EMSA OF THE FUTURE

Quote
emsa are physicians selling their professional credentials on behalf of stupid marketers. Think of it as work for hire with zero credibility and impact. They visit 2.2 customers per week.
 






Anonymous said:
EMSA is External Medical and Scientific Affairs. The "you people" you affectionately refer to are the RDMAs, RMDs, CSLs, Outcomes Res, Professional Affairs, Operations, Scientific Response and Exhibits. It is heavy with MDs and numerous others with scientific degrees. The general perception is if you are not a doctor there's no place to go within EMSA. A good number of these people, however, work with the teams to help develop or comment on strategy.

Also there are two surveys. One on engagement and the other on cultural assessment. The surveys results are not on EMSA but by EMSA.

There may have been one other group within the organization that was actually more pessimistic than EMSA that Merck can reclaim industry leadership, achieve strategic objectives and change the culture to become a high performance organization. Maybe you think Merck is headed in the right direction but people with medical and scientific backgrounds that work closely with marketing and senior leadership don't see it that way.

Industry leadership? Will this company ever get a new product approved? How do you become a high performance organization when there's less and less to sell? How's that NCM working out?

So yeah, given the makeup of EMSA, not surprising that they don't think much of senior leadership and their ability to bring Merck back to an industry leader nor think the executive committee is accountable nor think we have good divsional leadership.

What do you think?
Click to expand...



Well said.
 






Anonymous said:
EMSA is External Medical and Scientific Affairs. The "you people" you affectionately refer to are the RDMAs, RMDs, CSLs, Outcomes Res, Professional Affairs, Operations, Scientific Response and Exhibits. It is heavy with MDs and numerous others with scientific degrees. The general perception is if you are not a doctor there's no place to go within EMSA. A good number of these people, however, work with the teams to help develop or comment on strategy.

Also there are two surveys. One on engagement and the other on cultural assessment. The surveys results are not on EMSA but by EMSA.

There may have been one other group within the organization that was actually more pessimistic than EMSA that Merck can reclaim industry leadership, achieve strategic objectives and change the culture to become a high performance organization. Maybe you think Merck is headed in the right direction but people with medical and scientific backgrounds that work closely with marketing and senior leadership don't see it that way.

Industry leadership? Will this company ever get a new product approved? How do you become a high performance organization when there's less and less to sell? How's that NCM working out?

So yeah, given the makeup of EMSA, not surprising that they don't think much of senior leadership and their ability to bring Merck back to an industry leader nor think the executive committee is accountable nor think we have good divsional leadership.

What do you think?
Click to expand...

I think we are in a world of hurt. Overall survey results are abysmal. After all the burning bridges, one Merck, Plan(s) to Win, NCM, platitudes, passive agressive behavior and layoffs only half of the workforce is involved in turning this ship around and feel they are heard or have the capability to help. That's unchanged from last year and virtually unchanged from the benchmark. While there's significant disruption from layoffs, reorganizing and reducutions in resources there have also been unprecedented failures in the labs in getting phase III pipeline products to market with no accountability at the top.

To hide this mess and out of desperation they "reverse merge" with SP. You can read Hassan's history of selling companies and make your own determination if there's as much value at SP with in line and pipeline yourself. Desperate move for desperate times.

Oh, I almost forgot. With all the disruption and uncertainty the social programs like "Go Green" move on unabated. Despite paying engineers to properly design cooling and heating plans that have been working fine, Merck has decided to shut down selected cooling and heating units making the building hot, damp and generally gross in affected areas. Screw up numerous phase III compounds no problem! Bring a fan into your cube to cool down from the heat and humidity and security absconds with the fan and you get a warning. Heaven forbid you want to work with dignity and comfort.

Let me end with a question, does this instill confidence in you?
 






NO.

On the SP board they are saying TRA is a bust. Zetia and Vytorin contnue to fall. Remicade may revert back to J & J through arbitration and Dickie says it won't make a difference.

Remicade is 2 bil dollar drug. How can it not affect the value of SP? It's indicative of how desperate Merck.

Love the part about Merck saving money by not running the AC. Priceless.
 






Anonymous said:
NO.

