As the discussion continues I see one or two objections to her reasoning. Firstly, I don’t think that her company’s statistics on cost-effectiveness is numerically sound and secondly I feel she has glossed over a safety issue without really alluding to her reasoning. She seems to be progressing further down her line of argument but my mind is still mulling over items brought up about 10 minutes ago . . .
IF THIS REPRESENTATIVE is watching me carefully for cues to following our interactions I am probably giving out some worrying signs. Do not presume that overt acknowledgement means agreement with due process and argument. At the beginning I was probably providing factual and agreement nods – which she probably read as ‘this is going well’. More recently however I have probably been providing softer acceptances. The understanding nod, which displays ‘I see what you mean’ should not be interpreted as ‘I agree with your argument’ Furthermore, the encouraging nod (wow that’s interesting) allows me to share enthusiasm and excitement without any equivocal shift in attitude. Many appointments go like this. You must remember that prescribing/sales involves an ‘action’ from your customer. Universally, a person’s actions are as a result of their attitudes. And if you are not shifting attitudes, then you will not get the actions you require (to hit bonus). The ‘nods’ I am giving do subconsciously change but I won’t be aware of it. And very frequently neither is the representative. You should be training yourself to notice the variation in nods of agreement – I can assure you that you will notice the shifts in the types of ‘nods of agreement’ if you look for it. Use these cues as mild warnings that the customer is going through the motions. The weakest level of agreement is the acknowledgement nod (yes I am still listening) which may or may not be true (yes I am still hearing but not listening!). Life would be much easier (though unpleasant) if your customers always told you what they think. It would be easier than keeping you guessing or worse still coming out of an appointment with a beaming smile and sagging sales
4. NEUROLINGUISTICS – JUST PLAIN LIES!
She stops talking – looks back at me and smiles. Before I have chance to say anything she beats me to it. So – is the PCT thinking of funding this agent? Do you think the drug is good? Wouldn’t you agree that the service we can offer is far better than our competitor’s? Much of relationship building in sales is in listening. Not just listening to what we say but how we say it. This is difficult in today’s hectic world of one appointment after another with intermittent bouts of stop-start traffic, car park road rage and listening to your own echo in a hands-free conversation whilst driving to your next appointment. But much is obtained from questioning and importantly listening. I have noticed some pharmaceutical companies are really taking note of this and employing it as part of the sales and marketing strategy. I have been party to many conversations where agreement, nodding and almost any type of activity which encourages the representative to shoo out of the surgery/office/practice and bring the ‘sales call’ to an end is applied. There are many situations in our daily lives when we wish to hide our true feelings. We say one thing, but feel another. This must happen on a daily basis in appointments all over the country. But whilst this can’t be avoided, representatives can be sensitive to cues so as to have a better understanding of their customer’s attitudes. Key psychological experiments have attested observed behaviours that people do when they are lying or deceiving. Remember your customers are not necessarily lying as a motivated action, but they may feel uncomfortable in overtly agreeing with all of the sales pitch but are under obvious pressure to answer your questions/call to prescribe. A study in nurses who were told to lie to relatives revealed reduced frequency of hand gestures normally used to support the spoken word (it seems if we know we are lying we don’t want our hands to give us away!) - when lying, auto-contact is increased (we all touch our face/ear/nose/chin, but the frequency of this increases when we lie). - In particular covering the mouth and touching the nose. - Increased body shifts (trying to get out of the situation) - Hand shrugging is common (like expressing ‘I don’t know’ even though you are stating something) - Facial micro-expressions (most of which are too quick for human eye, especially if we are not looking for it). Fascinating – it seems even when we want to lie, the face registers this inner conflict, even if it is only for a fleeting moment before it is consciously suppressed. - Increased hesitation before replying to a question and speaks slower than usual when finally responding to the question - Tone of voice is uneven, sometimes higher pitch and often rises at the end of sentences The final aspect of lying is the directional gaze, an observation which is very much within the domain of neurolinguistics. The brain has evolved two hemispheres which differ in specialisation. The left hemisphere (logical side) tends to favour logic, rationale, analysis and linguistics. The right hemisphere (creative side) seems devoted to creative, artistic and spatial thinking. When observing hemispheric activity of the brain during the process of answering a question, when expressing facts based on logic we use the left side, but when confabulating or creating an answer we use the right side. Studies have shown that the individual who is telling the truth tends to gaze to their right (your left). When lying, the eyes gaze to their left (your right). This is because the brain controls visual fields to the opposite side to that of the hemisphere used. In fact there are distinct visual field sectors to which the eyes will briefly deviate to depending on whether the individual is recalling a fact, fabricating a story, or stating a fact. It’s by no means fool proof. But it is well studied and increasingly of importance as the understanding of human psychology during the sales process is realised by pharmaceutical companies.
5. NEUROLINGUISTICS – WHEN WILL WE MEET AGAIN ?
After some Q&A, I notice I seem to be shifting in my seat, looking at my watch and fiddling with the free gift pen that I have just accidentally broken . . . I guess I am exhibiting contradictory messages. I want to appear interested but I am not. I want to answer her questions - but don’t want to start a protracted argument. I am not bored - but my attention span is waning… Besides, her product is important and we are evaluating it in the near future. After making some subtle motions (and some unsubtle ones) I abruptly stand up and thank her for her time. I have scribbled some notes and request one or two papers from her. Inevitably, the most interesting part of her ‘presentation/discussion’ is not allowable for me to take away, though I can expect a visit from the ‘men in black’ from head office if so requested. I make effort to see her out and ask if she knows where she is going/how to find her way out of this place. An interesting social junction occurs as she sees one of her competitors wave to me as we gather at the top of the stairs. I prepare myself for the next appointment as no doubt, she is preparing for hers . . . Please – do come in, and step into my office.
||OMAR ALI is the Formulary Development Pharmacist for Surrey and Sussex Healthcare NHS Trust and is a PCT Formulary Adviser to 2 PCTs. He is a lecturer on the MSc on Pharmacy Practice at Portsmouth University and is also an adviser to three Drugs and Therapeutics Committees in the South of England. Omar is a National Speaker in the UK (cardiovascular, diabetes, mental health) and is an Executive Board Member for the National Obesity Forum. He can be reached directly on ‘firstname.lastname@example.org’