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Defining the boundaries of medical consultancy

Medical research often raises more ethical issues than any other research area and consultancy is no exception. Dr Craig Ritchie, who works with elderly patients with mental health problems such as Alzheimer’s disease (AD) and other forms of dementia, is acutely aware of this fact. When vulnerable people are involved, consultants must take extra precautions not to be influenced in the interpretation of data, or allow patient care to come second.

Dr Ritchie has worked as a consultant for a number of years, through a variety of posts at different universities. Now at Imperial, he continues working as a consultant both privately and through Imperial Consultants.

Most of his consultancy work involves advising on the plans for clinical trials of new drugs for treating AD. At this stage, the trial hasn’t got the go-ahead and Craig advises clients through report reviews and advisory boards.

Such pre-trial support can lead to further collaboration with the College. “At least one consultancy job has led to me being asked to be the Principal Investigator of an early-stage clinical trial. I am not sure if Imperial would have been involved had I not acted as a consultant at an early stage of the process.” says Craig.

Early-stage clinical trials involve finding out initially how safe a drug is and demonstrating evidence for its mechanism of action before testing it in a larger group to measure both side effects and clinical benefits.

Dr Ritchie spends half of his time working at Imperial and the other half working for the West London Mental Health Trust as a clinician to patients with dementia. His team are able to embed these early-stage trials into their clinical services, providing an extra therapeutic option for their patients.

The trials provide much-needed income for the Department. “They cover the cost of research, allowing us to employ people off-grant” explains Craig. “The College benefits from the interaction with industry and the income.”

Craig sees working with industry as necessary to achieve the goal of finding better treatments for conditions such as Alzheimer’s. The manner of the interaction with industry was one of the factors that attracted him to Imperial. Large collaborations with organisations such as GSK show that the College is serious about engaging with industry to move medical research forwards.

But medical consultancy isn’t always clear cut, and working with pharmaceutical companies isn’t seen as a good thing by everybody. However being open and upfront about your consultancy work often avoids any potential conflicts of interest. All consultants must obtain approval from their Department head for each job, as well as sign the College’s Register of Interests.

“Academics need to recognise the ethical issues involved in working as a medical consultant.” argues Craig “It’s vital to be explicit about the boundaries with the company from the beginning and define what they want from you. When that’s not thought about, then it can be potentially harmful.”

If you have any questions or concerns about consultancy, please contact us via email consultants@imperial.ac.uk or phone 020 7594 6565.