On the SP board they are saying TRA is a bust. Zetia and Vytorin contnue to fall. Remicade may revert back to J & J through arbitration and Dickie says it won't make a difference.

Remicade is 2 bil dollar drug. How can it not affect the value of SP? It's indicative of how desperate Merck.

Love the part about Merck saving money by not running the AC. Priceless.
Click to expand...


This could be right out of Dilbert; don't know whether to laugh or cry.
 






I guess my issue with the leadership team in EMSA is that with the NCM and new rules of accountability being put in place to create this "high performance" organization - we finally have an opportunity to affect positive change in Senior Leadership. RKM and several of his direct reports are simply not effective leaders. Nothing against them personally, we just finally have some quasi objective data from Plan to Win and Dennison Culture surverys getting at what I think is part of the basic problem with the department: lack of trust in their ability to lead, and a strong fear of speaking up without fear of retribution, and a general lack of communication and perceived value of their work. This was the first time these department wide surverys were done and results were made public internally. A piece of our AIP bonus is tied to these results later in the year. So yes I am worried that nothing will change - the problem leaders will never change their behavior - it is more a personality issue and you can't teach how to relate, engage, motivate, and mentor employees. The attempts now by some of the leaders to do things differently are so obviously contrived and disingenious. People see right through this crap very quickly.
 






Anonymous said:
I guess my issue with the leadership team in EMSA is that with the NCM and new rules of accountability being put in place to create this "high performance" organization - we finally have an opportunity to affect positive change in Senior Leadership. RKM and several of his direct reports are simply not effective leaders. Nothing against them personally, we just finally have some quasi objective data from Plan to Win and Dennison Culture surverys getting at what I think is part of the basic problem with the department: lack of trust in their ability to lead, and a strong fear of speaking up without fear of retribution, and a general lack of communication and perceived value of their work. This was the first time these department wide surverys were done and results were made public internally. A piece of our AIP bonus is tied to these results later in the year. So yes I am worried that nothing will change - the problem leaders will never change their behavior - it is more a personality issue and you can't teach how to relate, engage, motivate, and mentor employees. The attempts now by some of the leaders to do things differently are so obviously contrived and disingenious. People see right through this crap very quickly.
Click to expand...


Comments made by A. Schechter in April, 2009 filed with the SEC:

...The second thing that we want to improve upon and use the integration to help us with is courage and candor, making sure that people are challenged status quo, that they feel comfortable, truly comfortable speaking up, debating what’s important, that people feel they have the opportunity to say what’s on their mind and challenge ideas, that we take appropriate risks, that we accept failure at times.
So, we’re really trying to make sure that as we build new processes for the integration that we build this mindset into the way we work every day. And I think if you look at some of the discussions that we’ve already had between Merck and Schering-Plough and Merck and Schering-Plough together, you’re starting to see people really challenge one another in spirited way, in a good way, respectful but being very upfront and honest about what people are feeling and what they’re thinking. And we’re going to continue to make sure that we have that type of process moving forward so that we really build in to the integration courage and candor...

"Spirited way"? Um, don't think so. I can just see my boss allowing that one. Right. And btw did anyone run this idea by Dick Clark and his six sigma team? The process for six sigma-ing spirit isn't in the manual.
 






Anonymous said:
Comments made by A. Schechter in April, 2009 filed with the SEC:

...The second thing that we want to improve upon and use the integration to help us with is courage and candor, making sure that people are challenged status quo, that they feel comfortable, truly comfortable speaking up, debating what’s important, that people feel they have the opportunity to say what’s on their mind and challenge ideas, that we take appropriate risks, that we accept failure at times.
So, we’re really trying to make sure that as we build new processes for the integration that we build this mindset into the way we work every day. And I think if you look at some of the discussions that we’ve already had between Merck and Schering-Plough and Merck and Schering-Plough together, you’re starting to see people really challenge one another in spirited way, in a good way, respectful but being very upfront and honest about what people are feeling and what they’re thinking. And we’re going to continue to make sure that we have that type of process moving forward so that we really build in to the integration courage and candor...

"Spirited way"? Um, don't think so. I can just see my boss allowing that one. Right. And btw did anyone run this idea by Dick Clark and his six sigma team? The process for six sigma-ing spirit isn't in the manual.
Click to expand...

