Industry, researchers, academia, educators, health plans, clinicians, patients, and beneficiaries contribute to our knowledge of wound care through research and development (R&D), clinical practice, measured scorecards, and outcomes. Translating this knowledge into new products, practice standards, risk assessment tools, outcomes measurements, and the like is an important contribution that these groups make individually and collectively.
Tearing Down Walls
The recent media celebration of the 20th anniversary of the fall of the Berlin Wall is an enduring inspiration for the symbol of learning about and dealing with misperceptions, fears, and actually collaborating better outcomes. Organizational dynamics and behavior consultants make handsome livings diagnosing and coaching organizations to tear down their silos and collaborate; in fact, one such consultant was fond of commenting that "sometimes in a large academic institution the only thing you have in common is the ventilation system!" I personally think those days are long gone. In fact, most organizations are working at warp speed to foster collaboration by reducing the duplication of services, eliminating barriers, reducing expenses, enhancing productivity, and improving outcomes.
Wound Care Partnerships
Indispensable partners in the effort to advance our understanding of wound care are product manufacturers and the pharmaceutical industry-they are in the business of transferring technology to patient care (ie, moving products from bench to bedside), yet of late, "big pharma" is under intense scrutiny by the regulators, investors, and the public in general. Healthcare manufacturers, like everyone else, want to and for the most part do an excellent job. However, these organizations occasionally make mistakes in their quest to balance the development of lifesaving products with the need for profits. The cycle is initiated when the industry begins to raise capital through investors to fund R&D. Products are developed, marketed, and delivered to buyers for a profit. The profit is returned, in part, to the investors, but a substantial portion is used to fund continuing R&D, a very expensive proposition indeed. Marketing for newly developed wound care products is part of the cost of R&D. In the past, most marketing efforts in the wound care arena were aimed at healthcare professionals and the organizations for which they worked. Most of this marketing activity took place at national conferences (ie, on the exhibit floor), through sales force activity at clinical practice sites, and through sponsored events (eg, sponsoring speakers for continuing medical education activities).
With healthcare reform looming on the horizon, with its conceptualized regional and national purchasing groups, marketing targets no doubt will change-driven by price and hopefully quality. Now the marketing bull's-eye has expanded, incorporating new methods and new client bases, including direct marketing to the patient-just watch the evening news or try to access the Internet.
New Partnerships
Pharmaceutical and wound care product manufacturers contribute much to our economy, quality of life, and health; patients, clinicians, professional organizations, researchers, and investors benefit from their entrepreneurial activities. Yet, wound care professionals have not always been eager to embrace the industry, preferring to keep them at arm's length with some exceptions-sponsorship, food, and gifts. The industry now wants and needs more substantive relationships. The fact that both clinicians and the industry are held accountable for the outcomes of care and the proper use of products based on evidence and efficacy dictates the development of new partnerships and paradigms.
Patient-oriented research is of interest to the Centers for Medicare & Medicaid Services, integrated healthcare delivery systems, health maintenance organizations, and manufacturers of wound care products. The industry wants partners (researchers) who can understand and meet its needs. The ideal partner for the pharmaceutical industry, for example, will have a track record of research published in peer-reviewed journals and an understanding of the basics regarding the regulations and processes of the Food and Drug Administration. In general, it will be in the industry's best interest to establish long-term relationships with high-quality academic and professional organizations that have the ability to move programs and projects forward and process data in a manner that is consistent with the pace of the corporate world, but with the rigor demanded to ensure safety and quality.
Effective Relationships
Management guru, Stephen R. Covey,1 has written about the habits of highly effective people. Wound care professionals can take a cue from Covey and develop the following habits that, if applied, could lead to highly effective relationships among clinicians, researchers, and the wound care industry.
* Make sure there is a significant integrity overlap among researcher, intermediary, and the corporation providing the funding. Agree in advance to report all results, even if they do not favor the product being researched (journals are now publishing negative results and full disclosures).
* Do what you say you are going to do. We live in a world in which people expect more than they receive and when overly enthusiastic people promise more than they can deliver.
* Relationships must be goal and outcome oriented. Basing the relationship on economic terms first is putting the cart before the horse. The more you accomplish as a team, the stronger the bond, which in turn adds economic value.
* Assume that the academician and researcher do not have a monopoly on virtue and clinical scientific knowledge. Be humble; the industry has more than its share of accomplished scientists.
* Base your relationships on mutual respect. Find the experts in your area of interest, regardless of institutional affiliations, and work with them. Ego-driven relationships do not often produce clinical products that benefit patients.
* Be able to communicate; this builds trust. Trust is being able to exchange information. Maintain confidentially-it is the keystone of building trust.
* Incorporate consumers, clinicians, and statisticians early on in the process. If it appears that patients will not benefit from the work that is being done, place your efforts elsewhere. As mentioned earlier, be prepared to report all results, even if they do not favor the product you are researching.
Summary
Forging partnerships with industry payers, clinicians, academicians, and wound care organizations is a win-win situation. For industry, it means an opportunity to work with thought and content leaders on important product research. For researchers and clinicians, it means an opportunity for funding for new or continuing research projects and to potentially help patients. For both, it means another opportunity to publish and memorialize their findings in a respected, peer-reviewed journal, thus expanding our knowledge of wound care.
Richard "Sal" Salcido, MD
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