Tips for Selling to Doctors

 

An Interview with Dr. Bob Nelson; Atlanta GA; How Doctors Think August 15, 2013

I think you are correct as to the influences that shape doctor’s thinking.  Koch’s postulates of scientific reasoning and causes disease are very important.  More importantly, where does all the didactic teaching leads to as far as the thought process? 

When evaluating a treatment of new drug for example... most doctors want to know the treatment or intervention interacts or influences normal physiology, as well as how it impacts or alters the disease state.  What they are told or read, must jive with the current accepted understanding of the disease process.  The result of the treatment must be measurable with a verifiable outcome.  The outcome can take many manifestations, but mostly we want to see a measurable advantage in a patient’s health and well-being the “acid test” of efficacy.  The more anecdotal verifications of data that we receive in the form of the positive patient feedback, then eventually we validate the data as “real”.  Equally important is the therapeutic index, which is essentially the ratio of a good outcome compared to unfavorable or side effects; expressed as the toxicity dose 50 / effective dose 50.  The higher the ratio the better. 

 

The other issue that I (and many doctors) look at is the absolute vs. the relative effect of an intervention.  To determine these values, it is essential to know the prevalence of a disease or condition in the population you are studying.  This is a very important concept because most pharmaceutical data is presented as “relative risk reduction/benefit increase” as opposed to absolute risk reduction or benefit.  Knowing the absolute risk/benefit numbers is essential to determining the idea of the “number needed to treat”, which is essentially the number of patients you need to apply a treatment or invention to in order to have one good outcome  (or prevent one bad outcome).  For example, the relative treatment benefit of two different treatments for unrelated conditions might be 50%.  However, if the prevalence of condition “A” is 1% and the prevalence of condition “B” is 10% then I only have to treat 20 people with suspected “B” to benefit one person.  But, I would have to treat 200 people to benefit one person if trying to intervene in condition “A”.    So, if the prevalence of the condition is very low in the population, even a treatment with a very high relative benefit or relative risk reduction could require you to treat a very large number of patients in order to benefit one person.  This must be balance, of course, against the severity of the condition you are treating: mild, moderate, life-altering, or life-threatening, etc...

 

 

 

89% of doctors surveyed said they wanted more use of clinical studies in their interactions with industry representatives.  Doctors live and die by the clinical data and they need data to be able to make a decision to change to a new product or service.  Back in 2005 when the pharma sales force count reach over 100,000 we began to hire sales reps who were more marketers than scientists.  Doctors have been subjected to 30 second marketing pitches over the last decade and have been left feeling empty because they are not getting the clinical discussions they need in order to make an objective decision to change products or services.  Next sales call, use your time top present a clinical study rather than a sales aid. 

Doctors Want Less Mirrored Reps, but Will Give Time if You Add Value.

Based on past research, it is clear how doctors feel about the quality of the pharma sales force.  They want more use of clinical studies and evidenced based medicine in their discussions with industry representatives.  Basically they want more of a scientific discussion and less of a sales pitch.  Next let’s examine how doctors feel about the quantity of sales reps calling on their practice.   At its height, biopharma’s total sales force numbers reached up to 100,000.¹  The 10 to 20 percent reduction in sales force numbers over the last several years²  appears to be more in line with what physicians feel is appropriate for their practices.  In 2008 90% of doctors said they wanted fewer reps calling on their practice.  Today only 52% wanted fewer reps calling on their practice.  Physician’s attitudes towards mirrored or pod reps calling on their practice has remained steady at 75% of doctors wanting less or significantly less mirrored sales reps calling on their practice.  Why are doctors so united in wanting to see less reps calling on their practice?  To understand that we must understand the problems caused by multiplying the number of reps calling on a practice.

 

1.     More Sales Reps Added No Valued to the Practice                                                            When companies moved from 1 sales rep to 2 sales reps it meant that now a practice would see 40 reps a week instead of 20.  This increase put a strain on the office staff and caused many practices to stop seeing reps all together or limited their time to 90 seconds or less.  Doctors didn’t see this move as something that would better meet their needs; they saw it as an attempt to get a sales message in front of them more often.  There is no value to a doctor of hearing a sales message twice a month vs once a month.  Mirrored reps benefit the pharma company not the doctor or patient.

2.     Less Time Meant Less Science                                                                                                    When doctors began to limit the sales reps time to 90 seconds or less, there was no time to get into a clinical discussion.  Sales presentations became 60 second sound bites highlighting the products features and benefits that focused more on marketing and less on science.  Plus, in order to fill all those positions so quickly we hired reps with more of a marketing background and less scientific experience.  A doctor in a recent survey put it best, “We expect pharmaceutical representatives to better understand the medical practices we serve.”  “If they want to increase their time with physicians, they must deliver more targeted clinical information to meet physician’s needs.”

     

1 The New Sales Force. Pharmaceutical Executive, March 2009.

2 Tearing Up the Rule Book: Hay Group’s 19th annual Sales Force Effectiveness Study. Pharmaceutical Executive, February, 2010.

 Summary

Doctors do not want to feel like they are being marketed to.  They can smell a sales pitch a mile off.  I have worked with and for doctor for the last five years.  I can’t tell you the number of doctors that came up to me and said they didn’t like being sold to.  When I asked these same doctors to tell me about their favorite reps, they told me about reps who were friendly and provided a service to the practice.  Doctors don’t want to feel like they are being sold.  They want to feel like the rep calling on their practice genuinely cares about them, their staff and their patients.  Representatives who attempt to develop a relationship with their accounts and provide a value will see sales grow organically.  Doctors prefer a scientific discussion to a sales pitch and will give the time needed to listen to a rep present a clinical problem their product can solve.  When you have a relationship built on trust and providing value doctors will allow you to provide solutions to clinical problems they see every day.  Keep the doctor’s and patient’s best interest in mind and you will see your sales soar.