored by their employers because finally the pharmaceutical and other medical companies, who pay for their up gradation and consequent certification, will benefit from their acquired knowledge and skills.

Recommendation
Transparency of working, openness to public scrutiny and changes in the industry are compelling the change for how MRs perform their jobs. The national certification will ensure in delivering better professionals to whom the medical profession can look up to for scientific, evidence based, and high quality helpful information. As the momentum for changing the MRs is growing, the health care has to speedily introduce the reform to stand up to the call.
It is fact that in India the majority of doctors depend for medicine information and new medicines on MRs. The certification process will assure doctors and patients that good, useful information is being shared by competent stake holders.