Courage, candor, challenge people? Hey, where's my sales objective? It's middle of June and no sales objective - I thought I was in sales, I guess not.
 






Anonymous said:
emsa are physicians selling their professional credentials on behalf of stupid marketers. Think of it as work for hire with zero credibility and impact. They visit 2.2 customers per week.
Click to expand...

The survey results and these collective posting are indicative of failure of ESMA and leadership at Merck. It is amazing and telling that leadership will not take any action when colleagues taking risk to are provide such telling feedback....leadership is in lalaland!
 






The problem is that RKM is all about #1, games the system for himself and just going through the motions. He cares only for #1. RKM plays a nice game (surrounded by bunch of freaks). His usual pattern is to ask for input and then do as he pleases. He is a control crazy when it comes to bonus pay outs, ratings and yet paradoxically is clueless on what is happening on a day to day basis. Obviously lacks the leadership necessary to bring about candor, trust and developing integrated productive teams. The change cannot be ushered by just calling a meeting (going thru motions) and presenting the survey results and showing insincere sudden interest in what we have to say. It about demonstrating with actions and deeds which are difficult to deliver when you are dealing with his narcissist personality traits.
 












Anonymous said:
I guess my issue with the leadership team in EMSA is that with the NCM and new rules of accountability being put in place to create this "high performance" organization - we finally have an opportunity to affect positive change in Senior Leadership. RKM and several of his direct reports are simply not effective leaders. Nothing against them personally, we just finally have some quasi objective data from Plan to Win and Dennison Culture surverys getting at what I think is part of the basic problem with the department: lack of trust in their ability to lead, and a strong fear of speaking up without fear of retribution, and a general lack of communication and perceived value of their work. This was the first time these department wide surverys were done and results were made public internally. A piece of our AIP bonus is tied to these results later in the year. So yes I am worried that nothing will change - the problem leaders will never change their behavior - it is more a personality issue and you can't teach how to relate, engage, motivate, and mentor employees. The attempts now by some of the leaders to do things differently are so obviously contrived and disingenious. People see right through this crap very quickly.
Click to expand...

Merck's overall 2008 results show declines across all 12 measures since 2007. Miriam Graddick Weir stated, "this has been a challenging year for Merck, and our scores reflect that." What an epiphany!

Senior leadership sucks across Merck not just in EMSA. EMSA didn't make the decision to institute NCM and given the weak sales performance, doesn't appear to be a wise move. Forget EMSA, focus on the senior leadership that makes the boneheaded decisions that will cost you your job one day like the disasterous pipeline, failure to get compounds to market and reverse mergers that fool no one.

Things are so bad all across the company they are going to start giving away NMIP "points" so you can be as happy inside as the sales reps are outside. Miriam knows you'll be a "point whore" and morph into a high performing cog in Merck's wheel.

Also, please share your fears and stories of retribution. Can't say I've heard any through the rumour mill. Those seemed to end when Med Services and CDP were carved out.
 






I realize there are challenges across most parts of the organization, but the local environment is what tends to impact us the most. Tend to be influenced by our span of impact and control. We are all moving through our component pieces to create a high performing organization that hopefully and collectively will help move this company forward in the years to come. Where there is such a clear roadblock to this goal with the current EMSA leadership - that is a problem.

Regarding the post about "sales" and EMSA - remember the Medical Affairs function in Merck as with most big Pharma reports into Sales Management. Although we don't participate in the SIP (sales) bonus plan, our AIP EMSA bonus pool is directly and clearly impacted by McMahon's and USCO grid performance. So our ability or inability to meet the grid objective of becoming a high performance organization at the USCO level will DIRECTLY impact the USCO bonus pool for this year. And as much as EMSA is dragging all of USCO down on this metric our bonus opportunity will be negatively impacted unless something truly and fundamentally changes in EMSA.

Collectivley the vast majority of individual employess in EMSA are doing a great job IN SPITE of the leadership challenges. Imagine what could be done incrementally if all the negative influence at the top of EMSA was removed - not to mention the positive impact on retention of key talent.
 






Anonymous said:
You must be in the wrong area EMSA is not about sales objectives even though we report to sales area of the company.
Click to expand...

