Almost two-thirds of US doctors either ban drug reps or require them to make appointments. The bad news comes from the twice-a-year survey of doctors conducted by SK&A.

Between June and December 2008, the percentage of docs who require appointments rose from 31.4 percent to 38.5 percent. The number that forbid rep access altogether went from 22.3 percent to 23.6 percent. These findings are based on telephone interviews with 227,000 medical practices representing 640,400 doctors.

“Today’s field sales forces are facing increased limitations, as their influence on prescribers is being highly scrutinized,” said Dave Escalante, president and CEO of SK&A, in a company release. “When we repeated the survey during the second half of 2008, we found that 22 percent more physicians require appointments. There is an opportunity for marketing and sales to understand these trends and the advantages of the many more touch points available to educate physicians beyond the traditional office call.”

About 40 percent of general practitioners and 37 percent of specialty physicians now require appointments. Moreover, the survey found physician access and appointment policies are largely influenced by the ownership, size, and location of the physician’s practice. Physicians working in group practices owned by health systems or hospitals are less likely to see sales reps and more likely to require appointments than those who are working in independently owned practices. Physicians working in offices with 10 or more practicing physicians are more likely to restrict access than physicians working in smaller offices of one to two doctors.

Some additional results:

• When a medical practice is owned by a hospital, sales reps can expect more obstacles to reaching physicians. The survey found 31.2 percent of practices owned by hospitals have "no-see" policies, and 44.6 percent require appointments.
• Medical practices owned by health systems are slightly more restrictive. The survey found 34.7 percent of these practices have "no-see" policies, and 52 percent require appointments.
• The busier the practice, the harder it will be to see a physician. Physicians in busier practices, as measured by daily patient volume, are less accessible than those with smaller patient populations to manage.
• Finally, the survey found major Metropolitan Statistical Areas (MSAs) might not follow the regional trend. In San Francisco, for example, physician access is over 56 percent more restrictive than the regional average.

So how can reps gain more access? By working the front desk.

“Office managers and receptionists are the true gatekeepers at physician offices,” said Escalante. “One of the best ways for sales reps to secure appointments is to build and maintain relationships with these influential people, and to understand access policies at the site and group level.”