Tuesday, August 18, 2009

Veering, steering madly across the sun

It's kind of been a while since my last post. I had to delete the last one, but I'm ready to post again. Below is a personal mission statement that truly reflects where I want my career to go. Although it may not appeal to everyone, it is a candid representation of how I feel.

I initially went into pharmaceutical advertising with the intent of helping people. As a medical copywriter, my job was to pull data from unabridged clinical study reviews (CSR) and create meaningful messages that physicians would find both relevant and compelling. (This included determining statistical significance by finding the CI percentages and p-values in the raw data.) The primary goal for these messages was to convince physicians to prescribe more of the medication we represented. Through this incredible experience, I discovered a strength and passion for interpreting data and understanding patient perspective.

I observed several market research focus groups in four cities on patients with COPD (Chronic Obstructive Pulmonary Disease; most often the result of long-term tobacco smoking) designed to prepare us for the anticipated approval of a COPD indication for the drug I represented (Drug A). The purpose of the trial was to find out what specific symptomatic relief patients looked for in a COPD medication. Since Drug A is a maintenance medication, we wanted to know how this maintenance asthma medication could be beneficial for COPD patients.

Patients did more than recite a list of physical symptoms. They yearned to reach out to us about their disease on an emotional level, which we were unprepared to document. While it was frustrating that we weren’t getting the answers we anticipated, I was fascinated by the large number of patients, who offered us candid details about their disease.

In an attempt to determine whether COPD patients would fill their expired prescriptions, we probed them on why they would allow themselves to get so sick without seeking medical help. Most patients expressed an overwhelming sense of regret, because they were responsible for this self-inflicted, irreversible disease. They felt that after years of ignoring medical advice to stop smoking, physicians thought they deserved to die. Failure to treat their symptoms had led to a rapidly advancing disease. Although we were failing to fulfill our intended research, these data explained why so many COPD patients advance so rapidly in their disease despite available treatments. Later on, when we were searching through one of the CSRs, I noticed that patients with 190-pack-years had the same initial FEV1 levels as patients with 40-pack-years. These two incidents suggested that several other factors (behavioral and genetic, respectively) contributed to disease progression in patients with COPD, and I was eager to find out more.

When the market research trials were over, I decided to shift my profession to a field, which, first and foremost values appropriate patient care, even if it would cost me considerable income. I want to move my career in a direction where I can run trials that research other factors that affect disease progression in patients with COPD. I have decided that pursuing a career as an Epidemiologist draws the most parallels to what I wish to do—applying my background to finding correlations within clinical data and using those findings to benefit the patient.

I want to pursue my Masters of Public Health with a concentration in Epidemiology (and later a PhD), because I know I need more resources and educational tools than my background in advertising can provide.

I’m eager to obtain the necessary tools that will enable me to run flawless, reputable studies exploring possible genetic factors that can explain why some patients are more structurally resilient/elastic than others. With this degree, I also hope to become involved with the endless efforts of the Center for Disease Control and Prevention (CDC). Working with the CDC and learning how they follow prevalence and record statistics of diseases and behaviors will influence the measures and statistical models that should be used for future studies.

Additionally, although my desire to reach out to patients with COPD is deep-seated, there are several other areas of public health that I’m eager to explore and delve into. My experience in pharmaceutical advertising has exposed me to only a few examples of how patient care extends beyond prescribing medication, and I’m looking forward to expanding my knowledge of disease prevention in other fields as well. My goal is to find an academic program that will allow me to make a smooth transition from a profession that values a brand to one that values the consumer.