Dr S has been a practicing GP for over a decade. As an increasing number of doctors close their surgery doors to medical representatives, she remains one of pharma’s more accessible customers. But perhaps that’s not surprising. Having worked as a drug rep for five years in the late 1980s, Dr S has an empathy with the modern sales professional. Pf spoke to her to uncover her unique perspective on our profession.
The past few years have witnessed an avalanche of media coverage detailing how the changing NHS and healthcare landscape is impacting the role of the medical sales representative. Maintaining and improving relationships with a growing number of influential healthcare professionals and NHS institutions has challenged the pharmaceutical industry to adapt its commercial model and move away from traditional methodology. Indeed, if you were to believe last year’s Pharma 2020 report from PricewaterhouseCoopers, you might arrive at the assumption that the death of the medical representative is nigh. This overly pessimistic view is, of course, too simplistic to be taken at face value. Whilst the skill sets required to be a good representative clearly need to be refined and developed to align with the evolving NHS environment, pharmaceutical companies will still need to launch products using sales forces as their key source of 1:1 customer interaction. Sales roles will be (and in many cases already have been) redefined, but the core principles of selling will remain.
The impact of change is already being felt. The number of representatives in the field has reduced significantly in recent years and it seems likely that this trend will continue in the short term. So too will the identity of the customers they call upon. But, as true account management cements itself into the foundations of pharma’s commercial infrastructure, it will be important to ensure that the industry’s core traditional customer – the doctor – remains at the heart of the interaction. Amid talk of newer influencers and the increasing importance of non-clinical customer groups, it would be easy for pharma to marginalise the role of the GP and focus attention elsewhere. This would be a mistake. Gaining access to GPs is getting harder but, despite rhetoric to the contrary, the GP-rep interaction is still highly valued. PwC’s 2020 report claims that one in five doctors refuse to see sales representatives. By definition, this means that four out of five still do and, as such, value what they can offer. And nowadays, that offering is much more than simple product detailing – it is supporting medical education and providing value-added services to develop better health outcomes and true partnership working for the benefit of patients.
These are the benefits which pharma can offer to GPs – but do GPs in turn recognise their value? Anecdotal evidence may suggest that the role of the representative is not often appreciated, but this is not necessarily the case. Doctor S has been a GP since the late 1990s. Prior to this she worked as a medical representative promoting asthma and anti-allergy treatments in Wales and SW England. As the stereotypical poacher-turned-gamekeeper, she is uniquely positioned to offer a perspective from both sides of the GP-rep interaction. So, more than a decade after qualifying to practice and approaching twenty years since ‘carrying the bag’, what value does she place on granting an interview to a medical representative following a busy surgery? Reassuringly, she is very positive. “I have always enjoyed the chance to face-to-face chat about new products. It’s much more fulfilling than trying to find time to read journals – and I’ve always found that I can access up-to-date literature from representatives, as well as discuss it with them,” she says. “I also believe that pharma plays a crucial role in organising KOL meetings and facilitating GPs’ CPD. Meetings have always been an invaluable resource – a GP can lead a very solitary existence and it’s often easy to feel isolated in your practice. A source of peer-to-peer support cannot be overrated.”
Currently, Dr S will see a handful of representatives in an average week. “As a practice, we see around 3 a week, usually at lunch time. Time constraints have made speculative calls difficult, but we will all try to see our ‘favourite’ representatives on spec whenever we can.” This throwaway revelation emphasises the importance of building enduring trustworthy relationships, and maintaining a continuity of service, interaction and understanding. It’s a powerful argument for consistency and, in an era of key account management, highlights the value of long-term human-to-human interaction.
On a personal note, Dr S says she likes to be told the ‘pertinent facts about any new drug’ but admits two major ‘pet hates’. “I’m not keen on graphs and, moreover, I’m really not impressed by the overly ‘interrogative-style’ approach some of the newer representatives seem to have adopted – it reminds me of my medical school viva!!”
So, in a seemingly ever-changing NHS, does the GP still have an important role to play in the delivery of healthcare? Is the industry’s determination to switch focus onto newer customer-groups, many from a non-clinical background, the right approach? Dr S is unequivocal. “Whilst PCOs and pharmaceutical advisers increasingly try to take control of prescribing, GPs are the last truly independent practitioners,” she says. “Despite often being under quite a lot of pressure, we will insist on prescribing what we consider to be the most clinically appropriate and beneficial treatment for our patients. My view – shared by my partners and my Practice Manager – is that the judgement of the individual prescriber, the GP or Nurse Practitioner, is more important than that of those in managerial/budgetary roles.”
Despite these pressures and, of course, the challenges of working as a family GP in a busy 3-site practice in a deprived area of the UK, Dr S is clearly passionate about her role. But does she miss repping? “I loved my time as a rep, and learned a lot from it that I still find useful today. My background in pharma, in particular the exposure of dealing with GPs and hospital consultants, really helped me in my medical training. Also, my communication skills were really well developed. I’m now a GP trainer and teach year 5 medical students, as well as, more recently, GP registrars. My pharma training has proved really invaluable in this, particularly in terms of assertiveness and presentational skills.
“I also enjoyed the social side of being a rep, feeling part of a large organisation and working within a team. On the other hand, I enjoyed the freedom I had to plan my daily activity and the flexibility in my working hours – depending on how many customers I’d seen. Despite the recent industry travails, I would still recommend a career in the pharmaceutical industry to anyone. But in the current environment, the only caveat I would add is that a good product portfolio and an accessible territory would be vital considerations.”
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