The Gatekeepers’ New Rules

New research shows physician offices are less receptive to visits from sales reps. But doctors still appreciate professionalism, ethical practices, research, and follow-up.

By David Escalante Jr.

Spring has arrived, but medical sales reps are still finding themselves left out in the cold. By physician offices, that is. Years ago, sales reps had no problem dropping in on doctors to detail their company’s products, provide education and support, and develop relationships. Physicians are now choosier about seeing sales reps with the Internet at their fingertips and stricter “no-see” policies set by parent hierarchies. As a result, reps are frequently turned away or told to make appointments before visiting.

A 2008 SK&A survey of 226,400 U.S. physician offices revealed a decline in access and an increase in appointment requirements for sales reps from the pharmaceutical, biotech, and medical device industries. The survey reported an increase from 22% to 24% in the percentage of physicians who forbid sales rep access and a 23% rise in offices that require sales reps to make appointments. Appointment policies are largely influenced by the ownership, size, and location of the practice. Some trends revealed by the survey are:

• Physicians working in group- or hospital-owned practices are more likely than those in independent practices to require appointments.
• Larger offices, with six or more physicians, require sales rep appointments more often than offices with one or two physicians.
• Physicians in the Southern states tend to be more receptive than those in other U.S. regions to sales rep drop-ins.

The study also showcased wide gaps in no-access policies among physician offices by specialty. Less-common specialty areas with low patient and prescription volume tend to be less receptive to sales reps. On the contrary, specialties more receptive to sales reps tend to fall within practices that have much higher patient traffic and prescription volume.

• Pathologists, diagnostic radiologists, and neuro-radiologists had an average 91% no-access rate.
• Allergists/immunologists, diabetes specialists, and dermatologists averaged a low 8% no-access rate.

The data from this report clearly shows that physicians overall are becoming consistently less receptive to sales rep visits. But why? Here are some of the key reasons this trend may become more problematic for the pharmaceutical, biotech, and medical device industries.

Physicians Have Gone Digital
Technological advancements and our dependency on them have escalated tremendously within the past six years. While typically late to adapt to consumer trends in their practices, physicians have migrated rapidly to the digital world over the past two years. They are very busy individuals who seek to streamline their lives and practices. Sales rep visits—like many other once-inescapable, time-consuming tasks—are slowly being replaced by Internet access to information.
With such a wealth of information and support available online, physicians do not feel compelled to take the time to meet with sales reps to obtain information. E-promotion videos, e-detailing, webinars, online products, disease and treatment fact sheets, online medical communities and social sites, and even the pharmaceutical/medical device companies’ own websites can be viewed and read at the physician’s leisure.

It’s a Matter of Time
In most cases, a sales rep visit can be a waste of time for both parties unless the rep has carefully planned the visit to ensure a quality interaction. The average time a physician spends with a sales rep is two to three minutes, according to Accel Healthcare Communications. In a 2008 Health Strategies Group study, results showed that a physician who spends one minute or less with a pharma rep will typically prescribe 16% more of that rep’s product than he or she was before. Along with this, a three-minute interaction can bring that prescription rate up to 52%. These statistics show that sales reps can make a significant impact if their interactions are dynamic and meaningful. Otherwise, time is wasted, and physicians walk away with few benefits.

A 2008 study by Sermo and the Publicis Selling Solutions Group showed that physicians expect sales reps to be well-versed in their products and tenacious in their sales pitches. The survey reported that physicians sought “more knowledgeable sales representatives—better educated and professionally trained men and women.” It also found that they want sales reps who are “armed with clinical studies, an ethical outlook, and the willingness to follow up.”

A Higher Power
Medical groups, hospitals, and health systems that own physician offices have the authority to set rules with regard to sales rep visits. Such oversight can bring about serious roadblocks. If the medical group’s policy prohibits sales rep visits, which many of them do, sales reps are not allowed past reception. Ever. These types of policies emerged to prevent sales reps from disrupting patient time and interaction at offices and discourage them from over-gifting and improperly influencing physicians. The scrutiny of sales reps’ ethical conduct has resulted in more no-see policies nationwide.

According to the PhRMA’s Code on Interactions with Healthcare Professionals, sales reps can visit physicians during working hours, but they should “respect healthcare professionals’ abilities to manage their schedules and provide patient care.” The code also suggests that meals provided by reps be “modest as judged by local standards” and “limited to in-office or in-hospital settings.”

The policies also aim to prevent sales reps from influencing physicians to buy when the patients’ best interests are not served. The code explains its goal is “to reinforce our intention that our interactions with healthcare professionals are professional exchanges designed to benefit patients and to enhance the practice of medicine.”

Conclusion
While “no-see” physicians will probably remain inaccessible to sales reps, the survey results reported by SK&A can be used by pharmaceutical, biotech, and medical device sales reps to improve standards and service and to secure future access to currently accessible physicians.

Both sales reps and marketers can maximize their opportunities to connect with and educate physicians by understanding these trends. Before this can happen, sales reps must build and maintain solid relationships with receptionists and office managers who hold the power of access. If these “gatekeepers” trust sales reps, access will be more frequently granted, and benefits will be reaped by both reps and physicians. Once access is permitted, it’s imperative sales reps nurture their relationships with physicians by remaining persistent in future calls, following up after meetings, and acting as trusted advisers and confidants.

David Escalante Jr. is President and CEO of SK&A Information Services, Inc. (www.skainfo.com), a leading healthcare database and market research firm based in Irvine, CA. He can be reached at descalante@skainfo.com