It's all about sales or products or lack of etc. Point was sales management is incompetent if they can't roll out sales objectives, one of the key things driving a sales area, by the middle of the year. Sort of like MRL not producing new drugs.
 












Read all the recent posts over the past several months. The best I can say is the mid-year review process is underway and we need to be able to provide open and honest feedback about EMSA Senior Management to effect any opportunity for change. McMahon cannot be blind to the survey scores and the negative impact that EMSA is having on USCO overall. The responsibility lies squarely with RKM's inability to lead. Period. Let's hope the message gets through loud and clear.
 






Anonymous said:
Read all the recent posts over the past several months. The best I can say is the mid-year review process is underway and we need to be able to provide open and honest feedback about EMSA Senior Management to effect any opportunity for change. McMahon cannot be blind to the survey scores and the negative impact that EMSA is having on USCO overall. The responsibility lies squarely with RKM's inability to lead. Period. Let's hope the message gets through loud and clear.
Click to expand...

McMahon is not blind. He has bigger problems impacting commericial operations than a support group like EMSA - poor sales performance. When Adam and Dick ask how things are going they're not asking about the number of Outcome Research studies, grants or the calls made by RMDs. They're asking about sales and unfortunately they've fallen off a cliff. Bob's got significantly more & more important problems than EMSA.
 






We must reinvent and change these practices or we will perish. This crap is still going on and leadership cntinues to look the other way. The commercial pressures are too over bearing.

Sen Grassley asks medical journals about ghostwriting
July 8, 2009 | Michael O'Riordan
Washington, DC - Sen Chuck Grassley (R-IA) has sent letters to eight major medical journals asking about their policies and practices regarding medical ghostwriting [1].

With letters out to the American Journal of Medicine, the Annals of Internal Medicine, the Annual Review of Medicine, the Archives of Internal Medicine, Nature Medicine, PLoS Medicine, the Journal of the American Medical Association, and the New England Journal of Medicine, the journal editors are asked about ghostwriting as part of a broader effort to clarify the relationships between industry and medical professionals.

Grassley, the ranking member of the Senate Committee on Finance, notes that his committee has been examining medical ghostwriting for the past year. The practice involves having review articles, editorials, and research papers drafted by marketing or medical-education companies, with prominent or academically affiliated physicians adding their names to the paper late in the process. As Grassley's letter notes, these physicians sign on despite a minimal contribution to the paper or even knowledge of the article's contents, including the underlying data and relevant documentation.

There are concerns that "some medical literature may be little more than subtle advertisements rather than independent research," writes Grassley. With these articles then having an impact on physicians' prescribing habits and the subsequent cost to the American taxpayer through Medicare and Medicaid programs, any attempt to manipulate the scientific literature is troubling, he adds.

In April 2008, Dr Harlan Krumholz (Yale University School of Medicine, New Haven, CT), along with lead investigator Dr Joseph Ross (Mount Sinai School of Medicine, New York, NY), reported evidence of Merck employees preparing manuscripts, sometimes in collaboration with medical publishing companies, and then recruiting academic physicians to be the first authors [2]. The paper, published in the Journal of the American Medical Association, offered a glimpse into the behind-the-scenes influence of industry.

"What I would like to see is a clear and explicit statement from the journals that if there is a circumstance where there is found to be ghostwriting, there would be some significant consequences," Krumholz told heartwire this week. "If a bunch of journals banded together and said if we find incontrovertible evidence of ghostwriting, and there would have to be some process for making that distinction, then that person would be banned from publishing."



Full disclosure


In his letter, Grassley asks the eight journals their position regarding the practice of ghostwriting, specifically if they have any written policies in place. In addition, he asks if the author is required to disclose the involvement of drug, device, or medical-education and/or marketing companies in the drafting of the article and how these relationships are disclosed to the public. Finally, Grassley asks the journals if they have taken action against an author for failing to disclose outside involvement with the drafting of a manuscript.

The journals have until July 22, 2009 to respond to the senator's questions.

Krumholz said that while defining ghostwriting might be open to some interpretation, the journals should aim for full disclosure of who was involved in the drafting of the manuscript and zero tolerance for failing to do so.

