Thursday, August 02, 2012

Professional Association versus Trade Association

Would the AMA be more like a trade association if they suddenly began admitting drug company representatives as AMA members with the full membership rights to vote, be committee members and become members of the executive board? Why not? It’s the “American Medical Association” not the American Doctor’s Association, right? So anybody interested in medical things ought to be able to join, right? So why can’t drug reps and medical supply reps join that organization? Interestingly, the doctors have begun to see the ethical problems posed by their longtime close relationship with the drug company reps, and painfully begun a separation process (see NY Times article from 2007).

Would the AALL be more like a trade association if we changed our bylaws so that vendor reps had all the membership rights that librarians have? Would the antitrust issues that the specialist lawyer spoke about, concerns over price-fixing and rigging markets become more of a concern with an association if the consumers as well as the providers were full members of the association? Maybe we already have become more like a trade association and just didn’t notice.

I don't know if we need a scandal or some big books to wake us up to the problems that we have between law librarians and our vendors and publishers. We depend on each other, just as doctors and drug companies do. But there needs to be a bit more arms' length, and bit more care about the appearance, as well. And it gets difficult to maintain both the arms length and the appearance when everybody is a member of the same association and everybody is on the decision-making, even when they can be pressured, subtly or not, by their employer, against their own better judgement.

I like and I respect as individuals many colleagues who work or have worked for vendors. It does not make a librarian (or non-librarian) a bad person to work for Lexis or Thomson-West or any other vendor or publisher. But I can see very easily that if I worked for one of these outfits and then I were on a committee at AALL, and my boss came to me to lay some pressure on me about an outcome, I might feel a lot of concern about my job and my family! How much more would this affect our association if the position were on the executive board?


KenHirsh said...

Your question is both good and a fair one to ask. My impression of the long-time problems caused by the relationships between physicians and pharmaceuticals is that the patient is taking the physician’s advice without knowing about pharma’s influence on that advice, and the physician’s reliance on scientific studies that may not have been conducted objectively. These problems primarily arise from two activities: doctors’ receipt of free products to dispense to patients and their receipt of compensation in cash or kind (e.g., trips); and doctors/scientists conducting studies that are funded by the maker of the product under study without disclosure of that fact.

If a vendor employee becomes a fully qualified member of AALL, it is the usual case that the identity of member’s employer is publicly known. In fact, I think that we could both name the employer of every AALL member with whom we are well-acquainted. So I do not worry about this issue – when listening to the opinion of a vendor’s employee, I will take the fact of that employment into consideration when calculating how much weight to give to that opinion. Likewise, I would consider that fact among the issues I think about when deciding whether to vote for that member or to support their actions as an officer.

I think the bigger issue is one you have correctly called out – our inability as an association to deal fully at arm’s length with vendors. The association relies heavily on vendors for financial support. Well known examples are publication of the membership directory/handbook, sponsorship of the annual meeting, including events held by chapters and special interest sections, and donations to scholarship funds. The ethical impact of the effects of this support is a problem that is difficult to address, but one we must all try to discuss thoroughly. However, I do not believe that allowing vendor employees to be fully active members changes this issue from its present impact.

Betsy McKenzie said...

Hi, Ken! Thanks for your excellent comments. I think there are some messier things going on as well. For instance. There was a CRIV meeting that included a CRIV member who is a vendor rep. Not everybody knows who all is on the CRIV at all times. But that rep changed the direction of the conversation as they discussed a policy. Not necessarily the end of the world. Maybe it was a good thing to have a vendor's viewpoint. But on the other hand, how many members know that the policy was informed with that input? Betsy