Richard Smith: Who are the “medcomms community?”

Richard SmithHave you ever heard of the “medcomms community”? I suspect not, but they are shaping your world. It might be worth spending two minutes reading this blog to learn more about this shadowy crew.

Uncharitably, unfairly, and inaccurately they might be described as a bunch of ghostwriters. More accurately they comprise an industry, probably worth billions, who help the pharmaceutical industry (and a few others) publish their scientific studies, assemble their evidence, and develop and disseminate a “story” around a product or some other objective of the company. They are not researchers or marketing or public relations people, although the latter two groups are keen to occupy the highly profitable space of the “medcomms community.”

I encountered this crowd because I was invited to contribute to discussions at their meeting in the Natural History Museum in Oxford, where more than a century ago Thomas Huxley and the Bishop of Oxford debated evolution, and the bishop asked Huxley whether it was through his grandfather or grandmother that he was descended from a monkey. Last week’s debate was slightly less heated, but I was there (unpaid except for expenses, I hope) in my usual role of naysayer.

Trevor Jones, a former director of the Association of the British Pharmaceutical Industry, a jolly cove, and “inquisitor” at the meeting, was blunt in saying that the world of drug companies focusing on doctors had gone, the image of the industry was tarnished with its employees ranked alongside estate agents and journalists and only just above bankers, and “direct to consumer advertising” was appalling. It isn’t, he said, that our world is changing, it has changed.

Leo Francis, president of the Publicis Medical Education Group, spelt out how the world of the “medcomms community” had changed and began by saying that the exclusive focus on the doctor was dead. Now the community must think as well about payers, regulators, and patients. One in five patient groups in the UK is providing care, he told us, and Alex Wyke, chief executive officer of Patient View, said that her organisation knew of 20 000 patient groups in the UK.

Much of the discussion was then about how the “medcomms community” might reach out to patients. The patients, of course, are not going to be able to pay, and so the funding will come from the drug industry. The industry recognises that politicians have to be interested in the views of patients and that patient reported outcomes are becoming more important. Perhaps this is another way for the drug industry to show the value of its drugs.

Some of those in the hall were already working with patient groups, but most doctors, I suspect will find it ominous and even threatening that the “medcomms community” is turning its attention to patients. Some in the hall said that patients didn’t want involvement by drug companies, but are we being too narrow minded? Might the community with its undoubted skills in presenting evidence and creating stories not have a creative role in improving partnerships among doctors, patients, payers, and the industry?

My conclusion was that the “medcomms community” needs to increase its credibility by finding customers in addition to the drug industry and preferably including some non-commercial customers. While it’s seen as a creature of the drug industry it will always be seen as tainted.

You can see videos of most of the meeting at

Richard Smith is a former editor of the BMJ.