Understanding the wants and needs of a burgeoning group of thought leaders operating within the growing healthcare markets of South East Asia is a crucial first step on the path to engage with them.
“I never use this treatment. I tell my staff never to use it”.
A Taiwanese specialist used his halting English to share his opinion with me, a facilitator for a roundtable consultancy meeting.
I glanced around the room to the other advisors. One, an Indian doctor in his late 30s, gave a discrete shake of his head “Move on; he’s an outlier; he won’t change his mind”. A young Thai physician sitting alongside raised his eyebrow a half-millimeter to indicate the same. “Move on”.
The young and upwardly mobile
This meeting was an encounter with a core of Asia’s young ambitious rising stars. They had a robust grasp of clinical practice, the literature, and global opinion trends. Stepping back we can see in roundtables, advisory boards, and similar venues how these burgeoning thought leaders function in Asia.
Our young Thai was there by grace of his boss, who mandated that he attend as well. The rising star, a smart, talented, yet otherwise unassuming oncologist and his Indian peer disagreed with the Taiwanese gentleman who was undoubtedly their senior. But they would not challenge his opinion openly. Hierarchical norms were observed, with deference and respect.
The deference spectrum
On a spectrum of deference to seniors, bench scientists in the West exist at one extreme: their truth lies in the data irrespective of established pecking orders. Clinicians in the West are somewhere in the middle, necessarily so, because clinical practice is an amalgam of evidence and experience, of science and art. Physicians in Asia exist at the other extreme. Hierarchical norms are deep-rooted and vary along geocultural lines. In Asia, Confucianism looms large and shapes professional interactions, both formal and informal [1].
Recognising cultural differences in professional decorum is an essential first step toward engaging rising stars. Industry should take note since their ascent holds considerable promise for clinical research and education. Opportunities abound to enhance, extend and develop their relationships with senior colleagues. Like their more influential colleagues, rising stars are keen to publish, lecture, and participate in clinical studies. For many, however, the barriers to entry appear formidable and career progression frustratingly slow [2].
Living in isolation
Indeed, the steady growth in private sector health in Asia [3] is both an opportunity and challenge. Private practice can be professionally isolating for many physicians. Against this backdrop, industry’s role should be to offer the region’s rising stars the knowledge, tools, training, and platforms on which to develop their careers. A sense of structure to facilitate engagement with the clinical community is necessary though not sufficient. Many young physicians lack formal training on the design, conduct and communication of clinical research. And as market access and reimbursement issues intensify, physicians increasingly need a broader understanding of the real world value of current and emerging diagnostic and treatment modalities.
As ever, the success of physician outreach efforts is predicated on clearly defined objectives. Establishing an informal network of physicians in Asia, for example, is but one goal shared by pharmaceutical stakeholders.
Len’s fish
The respective strategic roles of old and new media, however, are subject to considerable debate. Certainly, physicians in East Asia are interested in online social networks [4], and opportunities to engage rising stars through this medium will evolve over time. However, Len Starnes’ mantra to “fish where the fish are” [4] should be heeded: if you build communities de novo, they may not come. As of late 2011 our own research suggested Smartphone penetration among young physicians in Asia was about 50 per cent, and equally distributed between iPhone, Android and Blackberry [5]. Clearly such fragmentation requires judicious use of mobile.
Physicians, like Dr Yeo Sow Nam, a pain management specialist in Singapore [6], and Dr. Iskandar Firzada Osman, an internist and blogger in Malaysia [7] need little encouragement to exploit the tools of old and new media. For others, targeted training in developing public profiles can mean the difference between career progression and stagnation.
Asia provides a window into a future for the West in which careers in medicine will be more competitive and less financially rewarding. As a Singaporean colleague once said “Ang Mohs [8] have had their day in the sun. They must learn from us now”.
Author: Nick Willhoft, PhD is managing director, Europe and Asia Pacific at Noveida Health and can be reached at nwillhoft@noveida.com
1. Bloom, I. Introduction to Confucian Thought. 2009 [cited 2011 December]; Available from: http://afe.easia.columbia.edu/special/china_1000bce_confucius_intro.htm.
2. Feng, Q., Professional and Career Satisfaction: A Questionnaire Survey of Singapore Doctors, in Faculty of Medicine. 2004, National University of Singapore: Singapore. p. 75.
3. Ang, S., Health Financing Country Profiles 1995-2008. 2011, WHO.
4. Starnes, L. Fish where the fish are. 2011 December 2011]; Available from: http://www.slideshare.net/lenstarnes/fish-where-the-fish-are-increasing-reach-and-influence-through-physicians-social-networks.
5. Noveida, Survey of attitudes among 63 gastroenterologists attending a conference in Taiwan. 2011.
6. Nam, Y.S.; Available from: http://www.painspecialist.com.sg/eng/profile.asp.
7. Leokid. Leokid’s life. 2012; Available from: http://leokid.wordpress.com/.
8. Anon. [cited 2011 December]; Available from: http://www.singlishdictionary.com/