Unhealthy spin
BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7400.1205 (Published 29 May 2003) Cite this as: BMJ 2003;326:1205All rapid responses
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It seems that public relations companies are not the only ones that
are experts at "third party techniques" to quote the first line of your
article.
I was surprised to see myself quoted in this piece for the following
reasons:
1. Neither Bob Burton nor Andy Rowell ever contacted me for comment
2. The quote attributed to me appears to have been taken, in part,
from a general article I wrote about best practice in crisis management
over 18 months ago. (Clever of the journalists to work out that I still
work for Lilly without checking!)
3. The words chosen to depict my view have been selectively edited
from my original comment and put into an entirely different and
unfavourable context.
The BMJ has a reputation for being one of the best medical journals
in the world. However, I now have reason to question the quality of its
freelance journalism in a way I never thought I would. Surely this is
sloppy journalism at its best?
In response to the summary points of the piece, I do not agree with
much of the assessment. Third parties will have a point of view - why
think it would represent the same view as the industry's? In my
experience, independent spokespeople are just that, and I include patient
groups in that equation, having worked for the voluntary sector for 5
years prior to joining Lilly.
No self-respecting patient group would ever allow itself to be the
unedited voice of the pharmaceutical industry. Equally, if the industry
were to withdraw funding from all patient groups, (which generally do
proactively publicise the source of that funding), how would they replace
that funding to support vital patient care and needs? Fundraising is a
tough business - maybe the critics should have a go at it and find out for
themselves.
Yours in sorrow more than anger.
Maxine Taylor, Director, Corporate Affairs, Lilly UK
Competing interests:
None declared
Competing interests: No competing interests
Dear Mr. Smith,
Bob Burton and Andy Rowell present their arguments against the
healthcare PR business with more bias than I have ever seen coming out of
any of our clients in the pharmaceutical industry!
Having worked with most pharmaceutical companies, many doctors,
journalists and patient groups since 1986 on PR and related services, I
would welcome the chance of responding to the points made in the article
as follows:
§ Our client’s messages are not disguised. It is clear from all of
our activity with external audiences including journalists who the company
funding the work is and what interest they have in the market.
§ The journalists with whom we deal, whether representing the medical
press or the lay media, are well informed as to our role and that of our
client. They seek information from a variety of sources rarely, if ever,
relying on us or the doctors with whom we are working for the totality of
information required.
§ Rather than generating “upbeat reports of preliminary results of
research…that raise unrealistic expectations of doctors and patients of
medical ‘breakthroughs’ that never eventuate” our clients are at pains to
provide proper information without overstating the benefits. If a product
is over-hyped and then fails it reflects very badly on all concerned and
is simply not worth the long-term damage to corporate reputation.
§ It is quite right that independent doctors and patient groups are
involved in issues management. If a major news story breaks about a
widely used treatment, patient’s become understandably concerned and it is
quite appropriate that they hear the views of all well-informed
stakeholders. Some issues thrust into the public domain, for example some
of the pill scares, have been quite unfounded and have resulted in serious
consequences for patients who have suddenly stopped their treatment as a
result. Well-informed doctors with whom we work on behalf of our clients
help in these circumstances.
Unfortunately health is a political issue at the heart of government
debates over taxation, financing and the role of the private sector in the
delivery of public services. In this context I am afraid everyone ‘has an
agenda’. If our clients want to sell more statins, better cancer
treatments, antipsychotics with far fewer side effects to name but a few
of the areas in which we work then I for one am proud to help them. Your
readers need to understand that over the years various government agencies
and some doctors who are considerably less informed than they should be
have prevented patients from accessing these medications.
I often wonder how many lives lost to heart disease during the
nineties would have been saved had the main company in the field been less
tightly regulated in their communication with patients. When the
government finally agreed to widen funding for statins, the products had
already been available for the best part of ten years. A shame for all
those patients who needed them at the time and never received them. At
least those members of the public who saw some of our work, so maligned by
your article last week, will still be alive.
Finally – although I welcome the chance for an open debate on these
important issues, I am concerned that the fall out will make life even
more difficult for patient groups who do a wonderful job for the most part
and manage on a shoestring. Despite the financial pressures I have never
come across one that would trade it’s independence for an injection of
finance – they only agree to work with our clients when they believe what
our clients are trying to achieve will benefit the patients they
represent.
