S01 E02

Pharma and Physicians: The Evolving Relationships

Dr. Shafiq Qaadri Headshot.JPG

Dr. Shafiq Qaadri

Family Physician & Novelist

In our second episode, Peter Brenders, Founder & President of Kontollo Health, talks with the Dr. Shafiq Qaadri, Toronto family physician and parliamentarian, about the evolving relationships between physicians and pharma.



Thank you for downloading the second episode of the NPC Podcast from the National Pharmaceutical Congress. This program is all about discussing and considering the purpose, process and people of the pharma industry during the age of Covid. Today we're continuing the healthcare conversation by answering questions sent by listeners like you.


This program is presented in co-operation with Impres. Impres’ best-in-class commercial solutions drive top-line and bottom-line growth with maximum salesforce, flexibility, speed and efficienc. Learn more about their next-generation commercial model at www.impres.com.


On today’s podcast our guest is Dr. Shafiq Qaadri, Toronto general practitioner, columnist, novelist and politician. Your host for today’s podcast is Peter Brenders of Kontollo Health.


First, here’s Mitch Shannon of Chronicle Companies.




Thanks, Liona. And thanks to those of you who sent comments about our first podcast last week.


This podcast is about getting you informed responses to the many things that we in the life sciences need to know about the post-Covid future of our business. We welcome your questions. Just call our comment line, leave your name, a call back number and the question that you would like to ask, we’ll use the best ones in our future NPC Podcasts. Call 647-875-9011 and you might be part of our next episode.


This week we have a question from Jeffrey Wayne about telehealth. Jeff wants to know how the experience is affecting patients and doctors and he wonders if there’s an opportunity for Pharma to support education and counselling.


To get some answers, our host Peter Brenders spoke with Dr. Shafiq Qaadri, who’s lengthy CV includes four terms as a member of Ontario’s parliament. Here’s some highlights from their conversation:




Hello. I'm Peter Brenders with the NPC podcast Series. today. We have a special guest: Dr. Shafiq Qaadri, family physician, CME lecturer and four term member of the Ontario provincial parliament. 


Dr. Qaadri joins us today to talk a little bit about physicians and the impact covid-19 has had on their relationships with the pharma industry.


Hello, Dr. Qaadri.




How are you doing, Peter?




I’m very well, thank you.


So let's start with the impact that Covid has had, not so much generally on the practice of the medicine, but on that relationship or the interactions that physicians are having with the pharma industry. How have things changed?




Well, it's been a complete blowout as you can imagine. It's a complete depersonalization. We're either we've shut our offices or hiding behind screens and masks or screening folks for fevers before they can even see us. Many of my colleagues are back to basically telehealth only. So it’s been a complete reconfiguration of the whole model.




Do you see this continuing? Or how long do you see this sort of reconfiguration continuing?




Well, that’s anybody’s guess as you very well know, Peter. We try and of course follow the public health warnings, what the premier is saying, following the leads from what the world health organization. No one seems to really have a full handle on it.

We’re in the middle of summer. Are we going to have, for example, a second wave as doctors often experience flu waves for our patients in September or October as winter begins to hit. So it seems whatever answer I give you or whatever answer is available, it probably only applies for one week at the most.




With this change that’s happening, with Covid, and how the practice for physicians and their interactions with patients and the pharma industry has dramatically changed as you say, how are physicians working with the pharma industry today?




Well, one thing I have to credit the pharma world. They have really gone digital in a big way. I think they had the contact list and the infrastructure already in place for e-outreach, it’s really revved up. So I get anywhere from 5-10 email invitations on a daily basis for accredited, for non-accredited, for late breaking news.


So I think the pharma world has really stepped up to help us continue to interact, learn from them, new trends, new treatments, and of course, research that is ongoing and important. And of course, beyond just Covid, just generally across the whole medical spectrum.




So, do you find these changes that pharma has put in with respect to digital engagement an improvement on the interactions?




I think in a way it’s been a forcd improvement in the sense that we can’t, we’re getting a bit reluctant to really even see anyone in our offices. You know, you have to like be an old and registered patient, you have to not be having a fever and preferably nothing that’s going to be trackable to even vague Covid related symptoms.


So, the fact that person to person, rep to physician encounters are likely much, much lower these days, I think it’s a very welcome addition that we still have that knowledge, that river that’s coming at us. Because otherwise, as you’ll know, one month out of practice, you’re basically behind the times.




So, how do you compare the quality of a virtual call from those previous in-person visits?




