Physicians face many financial pressures. Faced with skyrocketing malpractice premiums and reduced reimbursements from government
and insurance payers, doctors must serve many more patients—about 21 percent more than they did roughly eight years ago—just
to maintain their income, according to the Medical Group Management Association (MGMA) Cost Survey: 2005 Reports based on
2004 data. In addition, physicians can incur more costs from violating regulations. HIPAA, for example, creates expenses for
storing patient acknowledgement forms and—for many offices—lobby reconstruction. To compensate for the numerous financial
drains, many doctors have refocused their time and attention on serving current patients and securing new ones.
In this time-pressured climate, meeting with pharma reps has become less of a priority. Overworked and crunched for time,
many doctors see little incentive to meet with reps since the doctor-rep visit takes valuable time away from their patients.
Many actually view the visit as a financial burden, if not a financial loss.
The physician's office staff represents another roadblock for reps. The staff has the time-consuming and often stressful responsibility
of scheduling and managing these visits and imposing limits on visit frequency. Some offices report that they spend anywhere
between five and 40 hours per week managing rep visits. To streamline this process, some pharma companies have turned to a
neutral third party to assume these scheduling responsibilities. This way, doctors and staff know which reps are coming, when
they are arriving, and what they are carrying in advance. This improves meeting efficiency for all parties. It takes the administrative
burden off of physicians' offices and the financial burden off of doctors, who, with a set schedule to follow, can better
maximize their time with patients.
Currently, many physicians' offices create deterrents to confine sales-rep activity. Seeking to balance the benefits and costs
of rep visits, some practices accept only a limited number of reps (e.g., five reps per day), and then post a "no more reps
today" sign after they've met their quota. Some physicians agree to see reps, but then deliberately make it so difficult to
set a time to meet that most reps give up. Even reps who schedule their calls in advance may experience reluctance from office
staff. Reps say they face restrictions on at least 82 percent of visits to medical offices, according to a survey conducted
by Smart Practice Management. Many times these restrictions are arbitrary and disparate, vary by office and region, and are
subject to frequent change. These constraints come in many forms:
Reps may never—or must—bring lunch
- Reps must have badges (or not) and/or must sign in with security, the front desk, or some other party
- Reps must stock the sample closet and document their delivery—or may never approach the closet
- Reps must be accompanied by office staff and/or avoid certain office areas entirely
- Reps may only visit on certain days or in certain time windows. About 44 percent of offices surveyed by Smart Practice Management
impose this restriction, and in that group, nearly one in seven have physician-specific time windows.
The physician backlash against detailing can be costly for pharma. Some offices have banned reps altogether to save time and
The same survey found that seven percent of offices across all specialties ban reps; the prevalence of this varies across
the country. For example, in New Jersey, approximately six percent of medical offices refuse to see reps, while in Massachusetts,
that number is closer to 16 percent. In one extreme example, a New England rep carrying three widely different drugs reported
that 94 of 125 target physicians were not accessible. A 2004 survey conducted by PreferredTime found that of 5,475 offices
within the Northeast, nine percent had no-see policies in place.
Look Who´s Talking
Implications for Pharma
More efficient scheduling can help pharma promote its products more successfully. With fewer scheduling conflicts, reps can
avoid wasted trips to doctors' offices and long waits to see them. Plus, this gives them a competitive edge over other reps
who may be waiting in the parking lot or lobby to speak with the same physician. Further, streamlined scheduling allows reps
to organize their entire schedules from one source, which enables them to be effective immediately upon entering a new territory,
since their training need only comprise product knowledge rather than office idiosyncrasies.
The Future of Live Detailing
In the current medical office climate, live detailing faces a number of challenges and threats, including e-detailing, a Web-based
method of selling that replaces face-to-face interactions between reps and physicians.
However, better scheduling can restore faith in the live detail visit and reduce the frustrations associated with unscheduled
pharmaceutical rep visits. Reps can see time savings and improved relationships with physicians. Doctors, in turn, can devote
more time to patients, and in turn, will have a better attitude toward reps. With this infrastructure in place, the pharmaceutical
industry can function as it once did, sending skilled reps on successful sales calls that are well-received by physicians.
Stefania Nappi is CEO of PreferredTime, Inc. She can be reached at firstname.lastname@example.org
Briscoe Rodgers is president and founder of PreferredTime, Inc. He can be reached at email@example.com