Yours sincerely,
Margot James
Chairman
Shire Health Group
Competing interests:
None declared
Competing interests: No competing interests
I consider the term "spin doctor" too flattering for those who seek
to mislead or in some cases denigrate. I suggest the term "fan doctor",
as in ".... hiting the fan", is more descriptive.
Competing interests:
None declared
Competing interests: No competing interests
Healthy Skepticism thanks Bob Burton and Andy Rowell for the helpful
publicity for our organisation given in their excellent overview of public
relations techniques.
However I would like to stress that whilst we are based in Australia
we are an International organisation.
We invite all BMJ readers, regardless of nationality, to join our free
mailing list by visiting www.healthyskepticism.org
We started in 1983 as the Medical Lobby for Appropriate Marketing
(MaLAM) but have recently changed our methods and name to become Healthy
Skepticism.<1>
Our aim is to improve health by reducing harm from misleading drug
promotion. Our methods include research, education and advocacy.
There is no such thing as a free lunch. We are honest about that. To
remain independent our core funding is from subscriptions. Many of our
Free Subscribers become motivated to support our work by upgrading to
being Paid Subscribers for AUD $75 (approx Euro 41 or USD $49). Our
Members are Paid Subscribers who support our aims.
I would also like to mention that I am a different person from the
British Dr Peter Mansfield who is famous for his position on
vacinations.<2>
1. Mansfield PR, Lexchin J, Vitry A, Doecke CJ and Svensson, S. Drug
advertising in medical journals.
Lancet 2003 Mar 8; 361(9360)879.
2. Majeed A. Referral of Dr Peter Mansfield to the GMC
BMJ 2001; 323: 356.
Competing interests:
If Healthy Skepticism gains more subscribers then our organisation might be able to pay me for my work.
Competing interests: No competing interests
Ethical Health Communications
Ethical Health Communications
Edelman Health and BioScience Communications (the healthcare public
relations and medical education and publishing companies of Edelman,
respectively) would like to take this opportunity to present our
perspectives on the role and need for ethical healthcare communications
and industry sponsored continuing medical education.
Those involved in healthcare communications and medical education
have two distinct roles. The first is to ensure that there is access to
clear, truthful and immediate information about health and healthcare.
The second is to facilitate fully disclosed partnerships amongst all
stakeholders within healthcare, including researchers, clinicians,
policymakers, payers, patients and their families. All those involved in
healthcare communications and education must take responsibility for being
part of the solution and not exacerbating the problem of ‘entanglement’.
To this end Edelman Health and BioScience Communications endorse
complete transparency between those that employ our services and those to
whom we communicate. Not only do we abide by all regulatory codes of
practice at a national and international level, but we also enforce our
own ethical standards relating to disclosure and fair balance.
The entanglement between the healthcare profession and pharmaceutical
industry reflects larger ethical issues that pharmaceutical companies face
as corporate citizens. There is an unwritten social contract that entrusts
pharmaceutical companies with the development of products to safeguard and
advance the public health, with the corollary that successful companies
will profit from their risk and their labour. In a market economy,
private industry is usually better able to fund costly long-term, high-
risk ventures such as drug discovery and development, with greater
incentive to drive technical innovation and efficiency, than government.
It also stands to reason that those with the greatest knowledge of a
new compound and its therapeutic target will be the company, investigators
and scientists who have done the developmental work in this field. As long
as the tenets of transparency, disclosure and fair balance are adhered to,
there is no reason to exclude industry or its research partners from
playing an active role in health communications and medical education.
Nancy Turett
President & Global Director
Edelman Health, New York
1500 Broadway,
New York, NY 10036 USA
Nigel Breakwell
Managing Director
Global Operations Health
Edelman Health, London
28 – 29 Haymarket,
Piccadilly,
London, SW1Y 4SP, United Kingdom
Mark Deitch
Global Managing Director
BioScience Communications
1500 Broadway,
New York, NY 10036 USA
Dr Jasmine Zidane
Associate Director
BioScience Communications Europe
28 – 29 Haymarket,
Piccadilly,
London, SW1Y 4SP, United Kingdom
Competing interests:
None declared
Competing interests: No competing interests