I still prefer the in-person visits because not only is there an information transfer, but there’s a live human being and likely you’ve established a bit of a professional relationship with them. They know your story, they know a little bit about your practice. They can instantaneously tailor to your needs as opposed to “here’s an ivory tower announcement from Harvard med school.”




When you talk about the pharma reps having an understanding of your story and appreciation of what you’re looking for, it speaks to that a relationship has been built. How does a new pharma rep or a new company itself build a relationship with a physician like yourself in this virtual world?




I think they should learn from the big boys, whether it’s, you know, the Pfizers, the Astrazenecas, Sunofi, Aventis, and so on, who really trian their reps well, who come out and often they’ll even invite physicians to go in office, to help train and bring up to speed their reps and practice sessions.


And then again, there’s the relationships that are built, I suppose there’s a lot that can’t really be taught. You can’t teach someone to be an empathetic and slightly humours and oncall charming human being, but it takes all of that to break through to a physician who’s probably in a grumpy mood, likely behind schedule, has at least 3.5 patients who are waiting in the room and so there’s got to be something relatively rewarding before the doctor breaks through his filters and says “Ok, what do you really have to tell me?”




Have you seen any best practices in new digital engagement?




Oh sure, there’s so much available now. Whether it’s e-detailing where the physician is being treated to a video, possibly of a specialist, maybe of just a rep. There’s full programming that’s out there whether it’s three or four experts, both local and national and interntional. There’s a whole range of things, you know, whether there’s surveys that come out right away, pre-post testing, I mean, the sky’s the limit it seems in terms of the video and online relationship building.




You’re listening to Dr. Shafiq Qaadri, a Toronto family physiciain, CME lecturer and four-term member of the Ontario Provincial Parliament.


So, speaking of learning, you mentioned that if you’re out of contact for a month as a physician, you could be out of date on some new science and technology. Much of the scientific learning and continuing education that physicians received has occurred at large scientific meetings or more local CMEs, how do you see these continuing in the future?




Well, I hope they do come back, because I think the in-person, at dinner meetings are valuable because not only are you observing and being part of an appreciative audience for the speaker, but you’re also cross questioning the speaker, probably more liberally than if you just have the e-platform, plus you’re meeting colleagues and you might have a bit of a debrief afterward over dessert, corridor consultations as we would say and all of that helps to build perspective and build knowledge that you’re actually going to use as opposed to just acquiring credits for it. So, I think that judicious combination of the two are very valuable.




When you talk about cross questioning of colleagues and speakers, is there a way that this can work well in the absence of these in-person meetings.




I suppose it can but it’s more challenging, because you know, either you raise your digital hand and say “I have a questions”. It reminds me back to med school, there were always a couple of doctors that would like to dominate the conversation to show their brain power and cortical fortitude etc. And you know, sometimes folks who may just be asking pretty basic questions may be intimidated off-screen.


By the way, you’ll be pleased to know that not all doctors are e-savvy. Not all doctors are happy to be on Zoom and all the other platforms that are out there. So, it’s a bit of a touch and go, I think.




So, speaking of those types of physicians that aren’t e-savvy, as you say, and aren’t adept at some of the digital technology out there, what should pharma industry try to do to help them?




That’s an interesting question. I would probably cross-examine the doctors and say “is there anybody in the household that is under 30?” Because they’ll step up to the plate and set you up instantaneously. It can work. I mean, I have colleagues who are in the mature years and yet they do have, whether it’s a nephew or a grandkid who kind of helps them set up, whether it’s Skype or something else.


There are probably other ways as well. For example, a lot of folks are now, even if they’re not so e-savvy, they’re used to email. If there can be a single link that comes on email, whether it’s Zoom or whatever, I think there are ways to reach out. For example, reps are very comfortable now with iPad detailing where the physician essentially sits passively and watches it. But the video stream is available anywhere and at any time.


I’ve often looked at this stuff afterwards, after the rep has left. So, all of that is available and if worse comes to worse, I remember we used to distribute those eCards where you actually take the thing home and stick it into your USB port and it kind of does it’s thing on it’s own.




So, great suggestions. Making it easy for physicians. Introduce a single link, available at any time, anywhere. So, what are you hearing from you colleagues? How do your colleagues stay connected in this one? Pharma may be able to introduce some of these technologies, but you ‘ve talked about that relationship of connecting with your peers. How is that working?




