When the hospitality stopped, our medical education had to begin
The campaign against corruption in Chinese medicine did not end medical education. It showed how much of what the industry called academic promotion was buying access, and it gives companies a reason to fund teaching that doctors would attend without the meal.
For twenty years the Chinese pharmaceutical industry described much of its hospital promotion as academic. A company would sponsor a department meeting: a specialist from another hospital gave a talk, the department's doctors attended, there was a meal, and the speaker received a fee. Multiply that by thousands of hospitals and dozens of companies and you have one of the largest continuing-education systems in the country, financed almost entirely by the people selling the medicines under discussion.
From mid-2023 a campaign against corruption in medicine, led by health and disciplinary authorities, changed that system faster than any guideline had. Hospitals restricted visits by representatives. Many companies suspended meetings while they waited to see what would be permitted. Some doctors, especially in smaller hospitals, said they had lost their main source of updates on new treatments, and I believe them. But I have reached a conclusion that some colleagues in the industry find uncomfortable: the campaign did not destroy medical education. It showed how little of what we funded was education in the first place.
What the meeting budget was really buying
When I joined Tanqiao in 2021, marketing controlled RMB 640 million a year of what we called academic promotion, most of it spent on about 3,800 department meetings. Every meeting had an agenda, an attendance list and an invoice. Very few had a written reason why those doctors needed that talk at that time. When we analysed two years of records, we found that around 400 doctors received over a third of all speaker payments, and that the departments hosting the most meetings were, almost exactly, the departments buying the most of our medicines.
None of this was necessarily improper in each individual case. A respected specialist teaching colleagues is valuable, and a fair fee for preparation and time is reasonable. The problem lay in the pattern. When meetings are chosen by sales value, speakers by influence and frequency by quarterly plans, the budget is buying access and goodwill, and the teaching is incidental. Doctors understood this better than we did. Many attended for the meal and the company of colleagues, and learnt little they could not have read in a guideline.
There is a test I now apply to any educational spending. Would the doctors attend if there were no meal, no travel and no fee for anyone except the teacher? Would the company still fund it if it could not choose which hospitals received it? If the answer to either question is no, the spending is promotion, and it should be judged as promotion: by its accuracy, its balance and its cost.
Moving the money out of marketing's hands
In July 2023 I proposed that Tanqiao end marketing-sponsored department meetings entirely. We did not freeze them; we closed the programme. Of the old budget, RMB 230 million moved to medical affairs, to be spent on scientific exchange with a documented need and approved by medical rather than commercial staff. Speaker fees followed published bands based on role and preparation time, and no speaker could receive more than ten paid engagements a year from us. We funded an accredited online curriculum through the Yuequan Dermatology Teaching Society, which chooses its own faculty and content, and our funding is disclosed on every module.
The cost was not trivial. Our head of sales opposed the change, because meetings were the main reason his representatives were welcome in hospitals, and he was right that some of them lost that welcome. Two regional sales directors left. Sales of our hospital generics fell below plan in the second half of 2023. For three months many representatives had little to offer a doctor, because we had closed the old programme before training them for the new one. That sequencing was my mistake.
The deeper argument for moving the money concerns power. A marketing function that controls the sales materials, the incentives and the education programme decides what doctors hear about a disease, not just about a product. Separating those powers is not a gesture to regulators. It is the only arrangement under which a doctor has reason to trust the teaching, and under which a company can defend it when asked.
Measuring what doctors learn, not who attends
The old system measured attendance, because attendance was what the meeting was for. If education is the purpose, the measure must be learning. Our online curriculum asks doctors to complete short case assessments before and after each module. The society, not Tanqiao, holds the results and reports aggregate changes to us. By the end of 2025, 41,000 physicians had registered, about a third of them from county hospitals that our meetings had seldom reached, and average scores on case questions about safety screening before a biologic rose by about a quarter after completion.
These measures are imperfect. Online assessments can be gamed, and a better score on a case question is not proof of better prescribing. But they ask the right question. A company that funds education should want to know whether doctors understand the disease better, including when not to use the company's own medicine. If the only measure is reach, the programme will drift back towards the doctors whose prescriptions matter most to sales.
The field force has to change too. A representative's legitimate role is to give accurate product information and to connect doctors with medical colleagues when questions go beyond it. That is a smaller and more demanding job than the one many representatives were hired to do. At Tanqiao every specialist representative now passes an assessment on the disease, the trial data and the limits of permitted claims before visiting a hospital, and incentives include the quality of those visits as judged by managers, not sales alone.
I do not want to pretend this is costless for medicine. A doctor in a county hospital who used to hear a visiting specialist twice a year may now hear nobody, unless an online course or a professional society fills the gap. That gap is real, and companies that financed the old system carry some responsibility for funding independent replacements without controlling them. Our spending on promotion and education fell from RMB 640 million in 2022 to RMB 260 million in 2025. Part of what we saved should go back into teaching we cannot steer.
The industry described the campaign as a shock. For companies that relied on hospitality, it was. For doctors and patients it was a chance to discover what medical education looks like when nobody is buying the meal. I would rather Tanqiao helped to build that than waited for the old model to come back.