"The litigation has shown that people are approached, drafts are written, and they do some light editing, and it goes out under their name," he said. "It's not disclosed that this occurred." Full disclosure wouldn't preclude even heavy assistance from others or from medical writing companies, he added, but those involved need to be up front about their roles and the roles of third parties.


The issue of authorship has been in the news lately, including on heartwire, with allegations arising from a class-action lawsuit in Australia that prominent cardiologist Dr Marvin Konstam (Tufts University Medical Center, Boston, MA) did not significantly contribute to a 2001 rofecoxib (Vioxx, Merck) meta-analysis in Circulation [3]. Merck denied adding Konstam's name to the manuscript late in the process, with a Merck spokesperson telling heartwire that Konstam was involved in the design and authorship of the study and is considered an appropriate author. Konstam has also denied allegations of not being significantly involved in the study.

Contacted by heartwire, media spokespeople at the Annals of Internal Medicine and the New England Journal of Medicine said they are in the process of responding to Grassley's questions, and both directed inquiries regarding their policies of ghostwriting to their journal's websites. The Annals of Internal Medicine, for example, states that "authorship implies accountability," but also that "medical writers and industry employees can be legitimate contributors" as long as their roles, affiliations, and potential conflicts of interest are described in the submitted manuscript.

The New England Journal of Medicine requires all authors to attest to their contribution to the study, with an author defined by the International Committee of Medical Journal Editors (ICMJE). The ICMJE states that an authorship credit is based on substantial contributions to the conception and design of the study, the acquisition of data, or analysis and interpretation of the data. It should also be based on drafting the manuscript or critically revising it for intellectual content and should involve a final approval before publication.

Krumholz, who serves as editor of Circulation: Cardiovascular Quality and Outcomes, pointed out that the revenue generated from reprints of journal articles also places the journals in a compromised position. "It's another conflict of interest on the journal's part, because you're going to make a lot of money by publishing those articles," he said. "Not only has the company ghostwritten them but they're going to buy a lot of reprints to pass out."

Sources
1.Grassley C. Grassley asks top medical journals about ghostwriting [press release]. July 2, 2009. Available here.
2.Ross JS, Hill KP, Egilman DS, Krumholz HM. Guest authorship and ghostwriting in publications related to rofecoxib. A case study of industry documents from rofecoxib litigation. JAMA 2008; 299:1800-1812.
3.Konstam MA, Weir MR, Reicin A, et al. Cardiovascular thrombotic events in controlled, clinical trials of rofecoxib. Circulation 2001; 104:2280-2288
 












Anonymous said:
We must reinvent and change these practices or we will perish. This crap is still going on and leadership cntinues to look the other way. The commercial pressures are too over bearing.

Sen Grassley asks medical journals about ghostwriting
July 8, 2009 | Michael O'Riordan
Washington, DC - Sen Chuck Grassley (R-IA) has sent letters to eight major medical journals asking about their policies and practices regarding medical ghostwriting [1].

With letters out to the American Journal of Medicine, the Annals of Internal Medicine, the Annual Review of Medicine, the Archives of Internal Medicine, Nature Medicine, PLoS Medicine, the Journal of the American Medical Association, and the New England Journal of Medicine, the journal editors are asked about ghostwriting as part of a broader effort to clarify the relationships between industry and medical professionals.

Grassley, the ranking member of the Senate Committee on Finance, notes that his committee has been examining medical ghostwriting for the past year. The practice involves having review articles, editorials, and research papers drafted by marketing or medical-education companies, with prominent or academically affiliated physicians adding their names to the paper late in the process. As Grassley's letter notes, these physicians sign on despite a minimal contribution to the paper or even knowledge of the article's contents, including the underlying data and relevant documentation.

There are concerns that "some medical literature may be little more than subtle advertisements rather than independent research," writes Grassley. With these articles then having an impact on physicians' prescribing habits and the subsequent cost to the American taxpayer through Medicare and Medicaid programs, any attempt to manipulate the scientific literature is troubling, he adds.