Well, I think it’s kind of like everything, it’s a bell curve distribution. There’s some early adopters as we say, high on the uptake. A lot of folks are on these various physician chatrooms, whether it’s Sermo, or some of the others. Others still seem to be technologically immune and fight it at all costs. You know, I still know doctors who say to me “I don’t even know how to turn my computer on. The secretary does it.” So it’s a dispersion.




I’m Peter Brenders and you’re listening to the NPC Podcast.


Is there something that Pharma can do to help physicians connect with their patients better?




Oh, certainly. I’ve suggested in-house to a number of, for example, colleagues and managers, territory managers and brand managers. I think it would be fantastic if pharma was able to, of course with all the appropriate consent from team, start sending email blasts, or perhaps from the physicians point of view, directly to patients.


We could get folks to sign up and it shouldn’t be a blast from the pharma company itself, it should be, for example, from me. But I would be very pleased to bless it from afar, curate it once in a while. I mean, you pick a disease: Type 2 diabetes, heart disease, obesity, which you know, is probably one complex disease in itself, as we call it the cardio metabolic syndrome, and send us the latest, send us a pep rally. Tell him to go get the FitBit, here’s another dietary suggestion, foods and availability of fruits, for example, change seasonally and so on.


I think that would be a fantastic opportunity. I mean, everybody else does it, you just have to look at the retail guys, whether it’s Bed, Bath & Beyond or BMO or Uber or who knows, they’re always doing the outreach to their clients.




Let’s talk a little bit about the future. We have confidence that a vaccine will come, that treatments will be available some day and that maybe we’ll start to see more in-person engagement, more in-person interactions. As we get to that stage, what do you think physicians are going to think about, what do they think will be the risks associated with future in-person interactions with pharma reps going from office to office, for example?




Again, it’s a touch and go answer, are we in a Trump-filled world or Trump-less world, that will probably dictate a lot. Obviously, we’ll have to follow the guidelines on-site, there’s big debate now, whether we’re going to send our kids to school or university or college in September or October, airlines, travel, it all really depends.


Who knows, maybe if the thing actually disappears completely, the time may come where we’re hugging our reps on site saying “welcome home, welcome back, thanks for the Starbucks”. On the other hand, if there’s some nasty second wave or perhaps even a build-up of this first wave, as Dr. Fauci keeps saying, you never know. There may be more continued social distancing and isolation.




Okay, I’m going to put you on the hot spot then. When do you see life returning somewhat to normalcy?




The day after the U.S. election.




Dr. Qaadri, last question. What more can be done? What can pharma do to step up in these Covid times?




Well, they might be able to, for example, ramp up some of the compassionate use for some of the newer medications that are out there. Whether it’s, for example, for high-grade cholesterol or obesity or diabetes management. There are a number of new indications, new medications, and if physicians have been a little bit absent from the field, we may not really be aware of those.


I’ve yet to have a pharma national brand manager take me up on the kind of e-detailing to patients. I know there’s all sorts of consent hoops that people have to jump through, but I think all of these will really be a part of the portfolio, part of the spectrum of outreach. Not only to physicians, but also eventually to patients. Maybe they can use some of the disease organizations that are already pre-existing to do the outreach itself.




Well, on behalf of the National Pharmaceutical Congress Podcast series, we’ve been listening to Dr. Shafiq Qaadri, a Toronto family physician, CME lecturer and four-term member of the Ontario Provincial Parliament.


I’m Peter Brenders. I hope you found this interesting.




Thanks to Dr. Qaadri and Peter for those insights. If you enjoyed this podcast, why not share it or the previous episode with your colleagues. You can find the link at soundcloud, podbean, castbox.fm or our website www.pharmacongress.info. While you’re at it, you might as well subscribe to the NPC podcast and have it sent each week to your phone or inbox. Sign up at soundcloud.com or pharmacongress.info.


Registration will open soon for the 14th annual national pharmaceutical congress, which begins Wednesday, October 21st, 2020. Save the date and watch the website for details at www.pharmacongress.info.


Keep sending us your questions by email to health@chronicle.org or by phone, 24/7 at 647-875-9011. We’ll keep the conversation going and keep looking for informed answers.


Next week, Peter’s guest will be Pamela Fralick, president of Innovative Medicines Canada. The NPC Podcast was presented in co-operation with Impres, Canada’s next generation commercial partner. Learn more at www.impres.com.


From Toronto, I’m Mitch Shannon of Chronicle Companies. Our line producer has been Jeremy Visser. Your announcer is Liona Void. Have a great week everyone and stay safe.