Questions doctors hate ...

August 1, 2003
Dorothy Leeds
Dorothy Leeds

Dorothy Leeds is the Guru of Questions, an internationally known speaker and the author of “Powerspeak,” “Smart Questions” and “The 7 Powers of Questions.” The concepts in her books are the foundation for the hundreds of workshops and keynote presentations she makes every year. She can be reached at dleeds@dorothyleeds.com or at (212) 864-2424.

Pharmaceutical Representative

And what to ask instead.

Questions are the answer – the right questions, that is. Questions are a wonderful tool to engage and persuade. Smart questions are a sure way to win the trust and respect of your doctors. However (even though I love them passionately), I do realize that questions are not perfect.

In fact, unless they're asked really well, questions can be extremely annoying. Asking your doctor a question may give you information you need – but it won't help you build your relationship unless it is a good question, asked in the right way. A boring, canned, uncaring, uninteresting question will get you a boring, canned, uncaring, uninteresting answer. It's not only the questions you ask that matter, it's the intent and the attitude with which you ask them.

If you ask, "How are you today?" in an off-handed way, without eye contact and without caring, those things register consciously and subconsciously. Therefore, you'll get an off-handed reply: "Fine." Although things may be terrible, you'll never find out. If you slow down, make eye contact, show concern and say, "It seems you are having a tough day. What's the toughest thing you had to deal with today?" you might just open a dialogue and set yourself apart from all the other reps, because you are demonstrating interest and concern. If you simply ask, "How's your week going?" and then launch into your presentation, the doctor's attention level will not be too high. Try instead: "What was the most debatable thing you read about cholesterol this week?" or "What do you think about the latest FDA ruling?"

Put yourself in the doctor's position. What if you had to see several reps every week (if not every day), and they all asked you the same rehashed-from-their-last-visit questions, with only minor variations? You'd definitely be more discriminating about which reps you would see and how much time you would give them.

The seven worst question types

I asked almost one hundred doctors to tell me about the questions they hate to hear when reps walk into their offices. With their help, I came up with my "Top Seven" list of the following categories:

7. Annoying questions. Here's the scenario: You walk into a doctor's office you've visited many times in the past. She's had an overflow day, is obviously stressed and is having trouble paying attention to you. You forge ahead and ask, "Doctor, do you see patients with hypertension?" or "Doctor, how many patients do you have with XYZ?" This is information you already have - and the doctor knows it. Is it really necessary to ask again, especially on a day like this? Or even, "Doctor, can you tell me about a success you had last week with a patient using ABC drug?" This is not a bad question if you want the doctor to talk positively about something, but this is not the right time to ask it. Show that you are sensitive and flexible, and that you care. How much better to say, "Doctor, I can see how busy you are. Can I have your ear for just one minute? I promise I'll make it worthwhile." Or ask, "What is the one thing I could share with you that would make a difference to you today?" Then be sure to present something helpful and original. If the doctor doesn't have time, you might ask, "Doctor, if I don't take your time today, will you give me extra time on my next visit?"

6. Canned questions. When you walk into a doctor's office, you can be virtually certain you are not the only rep the doctor will be seeing this week – or perhaps even this day. Out of all those reps, which ones does the doctor look forward to seeing? Certainly not those who suffer from the "Telemarketing Syndrome." Everyone knows why telemarketers have such a bad reputation. It's because they ask questions from a printed script, penned by someone else's hand. They don't use any creativity in selling. They don't connect to you as a person. They all sound the same. In fact, they might as well be robots. It's easy for doctors to view reps in the same way, especially when they all come in asking the very same questions, like "How is drug X working with your patients?" and "What are you prescribing now for your ABC patient population?" One way to avoid asking canned questions is to ask a question that shows you did specific research before you got to the doctor's office, like "I know from my research and our previous discussions that you use XYZ as your first-line therapy. Can you explain to me how you first made that decision?" Then listen carefully to the answer and let your next question arise naturally from what the doctor just said, for example, "What has changed or been added since you made that decision?" You want your doctors to think of you as a person who asks intelligent questions, listens to the answers, and builds on the information that has been shared.

