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msJAMA
May 6, 1998

Everywhere and Then Some: Physicians Making Careers in Biopharmaceuticals

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JAMA. 1998;279(17):1401. doi:10.1001/jama.279.17.1401-JMS0506-5-0

Physicians from disparate fields are found throughout contemporary pharmaceutical companies, as well as throughout many biotechnology companies.

The opportunities for physicians are tremendously varied and often form-fitted. Depending on their interests and abilities, physicians may work in a variety of positions, including that of bench scientist, medical support provider, and administrator. Many devote the majority of their time to clinical and scientific responsibilities, ie, designing new studies, writing protocols, initiating and monitoring studies, interpreting data, preparing medical reports, extrapolating results, and developing a clinical strategy to bring a new drug or new indication for an existing drug forward.1

These responsibilities reflect many of the factors that attract physicians to the industry in the first place—a research career with ample resources, the use of special skills, a desire for change and challenge, an interest in pharmaceuticals, and a desire to contribute to development of new drugs.2 Naturally, there are lifestyle issues that motivate industry physicians as well, the most important of which are regular hours, remuneration, and career flexibility.2 A physician entering the pharmaceutical company at an entry level position can expect to earn $110000 to $120000 plus bonuses and benefits during the first year.3 Salaries advance proportionally. For example, pharmaceutical neurologists receive on average 20% more than those in equivalent academic positions, in addition to stock options and bonuses.4 Careers in the biopharmaceutical sector also have the advantage of opportunities to travel, to attend medical and scientific meetings, and to be involved in a variety of career settings.

There are, however, several factors that may deter a physician from entering the field. A survey in 1991 of pharmaceutical employees with MD degrees revealed several reasons for job dissatisfaction; these included bureaucracy, ethics being subverted for profit, autocracy, favoritism, and restrictions on initiative and responsibility.2 Subtle cultural issues are also involved. While the concept of MDs working within the pharmaceutical industry is gaining acceptance among physicians, there has long been a sense of mistrust of the industry that has kept some from making the transition.3

Another limiting aspect is the level of competition for highly coveted positions in the biopharmaceutical sector. Greater numbers of physicians are applying for these positions. Because the cost of discovery and development of a new pharmaceutical drug can total $100 million to $200 million or more,5 pharmaceutical and biotechnology companies are careful to hire only the most qualified applicants.

These industries seek in their physician employees varied and demanding qualities. Specialized knowledge is one. While generalists usually fill the niche of helping companies learn to deal with and interact in the changing world of managed care, subspecialist internists are the population from which most physicians are hired.3 For example, several of the largest drug companies, including Novartis, Merck, Bristol-Myers Squibb, and SmithKline Beecham, have significant research efforts under way in several areas relevant to the aging segment of the population and will need gerontologists as part of that effort. Tremendous advances in the development of novel neurotherapeutic agents, largely derived from biotechnologic advances in molecular biology and genetics, have expanded the pharmaceutical need for clinician-scientists with experience in neurology.4 Similar scenarios exist for specialists in oncology, virology, pain, epidemiology, respiratory disease, and infectious disease.

Experience with patient care may be the most unique and indispensable skill that MDs have to offer. This is an element most research scientists lack: actual experience with the kinds of people who might be administering or taking the drug in question. In business parlance, MDs speak the language of the clients—in this case, of both patients and other MDs. Still other MDs have had experience managing an office or a medical department or a clinical study.

Finally, MDs generally have extensive backgrounds in anatomy and physiology, and often are a part of the interdisciplinary teams that prepare a compound for clinical trials. They know enough science to understand the goals and procedures of the project, and their understanding of the relationship between medicines and organ systems helps bridge a crucial divide between the creation of the compound and its testing in humans. Classical physiology may become much more important to biopharmaceutical companies in the next 10 years as the Human Genome Project advances. This will require a shift from modern molecular biology back to classical physiology, employing genetic as well as surgical and chemical variables.

Physicians possess many attributes that cannot be provided by nonphysicians. At the same time, the opportunities that biopharmaceutical companies offer can be attractive. As physicians struggle with the economically driven vagaries of a modern medical career, they may find a comfortable and productive alternative in drug development.

References
1.
Spilker  B Career opportunities for physicians in the pharmaceutical industry. J Clin Pharmacol. 1989;291069- 1076Article
2.
Shaw  L A misunderstood specialty: a survey of physicians in the pharmaceutical industry. J Clin Pharmacol. 1991;31419- 422Article
3.
American Medical Association, Leaving the Bedside: The Search for a Nonclinical Medical Career, Revised Edition.  Chicago, Ill American Medical Association1996;
4.
Peroutka  SJ Role of neurologists in the pharmaceutical industry. West J Med. 1994;161328- 330
5.
DiMasi  JHansen  RWGrabowski  HGLasagna  L Research and development costs for new drugs by therapeutic category; a study of the US pharmaceutical industry. Pharmacoeconomics. 1995;7152- 169Article
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