If you’d prefer to listen to the newsletter, you can find my first podcast here. I am very excited about it, as you might imagine!
According to a recent Guardian article, more than 50% of GPs in France are older than 60, choosing to continue to work to give patients access to treatment.
What keeps me going? France’s oldest doctor says my patients.
At 98 years old he is still practicing because in the area of France where he lives there are not enough practicing GPs. His son retired as a doctor at 67.
The fact of that matter is that many more doctors stop working as clinicians soon after starting and not only the French healthcare system is suffering as a result. Beyond patients not having access to doctors, who will Medical Affairs teams interact with to share insights into new products and the best way of administering registered products, absent doctors, who have time to chat?
The focus of today’s newsletter is knowing as we do that we don’t have sufficient doctors working in the system, and knowing this isn’t good for patients, what can be done about it and what approaches could be explored to increase the numbers of HCPs in clinical practice beyond training more.
I’ll share the story of the breast cancer surgeon, the GP and the consultant who went into a bar with you next time. It’s a true story, there was also a physiotherapist, a nurse, a nurse’s mother and a dentist there. I learned a lot about what being a healthcare professional in the trenches is currently like.
If you have been reading my newsletter for any length of time, you will be familiar with the facts that 1) the population is aging 2) we don’t have enough HCPs for the population 3) this is a problem.
The Guardian article started me thinking about the impact of a lack of HCPs for the healthcare system and for patients.
While the problem of the lack of HCPs is an obvious one for patients and access to healthcare, it also has an impact on Medical Affairs business strategy. Medical Excellence training is being rolled out in almost every pharmaceutical company.
However, if there are no physicians to talk to, how will this training ultimately benefit the patients? Who will treat the patients, and how will your Medical Affairs teams be able to ensure that the treating physicians understand the product and can administer it competently to the patients, who need it?
The fewer HCPs there are treating patients, the fewer interactions we will have with them and the less benefit our medical affairs excellence programs will generate.
While automation can support the more efficient provision of medicine, AI is nowhere advanced enough to fully replace human physicians. This train of thought got me thinking about potential solutions, where do we have doctors, who are not working clinically, but who could?
Two key pools spring to mind – doctors who leave clinical practice, doctors who retire from other jobs.
One of my friends, an ophthalmologist, now runs a building company. Another, a GP, works in hospital IT.
I’ve met GPs, cardiologists, nephrologists, oncologists, anesthesiologists, pediatricians as well as a neurosurgeon and a thoracic surgeon who work in pharma. They are in medical, commercial and sales functions, some in clinical development, some in safety.
While training more doctors seems like a simple solution, the problem is, that many doctors stop practicing medicine. So training more doesn’t mean there will be more in the system.
Back in 2006 discussions were ongoing in pharma on how we could attract rising clinical stars away from treating patients to join our ranks.
I remember asking the question – if we attract them away from treating patients, then who will prescribe our medicines?
However, pharma is not the culprit here. The real question is what it is that makes doctors stop practicing?
Reasons I’ve heard include:
- I couldn’t afford a pram for my first child on my Polish doctor’s salary so I became a sales rep.
- Unwillingness to subscribe to the archaic belief that only a doctor who is on his feet for 22 hours without complaint is a good doctor
- Intolerance of working 16 hour days, when the same job could have been done in 8 hours, but process improvements are rejected because that is how it has always been.
- The strict hierarchies and how hard it is to advance a career
Many of the doctors I talked to loved the job they were trained to do but hated the working conditions.
This is back in 2006. I recently spoke to a clinical psychologist. She treats a great many young doctors. Her insights into what it is like to be a clinician today, indicate that not enough has changed since 2006 to keep doctors working. This is an issue.
So my hypothesis is that the working conditions need to change to encourage more doctors to remain as clinicians.
Beyond encouraging doctors to remain as clinicians, perhaps we could consider encouraging doctors, who retire from other jobs to start practicing again?
It is increasingly rare for experts to retire from pharma straight into retirement. Life expectancy is increasing. Healthy old age is frequent in affluent segments of the developed world.
So might doctors. who retire from other jobs consider working as clinicians once more?
My hypothesis is, yes, doctors, who retire, might consider working as clinicians again.
The question is – Is there a way to refresh their expertise and make them available to the system again should they be interested? If so, how? And what roles for?
I believe, that with careful selection, adequate training and support and the right roles, this could be a viable solution to some of the challenges the healthcare systems face.
It is, of course, a political debate and with so many different stakeholders involved from hospitals, to guild associations, to payers, I’m not hoping for a solution soon.
However, sometimes it’s worth exploring what we have instead of merely lamenting what we lack.
This brings me to the end of the section exploring the lack of physicians in healthcare and potential solutions.
On another note: I’m excited to have been selected as the deputy lead for this year’s Medical Information and Communication Conference in Lisbon supporting our wonderful longstanding lead Janet Davies.
Find the link here:
The entire committee is enthusiastic about the quality of abstract submissions this year, which are better than anything we have had in previous years, and we are looking forward to another great conference. The agenda is under development and we will be sharing it with you very soon, so stay tuned! Richard McCombie, Actelion, Peter Brodbin, Pfizer and Simon Johns, at Iqvia, are also planning a pre-meeting training event and are currently working on the agenda.
Looking forward to hearing your thoughts.
So might doctors. who retire from other jobs consider working as clinicians once more?
My hypothesis is, yes, doctors, who retire, might consider working as clinicians again.
The question is – Is there a way to refresh their expertise and make them available to the system again should they be interested? If so, how? And what roles for?
I believe, that with careful selection, adequate training and support and the right roles, this could be a viable solution to some of the challenges the healthcare systems face.
It is, of course, a political debate and with so many different stakeholders involved from hospitals, to guild associations, to payers, I’m not hoping for a solution soon.
However, sometimes it’s worth exploring what we have instead of merely lamenting what we lack.
This brings me to the end of the section exploring the lack of physicians in healthcare and potential solutions.
On another note: I’m excited to have been selected as the deputy lead for this year’s Medical Information and Communication Conference in Lisbon supporting our wonderful longstanding lead Janet Davies.
Find the link here:
The entire committee is enthusiastic about the quality of abstract submissions this year, which are better than anything we have had in previous years, and we are looking forward to another great conference. The agenda is under development and we will be sharing it with you very soon, so stay tuned! Richard McCombie, Actelion, Peter Brodbin, Pfizer and Simon Johns, at Iqvia, are also planning a pre-meeting training event and are currently working on the agenda.
Looking forward to hearing your thoughts.
