PE: How can pharma companies do that? How can their sales forces align themselves more closely with what doctors want and need?

MV: Consider the way a message is usually crafted: Ad agencies work with the marketers; they conduct focus groups in order to find the best way to promote their product, and they get comments about the information that's been presented. It's a very sterile environment, and the companies are looking at it from the aspect of, "Does it meet my corporate needs?" What the companies should be doing is asking, "How can we craft and deliver the messages in a way that clearly demonstrates a value to the doctors and helps them to achieve their clinical goals? How can we offer our products as solutions to the doctors?" It's not a leap of faith so much as a change in perspective.

The goal of the company, from a financial standpoint, is to improve product utilization. But if that is the sole driving purpose behind your messaging, and your sole driving purpose in training your representatives, then you lose the focus on the fact that there is another part of the equation, which is the doctor and the doctor's role in solving the clinical problems he or she faces on a daily basis.

MV: Frustration is a big one. They see more people in the company's rush for reach and frequency. There's a sense of frustration about not only the number of reps and the number of different messages they're hearing, but there's also a frustration with the value of the information.

The one thing that doctors really ask for, in terms of what they want from that relationship between the representative and the doctor, is valuable, balanced, applicable clinical information. "Help me solve the problems of my patients." Without that information, it's no more than a product presentation.

PE: Do docs ever feel that sales representatives may as well be trying to sell them a new type of laundry detergent? In other words, do some reps pitch docs in a way that feels really rote or run-of-the-mill?

MV: If you look at the buildup in the sales forces over the last 10 years—from 35,000 back in 1995 all the way up to 110,000 in recent years—many people were hired with no science background and with no knowledge of the marketplace. That's fine, because you expect the companies to provide the necessary scientific information. But there's been a focus on utilizing sales models that come from outside of the pharmaceutical/biotech industry. And when you take an individual who has no knowledge of the industry, and add a selling model from outside the industry, it really does ring less true with medical professionals.

PE: What are some of the best characteristics of a great sales rep, and what is a great sales experience for you as a doctor?

MK: The reason that doctors are limiting access these days is because the representative is walking in the door and in a sense saying, "Doctor, I want you to stop everything that you're doing. I want you to now involve yourself in my process." Then what I have to do as a doctor is change gears all of a sudden to accommodate the rep. And I don't have time, I don't have the willingness, and frankly, there's no value in me doing that anymore.

What's of value to us is that a sales representative can walk into our office and get us involved in the process. That way, we know what's going on, we're both thinking in the same way, we can understand better what the rep is saying. This all has to do with what we were talking about: the misalignment that exists between the sales representative and the doctor.

Sara Donnelly is Pharmaceutical Executive's associate editor. She can be reached at sara.donnelly@advanstar.com