Cincinnati reps pay for detail visits

Cincinnati-based Queen City Physicians is charging pharmaceutical representatives $65 for 10 minutes of time with doctors. The group, which is composed of roughly 50 physicians in specialties ranging from internal medicine to pediatrics, is hoping the fees will help pay for a new computerized medical records system and also streamline the detailing process for reps and doctors.

"We want to put value back on the encounter," said Pamela Coyle-Toerner, the group's president and chief operating officer. "We think reps have a great opportunity to communicate about their latest and greatest in research … the methodology that's working currently, as we view it from our offices, doesn't appear to make sense."

To facilitate the program, Queen City Physicians has set up a separate company, Physician Access Management, to serve as a third party and set up appointments with doctors and reps. Doctors contract to provide services for Physician Access Management and provide prescheduled times during the week when they are available for appointments. Reps interested in meeting with doctors schedule an appointment with Physician Access Management, and the money is distributed to Queen City Physicians in one lump sum. So far, 30 of Queen City's physicians have signed up to give the program a try.

"We know that our doctors' time is valuable, and we know there's a value we can place on that," said Toerner. "And quite honestly, if you understand where the dollar amount came from, if you go back to the guidelines, it has to be commensurate with the current market. That's what we're charging for our encounters with our patients. So it's the same kind of price tag that our patients are paying."

Reps who are dropping off samples are exempt from any fees and appointments; however, Queen City Physicians has limited the hours of sampling times by office - for example, no samples are to be dropped off first thing Monday morning.

Money-back guarantee

One positive aspect of Queen City's program is that appointments come with a money-back guarantee. If a representative schedules an appointment with a physician who takes care of patients or other calls during the scheduled time, he or she can go to Physician Access Management and say that the appointment didn't meet his or her needs. The rep can then reschedule an appointment with that physician, schedule an appointment with a new physician, or receive his or her money back. "There is no other way they can do that in the current system," said Toerner. "If [reps] plan this lunch and they feed the staff and they drop $250 for the day to do that, and the doc sees them for two seconds and says, 'Thanks for feeding my staff, I truly appreciate it. Great drug,' and then walks out of the room, what do you have?"

Reactions from representatives have been mostly negative, according to Toerner. "Representatives are certainly not thrilled with it, because they're not wanting to pay for something when they think they're bringing a value to physicians. My challenge to them is, they already are. [They're] paying in professional time that [they're] wasting waiting to see [doctors] on an unscheduled event. [They're] paying with all the other gimmicks to try to get [doctors'] attention. Let's try and get the right message in front of the physician and streamline the interaction."

Particularly at a disadvantage are reps who have spent months building up relationships with doctors, only to find that they must now pay money for interactions with them.

Despite concerns, Toerner said some reps have recognized the new arrangement as a way to finally be able to actually sell their products to doctors. "There has been positive reaction from reps, yes, because [they] finally get to do what [they were] chosen to do and not be a caterer."

Though most representatives contacted for this article would not comment due to company policies, at least one company said it would not participate in Queen City's program.

Doctor support

Reaction from doctors around the country to the new program has been overwhelmingly positive, said Toerner. "From other physicians around the country, it's been unbelievable," she said. "Applauding us having at least taken a stance and saying, 'let's try and do something differently, because this doesn't work for us either.' There has been interaction from physicians who are saying, 'I'm not comfortable with this, selling my time.' It will be interesting to see where they are two months from now."

Despite Queen City's aversion to pens, pads and lunches, Toerner believes reps have a lot to offer doctors. "Education is a very strong piece of it, and information that is always there in lots of different places, including the Internet, but it's the time in accumulating all of that data and sorting through it and giving [the doctors] information that's very helpful to them." PR