Is the role of the medical rep doomed?
Posted 27th October 2009 in Articles, Commercial | 16 comments
Peter West
Wyeth Europa
One could be forgiven for thinking that the medical rep is about to be added to the World Wildlife Fund’s list of endangered species.
The pharma industry is awash with talk about the inevitable doom facing the medical rep. They speak of the medical rep as some outdated, outmoded, non-thinking, inflexible, creature. A modern-day Dodo that cannot adjust to the changing environment around it.
I wonder whether this is really true?
The pharma business environment, like any other business environment, has evolved over recent years. Most pharma companies had not fully anticipated the scale of this evolution and have found themselves reacting to change rather than leading it.
Faced with reduced access to their prescriber customers the pharma industry’s reaction was not to try and understand why access was falling and address the root cause, but rather, to create additional trading faces to give them more opportunities for access.
In the UK, the blame was laid at the door of change in the political environment:
‘GPs were now too busy with GP fundholding - their administrative load had increased - and therefore they had less time to see reps. They were forced to have a minimum number of patients on their list so they had to amalgamate into group practices - spec calls had declined and long-term appointment systems were making access more difficult’.
“The pharma industry is awash with talk about the inevitable doom facing the medical rep.”
Notwithstanding these factors had a bearing on accessibility, the real issue was that GPs were getting less and less value from their interactions with medical reps and other sources of product information, like the internet, were beginning to fill the gap.
Even now, we have not addressed the issue of providing value to our customers - and the possibilities of internet marketing are still in their infancy. At least, perhaps, we are starting to focus on these two critical areas, but we have a long way to go.
When we speak of “value” we need to understand what that actually means to our customers. And even before that, we need to understand who our customers actually are.
Has there been any objective study of what constitutes “value” to our complex range of customers? What is “value” to a payer, compared say, to “value” to a prescriber? Are there some areas in common that we can explore? And what about the areas of difference? Are we tailoring our approach from one customer group to another? Or are we trying to provide a “one-size fits all” solution? Do we know what we already have that would be valued by our customers?
The facts are that the complexity of our customer base has increased significantly. No longer are we dealing mainly with prescribers, but also with policy makers, payers and patient-groups as well. This calls for a radically different approach.
In recent years many of our medical reps have evolved into Health Care Development roles. Apparently they focus on the payers and policy makers to create a more favourable environment in which to market our products. What is their offering - pharmacoeconomic data about their company’s drugs? Is that what these customers want?
“In any kind of relationship – business or social – trust is paramount.”
How many of these people have any first-hand knowledge of working in a payor or policy-maker capacity? Do they understand the objectives, needs and concerns from their customers point of view?
In any kind of relationship - business or social - trust is paramount. I suggest we would have a better chance of building this trust if the people we sent to see payors or policy-makers came from a similar background and were able to empathise with their situation to find common solutions.
We are, after all, not merely providers of medicines - but providers of healthcare solutions. We would do well to focus on this.
So where does all this leave our poor, beleaguered medical rep?
I believe the medical rep still has a critical role to play. Even in this world of communication explosion the value of face to face, human to human, communication is important.
But our medical reps must be able to provide knowledge and information that isn’t readily available from elsewhere. They must facilitate dialogue, not monologue. And they need to be properly equipped to do their job.
For this to happen the pharmaceutical industry needs to focus on a customer-centric strategy, in which medical reps play a key role and are fully supported by their companies to do so.
About the author:
Peter West is Senior Marketing Director, Infectious Diseases at Wyeth Europa, based in the UK.
For enquiries, please email westp2@wyeth.com
27th October 2009, 18:46
In its current form, yes they are doomed unless they change and adapt. I see the future for reps as being an information facilitator whereby they will have the technology to provide the prescriber with the information they need very quickly, but not necessarily have all the answers themselves.
28th October 2009, 21:10
Delta,
thanks for responding.
Some further questions then, for all to respond to perhaps...
who's responsibility is it for the medical reps to change? Theirs soley? Their employers? Both? What contribution should each party be making to this change?
are medical reps only suitable to be targeted at prescribers, or could they manage a wider customer remit than this?
29th October 2009, 10:00
Peter,
Excellent article. The human contact is indeed irreplaceable. The work we are doing at MedRep is based on a social model of learning - where she who delivers the content is more important than the content itself. I think that pharmas have a golden opportunity to leverage their reps as a force that helps doctors connect with trusted sources of knowledge. This is not surreptitious/subliminal marketing messages inside doctor portals like Sermo but on the table use of social software to help reps provide doctors with the science they need in as little time as possible.
Regarding responsibility for the change - I think pharmas must lead. I am a great believer in making the technology go away and providing simple, easy to use tools that will enable pharmas to make a series of small, easy to swallow, incremental changes to a new sales model.
At Medrep we are working to make this happen.
