INSIDE INFO

1. When and how often do you see medical representatives?
It’s variable. These days on average I see one rep a week, whereas it used to be more like one a day! The new contract has had an enormous impact on how busy we are. To use the stereotypical idea of doctors, the days of going on the golf-course are long gone! If I take the time to see a rep I have to use the only free time I will have in the week.

We used to have an appointments system, but now reps just have to call in and see what sort of day we’re having, in a way it’s gone back to the old-fashioned system. Of course this isn’t very good for the reps, but it really is the only practical way of doing it. Sometimes the Nurse Manager will see a rep, and if what they have to say is of interest the Nurse Manager will then arrange a meeting with the doctors.

2. What do you find useful about meeting with reps?
Essentially they are a source of medical information. Sometimes it’s necessary to be a little analytical of what they say and put it in perspective. They are also one of the few ways doctors network. If it weren’t for meetings organised by reps, doctors would probably never meet together outside of the Practice!

3. In your view, what could the sales-force be doing to improve their effectiveness?
My general experience of reps is that they are highly professional and patient; generally really good. However, I do think the pharma sales force waste a lot of time. What with different sales forces within the company, contract sales people and other companies co-promoting a product, there can be many people trying to sell the same product. The most I ever had was four different sales forces trying to sell me one product in one week! A lot of doctors now are beginning to ask the rep for specific information, rather than waste time going through information that just isn’t relevant to their role. Doctor-friendly reps will target their information to the doctor’s needs.

The pharma industry could also improve by not sending so much rubbish through the post! I feel sorry for the postman, who struggles to bring us a pile of letters, packages, posters etc that we will just throw in the bin. This is a waste of money and doesn’t do the industry any favours. It would also be useful if reps’ business cards indicated their speciality areas, as there is no way of knowing what they have called about if the card only has a name and contact details.

4. Do you feel the medical sales professional still has a valuable role to play?
The short answer is, definitely yes. The days of the vast sales force are certainly numbered, but they are starting to do things differently. The practicebased style meeting is now very popular and very effective. If a rep is selling products within the QOF framework they are more likely to have a good reception. The medical sales industry just has to change with the times.

Personally I have tried to break down barriers, particularly through my work with the ABPI and in commercial rep training. The pharmaceutical sales industry has more regulatory control than its customers these days. At the end of the day, it is a business, but it’s a business that is run in an ethical and controlled fashion.

5. What do you think are the major ‘don’ts’ for reps? What really winds you up?
My biggest hate is when a rep comes in with the opening statement, “What do you prescribe for X, doctor?” Where do you start? There is no easy answer to that question. From my experience that is a doctor’s number 1 pet hate, especially in more complex areas such as hypertension. Another one is the rep that tries to sell you a product you are already a high prescriber of, or one that you are opposed to for one reason or another. Or the rep that, with five minutes to go, will try and get in all their three products, whereas if they were sensible they would focus on one and leave information about the others.

A huge irritation, as mentioned earlier, is the rep that will go through their whole script without regarding what is actually relevant to general practice, and sometimes this information just seems to have been hacked together. The ideal rep will start with, “My products are A, B and C. What would you like to talk about?”

I will naturally have more time for reps if they come to talk to me about my areas of interest.

There have been a couple of cases where I’ve had to threaten to report people to the ABPI. For example, there was one rep that was telling patients in the waiting room to ask for a certain drug, and another who said he would give me something if I prescribed X amount of a product. Obviously these people are under the pressure of sales targets and these cases are a very small minority, 99% of medical sales reps are fantastic.

6. How often have you changed your prescribing habits based on information provided by a medical rep?
The best thing a rep can do is to leave detailed information with me that I can then take to a practice meeting for discussion. If we are all in agreement then we will add the product to the formulary. It is a more structural approach. My specialist areas are pain and respiratory medicine, so I will have more influence in these areas. Very few of our decisions are based in terms of finance, we will decide to change to a product if we genuinely feel it is better, regardless of cost, especially if the product fits in with the particular guidelines.

Despite some recent suspicion of reps, it is important that doctors stay balanced and try to avoid polarised opinions. To the majority of the sales force I would like to say, “Keep up the good work!”