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In a Dynamic Healthcare Market, Only the Adaptive Survive


“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most responsive to change.” In today’s healthcare market, Darwin's words have never been more relevant, writes Brad Ansley.

“It is not the strongest of the species that survives... It is the one that is most responsive to change.” In today’s dynamic healthcare market, these words attributed to Darwin have never been more relevant, writes Brad Ansley.

While the quote is typically attributed to Charles Darwin as a concept out of “On the Origin of Species,” the website Quote Investigator says that they can find no evidence of that fact. Instead, they believe that in 1963 a business professor from LSU presented this as his own interpretation of Darwin’s central idea. While the origin of the quote is in question, the thought conveyed could not be more pertinent to organizations selling in the life sciences market today.

In today’s financial, political and demographic environment most, if not all governments, realize that the rising cost of healthcare is not sustainable. Decreasing the cost of healthcare while improving patient outcomes is imperative.  As a result, regulatory agencies are building infrastructure that is driving significant changes to both the business model and practice model for healthcare providers (HCPs) and organizations. Now providers and organizations are being reimbursed based on value not volume.  They have significant incentives to participate in new practice models in both the public and private sector (i.e., accountable care organizations (ACOs)). Furthermore, organizations like the Patient Centered Outcomes Research Institute (PCORI) are providing $5B of research grants over a 10-year period to drive comparative effectiveness research (CER) in support of evidence-based care.

As the effect of these changes continues to cascade, life sciences companies realize that they impact the expectations their customers have of sales representatives. Successful organizations will be the ones that adapt and align the way they sell to meet these changing expectations.

In light of the current environment, what are the expectations of stakeholders in the healthcare market?  With limited time, an overload of clinical data and quality standards to meet, physicians and healthcare organizations expect representatives to deliver value by doing more than selling a product. They want representatives to help them achieve their business and patient goals by demonstrating a higher level of customer intimacy and situational fluency. This means understanding the organization’s goals, treatment protocols, and practice characteristics as well as understanding the impact of any recommended changes on the organization. They also expect representatives to have multiple touch points, marshal appropriate corporate resources, and provide objective clinical support based in the principles of evidence-based medicine to support any recommended solutions. These behaviors drive brand choice and customer loyalty.

This new definition of value changes the mix and proficiency level of competencies needed by sellers to succeed. Among the competencies needed to deliver on the new definition of value, sellers need to have a high level of proficiency in the areas of consultative dialogues, evidence-based medicine and account management.

Stakeholders in today’s healthcare market are looking for solutions that help them meet their practice and patient goals.  Yet many sales representatives show up ready to immediately discuss the marketing messages, and features and benefits without really understanding what or if their product solves a critical business or patient issue. This would be similar to a physician prescribing before diagnosing.  Many representatives do a poor job of diagnosing the buyer’s real problem. As a result, they prescribe the wrong solution or, even worse, fail to convince the customer that their solution provides any benefit at all. A sales professional who doesn’t diagnose their buyer’s pain and then helps the buyer to visualize how their capabilities are going to help, unwittingly puts him or herself in the position of being just another salesperson. This type of salesperson brings little or no value to the prospective buyer. Like a doctor that just throws pills at his patients without diagnosing them, salespeople that don’t diagnose customer pains are guilty of sales malpractice.

Another key element of conducting a consultative dialogue is speaking the same language as the customer. In the case of healthcare, that means incorporating the language of evidence-based medicine. Many of the regulatory changes are focused on the use of evidence-based medicine to ensure treatments are based on the best available evidence and to reduce treatment inequities. In fact, in addition to the emphasis on CER, the Accreditation Council for Graduate Medical Education (ACGME) now requires that medical schools teach five levels of competency in evidence-based medicine to be accredited for many specialties. Other regulatory changes require ACOs to document the presence of an evidence-based process in their overall practice. The impact of these changes is already surfacing in market research of HCPs’ expectations.  In the fourth edition of What Physicians Want! a report of the key findings from a biennial survey conducted by Publicis Touchpoint Solutions and Sermo, 77% of physicians surveyed said that wanted “higher quality representatives”-representatives that are trained beyond just their product and are ready to have a serious discussion about multiple therapeutic options.  In the same survey “more than 9 out of 10 physicians surveyed (91%) want representatives to make more use of clinical studies and EBM in their conversations.”[1] Given the market dynamics, it is no surprise that this percentage has grown in each of the last three surveys.

Life sciences companies are picking up on this trend.  According to an article published in FOCUS magazine entitled “Training the Sales Rep of the Future” by Kate Earle of TGaS advisors, life sciences training and development professionals were surveyed and asked to name the top three customer buying influencers. “For the first time, evidence-based medicine was found to hold the strongest customer buying influence.”[2]

Lastly, life sciences companies are shifting from a product centric sales model to a customer or solution centric model. While the individual physician is still a key stakeholder and influencer, more and more buying decisions are made by value analysis committees (VAC) or other key stakeholders committees.  Successful representatives in the market today see customers as accounts. They understand the key business or clinical issues from the point of view of each stakeholder and can paint a vision of the impact their recommended solution will have on the organization relative to each stakeholder. Additionally, buyers expect representatives to act as a solution coach to place key players and corporate resources in position to support the recommended solution and ensure that it helps the organization meet specific quality of care metrics.  The emphasis on solutions that help organizations meet quality metrics will intensify over the next few years.  According to a recent article in The New England Journal of Medicine, the US Department of Health and Human Services has, for the first time, set escalating goals for the percent of Medicare fee for service payments that are tied to quality or value metrics through alternative payment models like ACOs.[3] No doubt that these targets will filter into the private sector just as the ACO model did.

Complex healthcare issues are causing a myriad of regulatory actions. These actions are forcing changes in the business and practice models for HCPs and healthcare organizations. In turn, this mandates adjustments in sales representative proficiency for multiple competencies based on the changing needs and expectations of buyers. Winning sales organizations understand the competencies that are statistically proven to drive business and focus their training investments on driving proficiency in those competencies.

Brad Ansley, Director of Life Sciences, Sales Performance International (SPI).



[1] What Physicians Want! Survey, http://www.touchpointsolutions.com/resource/,  Publicis Touchpoint Solutions and Sermo. Accessed March 6, 2015

[2] Available at: http://www.nxtbook.com/nxtbooks/LtenFocus/2014winter/. Accessed March 6, 2015.

[3] Burwell SM. Setting Value-Based Payment Goals - HHS Efforts to Improve U.S. Health Care. N Engl J Med. 2015;

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