Best regards
Danny Lieberman
unified communications platform (as cisco calls it) or a social learning software platform (as we call it at Medrep).
30th October 2009, 16:52
Pete - I think responsibility has to rest with the employers. Reps tend to behave in a way driven by their training and incentivisation.
The real challenge here is that the role of a rep is a junior position and the good ones tend to quickly move into sales management or more strategic roles. Kind of perverse when you think that reps are the main point of interaction with the customers. Maybe the role should be incentivised and viewed as the more senior role it should be.
2nd November 2009, 04:13
Peter- I am a representative currently, and have been aggressively trying to find the ways in which our industry can adapt to bring value, and gain back a long lost respect between rep and provider. Our current model still only focuses the reps on the "top prescribing" doctors and therefore they disproportionately spend there time and energy on these few providers. There is no room in ther "call plan" for commulity based outreach, companies fear HIPPA so they do not allow reps to conduct community education events, and marketing budgets get wasted on lunch and dinners that few providers attend. If we took some of this time and money and shifted it to a "disease advocacy budget" and allowed reps to support community outreach/education programs more easily and even to organize them with the support of the doctor or hospital we could be seen assupporting their interests. If we truly put the patient first and showed it through our actions we would begin to become a partner in the system. Just like a personal relationship when you get caught lieing and cheating like the industry has so many times, it becomes difficult to win back trust.
5th November 2009, 11:50
Glycine11,
This is a very important approach and well-needed especially by patients with multiple issues and care-givers as noted by Tim Rothwell from Sanofi-Aventis. I talked about this in my blog post http://www.software.co.il/wordpress/2009/06/pharmas-and-social-networking/
Drop me an email to dannyl at medrepnet dot com and I might be able to help you
Best regards
Danny Lieberman
7th November 2009, 08:55
Nice to get a response from a representative - thank you Glycine11.
We should listen to our reps - especially the good ones - because they know what it's really like at the sharp end in front of the customer. And part of where I am coming from in my article, although perhaps not too explicit, is that there is a somewhat jaundiced view of what our representatives are capable of. Usually espoused by people who have never known what it's like to be a rep in the first place.
And in fact, the problem, I believe, is not with the representatives, it's with us. The management of the organization who fail to understand our customer base and what is needed - and subsequently fail to staff the organization adequately and provide training and support to those who need it.
Listen to what Glycine11 is saying to us:
"our current model only focuses on the "top prescribing" doctors"
"there is no room in the call plan for community based outreach"
"marketing budgets get wasted..."
Can we not see that this is completely the wrong way to be doing business? Do we have to wait until we've culled all our reps and then paid a fortune for some consultancy to tell us that this is actually the wrong way to do it?
In the meantime, the providers of e-marketing solutions (of which I'm a big fan incidentally) are circling like vultures overhead - trying to convince us that e-marketing will replace the traditional rep model.
And my position is that it won't. Although, it is an extremely valuable supplement of that I have no doubt.
Listen again to what Glycine11 is saying to us, look...
"If we truly put the patient first and showed it through our actions we would begin to become a partner in the system".
Key word: "Partner".
We come at this from different angles. The healthcare system sets out to promote health - the pharmaceutical industry sets out to manage disease. This may appear complimentary, but it's not actually, and it's part of the problem.
The sooner the pharma industry begins to see itself as having a role in healthcare promotion and not just disease management - the more likely it will be that it is regarded as "partner" in the provision of healthcare.
And representatives like Glycine11 - and not expensive Consultancies - are the best people to tell us how we can begin to do that!
19th November 2009, 00:23
To my point of view, today sales reps really face a lot of problems, which are not properly addressed or not addressed at all.
I really enjoyed the article and the comments, and it seems like everything said pretty much is quite a solution to the problem.
The question I wanted to ask is if anybody thinks that changes like these will be implemented?
21st November 2009, 10:35
Yourdailypill,
..if anybody thinks that changes like these will be implemented?
Not really.
The role of the medical rep is doomed - ..its started over many years, they (many) have recognized it and have change nothing in mind frames, only in ways of acting.
Compliance begin to work when you have create a "group feeling" ?
I will finished my strategy papers soon.
"Personalized medicine - in the leveled world"
3rd December 2009, 11:19
Peter,
I know from the work we are doing that the rep is only doomed if the Industry decides to let it happen.
It is the Industry’s 'share of voice' sales model and use of biased and unrepresentative data that ensures that reps are held in such low regard. Adding insult to injury is the ABPI code of practice, which has effectively removed the ability of reps to offer any kind of service or added value. No other industry or sector would ever treat their customers this way and health professionals resent it!
We work with local medical practices, PBC groups and other PCOs and, believe it or not, they are all keen to rebuild relationships with local reps. They blame companies for not evolving away from a sales model they know to be immensely damaging. They are hugely critical of the ABPI who they consider to be arrogant, ignorant and narcissistic, with no understanding of the relationships that should exist between the Industry and the NHS.
