Project a new image to hostile docs

Pharmaceutical Representative

Almost every representative can think of at least one high-prescribing, important customer who coldly rebuffs every rapport-building gesture the representative makes. Here's how to change that physician's mind.

Most sales representatives have trusting, productive relationships with 60% to 70% of their customers. Some lucky reps may boast an even higher percentage of 80% or 90%. But almost every representative can think of at least one high-prescribing, important customer who coldly rebuffs every rapport-building gesture the representative makes.

Whether the individual rep, his or her predecessor or territory peers are to blame, something has soured the customer against interacting with representatives. How can a sales rep overcome customer resistance, which, in some cases, is expressed as outright antagonism? And how can a rep prepare and stay motivated to call on these difficult clients?

Identify the problem

Reps must first try to identify what specific event, situation or disappointment has caused the relationship to unravel.

That reason may be as simple as not providing lunch to an office staff when one was promised or as subtly complex as a difference in personal communication and social styles.

"If a rep breaks a promise and doesn't deliver whatever service he or she was supposed to deliver, then that can cause conflict," according to Ty Faulkner, manager of sales training and field communication for Eisai, Teaneck, NJ. "But sometimes it's just personality conflicts. A physician may have become accustomed to being dealt with in a certain way and if a new person comes in and goes by a different protocol, then it can end up in an explosion between the physician and the rep."

In the case of a forgotten lunch, a rep may be able to make amends simply by apologizing and rescheduling. But if he or she was unable to fulfill a bigger promise, such as providing company money or services for a customer's annual fund-raising event, forgiveness and trust may not be so easily regained.

"It's hard to make up for those types of problems," Faulkner said. "Often, listening skills are key. A rep may need to give a doctor time to voice his or her concern. This allows the representative to step back and not be the target of that venting, and it allows the doctor to regain control."

Physicians are highly trained professionals but it's important to remember that they're also human. "Sometimes a situation can be so bad, you may need to go away and come back on another day," Faulkner acknowledged. "But you want to address the situation and acknowledge what you've heard. You want to let them know you're taking them seriously and are committed to taking care of [their concern] for them."

Some difficult physicians, however, will resist even the best and most genuine relationship-building efforts because of a more fundamental problem, according to Michael Kessler, M.D., president of Atlanta-based Medical Communications Center Inc.

"With the most difficult doctors, it boils down to the fact that they perceive all salespeople as being the same," Kessler said. "They see them as being unprofessional and they don't want to deal with unprofessionals."

As a result, pharmaceutical sales reps suffer for the sins of every other salesperson who has called on the doctor, whether that person was selling light bulbs or tongue depressors. The doctor doesn't value what the rep has to offer.

Furthermore, when reps try to reverse that opinion by using training skills they've learned, they may actually worsen the situation. "What the pharmaceutical sales rep has to understand is that sales training courses on consultative selling, probing and closing are not unique to the pharmaceutical world," Kessler said. "Those courses are given to every salesperson in the world. Doctors, who are the most oversolicited targeted market, have seen it all."

So what can sales reps do to distinguish themselves as different from other salespeople? They must reposition themselves as professionals and give difficult doctors exactly what they need and want in the precise way that doctors are used to receiving it. Their most powerful tool for doing this, according to Kessler, is the one they misuse the most: the journal article.

"One of the most frustrating things for difficult doctors is the way clinical information is presented to them," he explained. "The pharmaceutical world has turned the journal article into a marketing piece. We live and die by journal articles. They're how we educate ourselves, protect ourselves from malpractice suits and discuss things with our colleagues. Difficult doctors are turned off by how something that is so valuable to them has been so altered."

At the beginning of each journal article is an abstract that communicates the purpose, methodology and results of a study. When doctors speak to one another about journal articles, the abstract is the way they communicate scientific information. If they want to know more than what is outlined in the abstract, they read the whole article.

In order to be perceived as professional by these difficult doctors, reps should present the information the same way doctors do. Present it as it is in the abstract. Sales reps may mention their product and use its brand name, but they should avoid overpersonalizing the study to their company or product.

"How doctors discuss an abstract is always the same because it's how they have been trained," said Kessler. "When pharmaceutical reps come in and hone in one specific little piece of that article, they have just taken the most valuable piece of information they have and put it into a form that is foreign, unusable and disgusting to some doctors."

At this point, the purpose of the call - educating the doctor - may become lost as the doctor either dismisses the rep entirely or batters him or her with a series of challenging questions.

The relationship between the doctor and the representative, unstable to begin with, has become an unproductive contest of agendas.

It's up to the sales rep to put the relationship back on track.

Regain trust

When a physician becomes perpetually unavailable, abrupt, condescending or intimidating, a sales rep should realize he or she is on the defensive and act quickly.

Wilson Learning Corp., a training organization based in Eden Prairie, MN. Wilson suggests sales reps follow the "five A's" when they need to recover comfort and trust lost in a relationship: acknowledge, apologize, accept, adjust and assure.

"You have to acknowledge the situation and the discomfort it's causing," said Kate Shubert, a national account executive for Wilson who works primarily with the pharmaceutical industry. "You have to 'fess up. Once you do that, you have to apologize and accept responsibility by personally promising to resolve the problem. Then you have to adjust or correct the problem and assure that the situation has been resolved."

After a mistake, sales reps may never fully regain the full degree of trust they lost, but they should be able to regain some of it. "If you look at trust as a continuum, there's distrust on one end, contractual trust and proven trust in the center and absolute trust on the other end," Shubert explained. "If you mess up for whatever reason and lose credibility, you may never regain absolute trust but you can at least get to contractual trust."

In the contractual trust stage, a customer feels that a sales rep can be trusted only on a professional level. At the proven trust stage, a sales rep has demonstrated that he or she can be trusted beyond a merely professional level. Few sales relationships reach the absolute trust stage, which is the level of trust one might feel for family or very close friends.

Rebuilding trust may not be a quick process. Each call on the estranged customer should be carefully planned in advance.

Alerting the customer beforehand that the sales rep would like to address the situation on his or her next visit might be appropriate in some situations. And, perhaps most importantly, sales reps should prepare a way to leave graciously so that they can come back and try to mend the relationship again.

"Often, it takes a long time for a customer to build up enough trust to relay factual information about a bad situation," said Faulkner. "Customers will beat around the bush. We have to find out what the real motives are and clearly define what the issue is."

During their pre-call planning, sales reps should write a series of open-ended questions to uncover this information. Then they should eliminate from the list any questions for which they already have answers.

If a sales rep can answer a question, there's no point in asking it. "You don't have a lot of time and you won't endear yourself to the customer if you're asking questions you already know the answer to," Faulkner said.

Faulkner recommends phrasing questions with key words such as feel, demonstrate or explain: "Physicians like to teach and they are constantly in teaching mode. If you say to a doctor, 'Describe to me what the problem was with a previous rep,' you can prepare to sit back and listen for five minutes."

During the call, sales reps can tell the customer what they already know about the situation and then launch into the prepared questions.

This will accomplish two important goals: it will establish commonality between the both the rep and the customer by putting them both on the same page and it will move the discussion forward.

Learn from mistakes

As tough as repairing a bad situation can be, it's important to remember that some of the best learning experiences stem from the worst mistakes. Similarly, a reps' best sales relationships may stem from those on which they work they hardest.

"It's a tremendous learning opportunity," said Shubert, who worked as a sales representative for Pfizer before joining Wilson Learning Corp. "I remember working with one doctor and doing everything wrong until I finally followed my gut and said, 'We obviously have a problem here and I want to correct it.' That relationship wound up being one of my best." PR