In April 2008, Dr Harlan Krumholz (Yale University School of Medicine, New Haven, CT), along with lead investigator Dr Joseph Ross (Mount Sinai School of Medicine, New York, NY), reported evidence of Merck employees preparing manuscripts, sometimes in collaboration with medical publishing companies, and then recruiting academic physicians to be the first authors [2]. The paper, published in the Journal of the American Medical Association, offered a glimpse into the behind-the-scenes influence of industry.

"What I would like to see is a clear and explicit statement from the journals that if there is a circumstance where there is found to be ghostwriting, there would be some significant consequences," Krumholz told heartwire this week. "If a bunch of journals banded together and said if we find incontrovertible evidence of ghostwriting, and there would have to be some process for making that distinction, then that person would be banned from publishing."



Full disclosure


In his letter, Grassley asks the eight journals their position regarding the practice of ghostwriting, specifically if they have any written policies in place. In addition, he asks if the author is required to disclose the involvement of drug, device, or medical-education and/or marketing companies in the drafting of the article and how these relationships are disclosed to the public. Finally, Grassley asks the journals if they have taken action against an author for failing to disclose outside involvement with the drafting of a manuscript.

The journals have until July 22, 2009 to respond to the senator's questions.

Krumholz said that while defining ghostwriting might be open to some interpretation, the journals should aim for full disclosure of who was involved in the drafting of the manuscript and zero tolerance for failing to do so.

"The litigation has shown that people are approached, drafts are written, and they do some light editing, and it goes out under their name," he said. "It's not disclosed that this occurred." Full disclosure wouldn't preclude even heavy assistance from others or from medical writing companies, he added, but those involved need to be up front about their roles and the roles of third parties.


The issue of authorship has been in the news lately, including on heartwire, with allegations arising from a class-action lawsuit in Australia that prominent cardiologist Dr Marvin Konstam (Tufts University Medical Center, Boston, MA) did not significantly contribute to a 2001 rofecoxib (Vioxx, Merck) meta-analysis in Circulation [3]. Merck denied adding Konstam's name to the manuscript late in the process, with a Merck spokesperson telling heartwire that Konstam was involved in the design and authorship of the study and is considered an appropriate author. Konstam has also denied allegations of not being significantly involved in the study.

Contacted by heartwire, media spokespeople at the Annals of Internal Medicine and the New England Journal of Medicine said they are in the process of responding to Grassley's questions, and both directed inquiries regarding their policies of ghostwriting to their journal's websites. The Annals of Internal Medicine, for example, states that "authorship implies accountability," but also that "medical writers and industry employees can be legitimate contributors" as long as their roles, affiliations, and potential conflicts of interest are described in the submitted manuscript.

The New England Journal of Medicine requires all authors to attest to their contribution to the study, with an author defined by the International Committee of Medical Journal Editors (ICMJE). The ICMJE states that an authorship credit is based on substantial contributions to the conception and design of the study, the acquisition of data, or analysis and interpretation of the data. It should also be based on drafting the manuscript or critically revising it for intellectual content and should involve a final approval before publication.

Krumholz, who serves as editor of Circulation: Cardiovascular Quality and Outcomes, pointed out that the revenue generated from reprints of journal articles also places the journals in a compromised position. "It's another conflict of interest on the journal's part, because you're going to make a lot of money by publishing those articles," he said. "Not only has the company ghostwritten them but they're going to buy a lot of reprints to pass out."

Sources
1.Grassley C. Grassley asks top medical journals about ghostwriting [press release]. July 2, 2009. Available here.
2.Ross JS, Hill KP, Egilman DS, Krumholz HM. Guest authorship and ghostwriting in publications related to rofecoxib. A case study of industry documents from rofecoxib litigation. JAMA 2008; 299:1800-1812.
3.Konstam MA, Weir MR, Reicin A, et al. Cardiovascular thrombotic events in controlled, clinical trials of rofecoxib. Circulation 2001; 104:2280-2288
Click to expand...

how about.....Clifford J Rosen, Marc C Hochberg, Sydney L Bonnick, Michael McClung, Paul Miller, Susan Broy, Risa Kagan, Erluo Chen, Richard A Petruschke, Desmond E Thompson, Anne E de Papp, for the Fosamax Actonel Comparison Trial Investigators.
The ghost writers were anne de papp and the fosamax marketing team.
 






Top Bottom
Back
Quote