They do recognise that reps are well-educated, well-trained, intelligent individuals with much to offer. They want to invite reps to sit down with them in their surgeries, to listen to their needs and to explore how they can work together to expand and improve healthcare delivery to patients. This does mean customers taking more control over their relationships with reps (rather than just excluding them), and companies must be willing to respond.
We are beginning to facilitate that process now and have a team of consultants working with practices across the South East to open up surgeries to those reps willing to look beyond product detailing. The medical rep should be an ally and partner, not just a product vendor. The pharmaceutical sales force is the bridge between the NHS and the Industry and we want to repair the bridge before it collapses completely.
If anyone would like more information about this please contact me at alan@epic-consultancy.com
Kind regards
Alan Naismith
www.epic-consultancy.com
14th December 2009, 08:45
Some further thoughts...
Is the pharma industry perceived as a partner in "delivering health", or an inevitable beneficiary of managing disease?
What role does a medical rep have to play if the decision making power of a GP is taken away by PCT committees and policies?
5th January 2010, 13:27
In my experience, most health professionals see the industry as the latter but would very much like to see it evolve into the former. If companies can reposition themselves as allies and partners their status as beneficiaries becomes far more acceptable.
The concensus amongst our GP clients is that, regardless of who wins, after the general election PCTs will become simpler commissioning bodies with a role that no longer includes micro management of local providers. GPs and PBC clusters will have far greater budgetary reponsibility and with that comes a demand for prescribing autonomy. As long as they can establish themselves as partners in 'delivering health' medical reps could well find they have a very significant role to play in the coming years.
15th July 2010, 11:39
Over the past few years the number of GP Representatives within the UK has halved with a shift to specialist Key Account Manager (KAM) role selling to local health managers within the 152 PCTs.
Andrew Lansley's White Paper proposals will turn this on its head and hand commissioning power back to GPs. The Government plans to hand 80 per cent of the £105 billion NHS budget to consortia of GPs with an independent NHS commissioning board allocating budgets to these consortia.
GPs themselves seem to have mixed views regarding the proposals. Whilst many believe this presents an opportunity for clinicians to lead from the front and make a real difference to their patients’ health it is also reported that many practices are not ready and the time frame for implementation is extremely optimistic.
In the white paper PCTs and SHAs will be scrapped and GPs will have full financial responsibility from April 2013. So over the next couple of years are we about to see a re-emergence of the primary care representative and the number of these jobs increase within the UK.
Greg Holt
greg.holt@emedcareers.com
http://www.emedcareers.com/pipeline/
19th November 2010, 15:13
Interesting viewpoint Greg - and for the sake of medical reps I hope you are right.
My thoughts are that the reasons why the numbers of medical reps has halved is not entirely (or even mainly) due to the change in NHS structures. And if that's correct, then a further change in NHS structures is not going to be the catalyst for a reversal in this trend.
I think the biggest factor is the value of the selling proposition and not the ratio of potential buyers to sellers.
28th May 2011, 11:02
allow me to comment pete..I am a commoner from Indonesia..to my understanding, as the end user of any ethical or health products, the pharmaceutical industries should extend the projection of their marketing visions to the interest of their real stakeholders: THE COMMUNITY where they operate. I agree that hospitals and medical practitioners play the key elements in promoting people's health and safeguarding their life. Socially, hospital is the people's infrastructure established to serve them when health-risky situation emerges. In the meantime, doctors are the the ones whose existence is inevitably needed for without them a building dubbed "hospital" will be soulless. But the industries' marketing policies that position doctors as the most pivotal ones thus giving them the only key to channel pharmaceutical products, especially the ethical ones, whose harms will actually affect the end users-the patients-have substantially cornered the industries. What has been seen is that even GP , medical specialists and hospitals control, putting the industries in a subordinate position and changing the scheme that hospitals, GP or medical specialists are the interdependent players in promoting health safeguarding of the laymen-patients. So, the future marketing policies and strategies should be strengthening the triangle cooperation and coordination so that the three parties' efforts are emotionally felt by the society . The presence of Med Rep in the field should shift to focus more on "things beyond what the doctors can do" which will eventually help the people-patients or patients to be-improve the quality of life. Med Rep's jobs bearing with them the human touch will strike more on the base of the people's needs. Integrating sociological aspects when making decision for the marketing strategy will give an edge to the jobs Med Reps have to perform. The results??..stronger emotional bond..
4th August 2011, 22:51
You have highlighted a very important issue WaKepoh.
The industry is not closely in touch with its consumers - the emphasis till now has been its customers. And those are two different things.
Of course, the industry hasn't been allowed to be closely in touch with its consumers but things are changing.
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