5. Unnecessary questions. All of the doctors I polled agreed that they have less respect for the reps who take up time expecting answers they could or should get from other sources. Ask the receptionist or nurse as much as you can and spend your time asking the doctor questions that only he or she can answer, questions like: "Who are the experts you respect the most, and why?" "What journals do you read most frequently?" and "What would I have to do to gain your trust and respect?"

4. Put-down or condescending questions. Cynthia Krausse, assistant professor of obstetrics and gynecology at Mt. Sinai Medical Center, said she hates it when reps ask, "Will you write scripts for my drug for this patient type?"

"Unless a rep is coming in with brand-new information, I am knowledgeable enough to know who the drug is for," she said. "But reps are often condescending; they seem to be quizzing me on my medical knowledge. It's a condescending attitude that turns me right off."

In his book "Super Reps," Lou Sawaya states that the ideal rep, from a physician's perspective, "Does not lecture the physician."

3. Leading questions. At one time or another, most reps have asked, "This would be good for your patients with hypertension, wouldn't it?" Unfortunately, all the doctors with whom I spoke said they hate this type of question. They described it as childish, patronizing and all-too-common. I personally cannot understand why people are still asking it. Here's another one doctors don't like: "This would be helpful to you, doctor, wouldn't it?" A better question would be: "We've talked a lot about the benefits of the new advancements in statins. Which of these would be most helpful to you, and why?" Another obvious leading question is "Doctor, wouldn't you love to have a product that is very effective and has none of these side effects?" Is the doctor going to say no? This is not a very helpful question. Better to ask, "What are the side effects that are most problematic to your patients? And what problems do they cause you?" Doctors also told me they hate being asked to make promises they're not sure they can keep. For instance, reps often ask, "If I had a medication that could reduce or eliminate the side effects of X, would you use it as a first-choice therapy?" The doctor will be much more responsive if you say, "If I could answer your main concerns about my drug, would you be willing to give it a fair trial?" That's a promise most doctors are willing to make.

2. Guilt-provoking questions. It seems almost unbelievable, but many doctors who were polled said reps actually make statements like "Are you writing X? You should be doing more." Or they ask questions like "Will you promise to use my products and no others?" "Will you prescribe this drug? It would really be of help to me if you did," or even "Can you please prescribe more of this drug? Otherwise, I might lose my job." These kinds of questions – designed by reps to make doctors feel guilty about not writing their drugs – not only turn doctors off, they are also highly unprofessional.

1. Extremely unpopular closing questions. "Doctor, can I count on you to put the next five patients you see on my drug?" "Doctor, will you use this the first time you have a patient with this condition?" "Doctor, how many prescriptions can we expect from you?" In theory, these may be good closing questions. But doctors don't like to be pushed. They may respond positively to these questions and tell you that they're going to write your drug, but do they really mean it? I have observed at least 200 detail presentations, and most of the reps I've seen feel uncomfortable when they ask these types of questions - and it shows. Better to ask: "Doctor, since my goal is for you to see my drug as most beneficial to your patients, what specifically can I do to make that happen?"

Your relationship with your doctor should be progressive; each visit should provide you with new information that you can build on for future calls. Your closing questions should keep raising the level of commitment - the more committed the doctor is to you, the better your chances of increased prescriptions. You should also raise your level of self-awareness so that you become more conscious of what you are saying, doing, asking and missing by not listening more intently. Each sales call should not be a repetition, but an advancement and another step toward a better relationship (and ultimately more business for you).

The goal is to change doctors' expectations. They expect you to be detailers. What they want, and deserve, is a valued consultant who provides information to help their patients and their practice. The best way to become that valued consultant is to ask the right questions and really listen to the answers. PR

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