Selling to the middle

Pharmaceutical Representative

Mid-level practitioners can have a significant impact on a rep's business.

Mid-level practitioners can have a significant impact on our business. These important players represent an integral segment of both rural and metropolitan medical communities in an era when the notion of medical cost efficiency dominates.

Ultimately, this group may include more than just traditional mid-level practitioners. Changing policies may soon allow Pharm-D's prescription-writing privileges in some states. In anticipation of legislative approval, some offices in my North Carolina territory have already begun hiring such professionals.

This growing audience of mid-level practitioners presents a great opportunity to expand product sales. Although some bonus structures may specifically acknowledge only prescriptions written by designated practicing medical doctors, globally all pharmaceutical companies should prosper by supporting auxiliary medical providers.

In doing so, we sales reps may also enhance our understanding of the changing environment of attending physicians. We may discover, for instance, that a physician entrusts a great deal of routine therapy to mid-level experts while he expands his practice in other areas. Consequently, effective sales call preparations must encompass the needs of every office member with prescription-writing privileges.

To better understand the needs of mid-level practitioners, I designed a questionnaire that focused on what I could do better to embrace this escalating segment of our industry's business. Although small in sample size and geographic scope, the in-depth responses reflect a caring passion for the quality of medical care.

The project was structured for total participant anonymity although several of the 16 participants elected to sign notes of appreciation at the end. Because I work in a newly realigned territory, none of the comments should harbor any relationship biases. The following summarizes the responses of those surveyed.

Get sampling straight

Conflicting explanations on corporate sampling policies clearly marked an area of frustration with this group. One respondent expressed concern at being told by a pharmaceutical rep that state laws prohibited mid-level signatures. Another pharmaceutical company in the same state, however, offered no such explanation and freely allowed sampling to mid-level practitioners.

"[The sampling explanation] doesn't help my image of them!" the doctor wrote. "I think the rep is misinformed about that." Interestingly, the doctor continued, "What else is he misinformed about?"

Another participant indicated that sampling policies reflect "the company's old policies and ideas regarding mid-level practitioners." Still another remarked, "It's the drug that's important, not my ego...."

In my opinion, despite the rigidity of our laws and corporate policies, perhaps we need to take a better mental picture of how we handle our sampling objectives. If we cannot leave samples for whatever legitimate reasons, explore other avenues to ensure that these practitioners know that their needs are as important to us as their prescriptions.

Education and service

In response to corporate-sponsored articles and programs, a thirst for CME material and modern research materials prevailed.

One participant said that independent studies influenced him most. Another was offended when a company called him to gather information for a conference marketing call, only to cancel the event upon learning of his mid-level status. This was done despite the fact that his was the office provider generating the prescriptions in that product category. "This tells me that they don't understand our function and how we impact patient care," the doctor wrote.

In regard to service expectations from representatives, doctors ranked product information as top priority. Pricing information, patient education materials and samples were also important.

One respondent gratefully related how a representative curtailed future side-effect problems with a particular drug by discussing methods other medical providers were trying. "It helped me a lot," the doctor noted. Another told of how a representative helped gather information on an article she was writing after she failed to obtain the information elsewhere.

Dos and Don'ts

When asked for suggestions on dos and don'ts in our industry, the surveyed doctors made the following recommendations:


•Â DO be brief and accurate.


•Â DON'T hard-sell a product.


•Â DO support efficacy statements with unbiased studies when available.


•Â DON'T interfere with client time. Make an appointment.


•Â DO give local pricing


•Â DON'T come on heavy and tear into another rep or company. ("I'm amazed at how much of this I see," one doctor noted.)


•Â DO limit calls to new information if we are in a hurry.

In conclusion, we must assist our companies in partnering with mid-level practitioners. If we do, perhaps we can imagine being on the receiving end of this compliment made by a company with a marketing department for nurse practitioners: "I think the rep from this company knows more about what it means to be an NP than I do! It's great talking to someone who understands my field instead of having to explain who I am and what I do." PR