Resolutions

Don't try this at home. That ought to be the common lesson we draw from most examples of pharma's current performance in the public arena. Despite a series of political victories, the industry seems to save its most ill-favored face for the general populace.

A year that began with a pledge by companies to help fight worldwide disease and terror now ends with a queue of self-defensive gestures by PR-stricken executives. From newspaper reports to TV specials, from commentators throughout the political spectrum, criticism hits the industry on a near daily basis. Yet answers from industry emerge awkwardly or not at all. A mere handful of companies may stand in a negative light at any moment. But when even one company speaks, the public hears the industry's voice. And when a single company stonewalls, the public senses deception in all.

Still, the New Year demands a more positive proclamation-something that raises morale even as it implants realism. Resolutions do just that, though they also create internal standards perhaps loftier than any external actor could impose. Thus, for the new year of "ought three," here are a few "oughts" for the industry-principled actions to which companies and executives might well resolve themselves:

Listen to your greatest fans, and your worst critics-patients. Okay, people can often seem blind to your products' value and downright superstitious in their belief in alternatives. They can also organize, educate, and focus on their conditions in the most sophisticated ways, sparking great opportunities for treatment breakthroughs and alerting companies to competitive advantage. Reject the one, and lose the other. You might as well accept patients for what they are. Then, listen closely, consider carefully, and respond constructively.

Make friends with the media. Companies reflect the personalities of their top executives, and most executives in this industry seem especially media shy. Perhaps they've bought all the stories about the "liberal" press and so give up before they even start. Some bypass the business press as well. Journalists are generally more curious than critical, but if you stonewall them, they'll only dig deeper.

Consort to address common issues. When one company stumbles, it must right itself. When the entire industry falls from grace, at least it has an association or two to defend it. But when a segment of companies runs into trouble, it's a free-for-all; no mechanism for dealing with the matter exists. Companies under a common threat-such as the latest furor over diuretics versus other antihypertensives-make natural allies but must carefully avoid antitrust issues. In an independent, even temporary, consortium they may find more cohesive ways to respond.

The foregoing "resolutions" all boil down to a simple algorithm: Listen, Relate, and Act. They also imply deeper principles of effective communication. If something makes you feel either defensive or offensive, look for a third alternative. Avoid dividing the world into saints and sinners. Internal lessons follow as well: When hiring, seek the sincere, though imperfect, candidates who will contribute ideas as well as follow policy. Temper theory with reality-allow the stars to shine among the teams.

Some problems defy solutions, but that doesn't mean we should stop thinking about them. Perseverance furthers. And in this world, a resolution is better than no solution at all.