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Working with industry as a speaker, investigator and consultant
Young physicians should find a subfield about which they are passionate and start speaking at small local programs.
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Over the past dozen years, I have enjoyed working with many ophthalmic companies to design new devices, evaluate and improve current products, and educate fellow physicians about their use. This has given me the opportunity to work with the brightest minds in the industry, meet scores of new colleagues, and travel across the U.S. and the world. Many ophthalmologists, particularly young ones, want to know how to get started working with industry.
Choose your subfield
The principal key is to have passion about a specific subfield of ophthalmology. I most enjoy cataract and refractive surgery, so the vast majority of the consulting work that I do is in that area. I am not as interested in other topics such as retina, glaucoma or oculoplastics, and as such, I do not do any significant consulting in these fields. Find your specific area of interest and maximally develop your expertise beyond what is normally taught in residency and fellowship programs. Your goal is to have an amazing depth of knowledge about a relatively narrow field.
For development of new products, think about what you do in your clinic and in your operating room and decide how to make it better. What instrument designs could be made to simplify a procedure or to make it more accurate with better results? For existing products, start by using them extensively in your practice so that you have hands-on knowledge and experience. When doing talks at large meetings, speak on products that you are actually using. When I speak about my experience with using a specific postop medication, I am coming from the perspective of having used it thousands of times over the course of years. I do not give presentations about products that I do not actually use. Remember that it will take years to build a good reputation, but only minutes to lose it.
Start small and local
A good first step is to get to know the local representatives from the companies, particularly the ones who promote the products that you use the most. Ask them for any recent publications about their products and ask to be put in touch with their medical affairs team. You will be able to understand the clinical trials on a deeper level, and the team can provide you with more studies to strengthen your knowledge about the products and the disease states. Ask about speaking at local programs for the company. If those go well, you may be asked to broaden your reach to regional programs and then national programs. Traveling to other states to speak is an enjoyable way to meet new colleagues, but being away from your practice for a prolonged time may be an issue. Be aware that these sponsored events, often done as dinner programs, are considered promotional, the companies are restricted to speaking only about FDA-approved indications, and you will be limited to the corporate slide deck.
This is in contrast to a continuing medical education (CME) program, which is arranged independently by a third-party educational company with funds often secured from the ophthalmic companies. CME meetings tend to be larger regional or national meetings that can last anywhere from hours to days. At CME meetings, you are free to give your own opinion and method of using the ophthalmic products while being fair and balanced and, of course, disclosing your financial relationships. It is critical that you abide by the rules and regulations for both promotional and CME programs.
Financial relationships
There are laws and guidelines that govern the financial relationships that physicians have with pharmaceutical and medical device companies. The Physician Payments Sunshine Act requires reporting of any payments or items of value given from these industry companies to doctors. These transfers of value can be in the form of payments, travel support or even meals provided at meetings. A public database of these payments is available online at http://openpaymentsdata.cms.gov with data from 2013 to present. The Pharmaceutical Research and Manufacturers of America (PhRMA) and the Advanced Medical Technology Association (AdvaMed) both have codes of ethics that are used by nearly all companies in ophthalmology.
Physicians are paid commensurate to the work that they do and the value that they bring. Most payments are done per hour of work, although some may be done per job completed. Payments are often divided into categories: speaking, consulting, clinical research and royalties/ownership. There are standard payments for small programs that are reasonable but certainly not enough to make up for missing a busy clinic day or operating room schedule. Consulting payments tend to be paid per hour while clinical research may be paid per patient involved in a study.
Be true to yourself
With successful local talks under your belt, you will likely be introduced to the other members of the team, such as product managers, marketing specialists and high-level executives. All of these people will be interested in your true opinions of their products and their performance. They are looking for constructive ideas and feedback, not empty praise. On the podium it is also critical to be true to yourself and to speak from your personal experience, not to shill for products that you do not actually use.
Determine which activities you enjoy the most and pursue them. Initially I was most drawn to podium speaking, particularly at CME events where I could show videos of challenging cataract cases. Then for many years I really enjoyed the experience of doing live surgery at the major meetings around the world. I have also enjoyed designing instruments and helping format marketing campaigns. Among my favorite industry work is collaborating with the engineers who are the brains behind the full spectrum of products that we use in ocular surgery. Your feedback will help these engineers improve their lasers, phaco machines and other devices so that the next generation of machines will afford better and safer outcomes for our patients.
The time is now
Physician collaboration with industry is critical to the development of new products that will benefit patients. It benefits all parties involved: The physicians get improved devices, the manufacturers hone their products for better sales, and the patients get improved outcomes. There is a current need to recruit the next generation of consultants, speakers and key opinion leaders in ophthalmology. I am indebted to my many mentors such as Richard L. Lindstrom, MD, and Robert Osher, MD, who were instrumental in my career path. If you are passionate about a specific aspect of ophthalmology and you are willing to share your enthusiasm, I encourage you to seek out a mentor and pursue a relationship with industry.
- For more information:
- Uday Devgan, MD, is in private practice at Devgan Eye Surgery, Chief of Ophthalmology at Olive View UCLA Medical Center and Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, UCLA School of Medicine. He can be reached at 11600 Wilshire Blvd. #200, Los Angeles, CA 90025; email: devgan@gmail.com; website: www.DevganEye.com.
Disclosure: Devgan reports no relevant financial disclosures.