Managing the Crisis of Marginalization

“Way out there in the blue, riding on a smile and a shoeshine” is how Arthur Miller’s Willy Loman described his life as a sales person. It was both a tribute to and an obituary of the traditional sales profession. It’s also a feeling that’s quite familiar to primary-care sales reps trying to do their job in a very tough sales environment.

Much has been written about the decline of face-time with primary care physicians, but the lack of access that troubles many pharmaceutical sales organizations is often due more to a lack of relevance than a physician’s short attention span or heavy patient load. Sales organizations in any industry become irrelevant for one simple reason: Customers find a better (cheaper, faster, more convenient) way to buy products and get the information they need.

To counter the declining marginalization of the sales force, many large pharmaceutical companies have taken aggressive measures, including developing sales centers of excellence and implementing sales force effectiveness strategies. Novartis has moved to a regional model in the US, and AstraZeneca has created a sales and service model with sales associates delivering the samples, better trained reps delivering the science, and inside sales calling on hard-to-sees.

These are all important structural changes towards creating a new service model, but how do they impact the experience of the primary care physician? Are we performing well on those attributes that doctors care about? Are we giving them the kind of customer service they need and want, with a cost structure we can afford?

The key to managing the pharma sales force crisis of marginalization is to know when the customer wants good customer service and when the customer needs good self-service.

Customer Service or Self Service?

In 1999, Fast Company predicted the death of the travel agency. After the launch of Orbitz.com, pundits assumed that leisure and small business travelers would rather search for discount tickets online than pay full-fare through a travel agent. Airlines followed suit and drastically cut the commissions paid to travel agents. Did this hurt the industry? Yes. Did it kill it as predicted? No. It merely forced the travel industry to change.

Last month, a colleague took his family on their first-ever Caribbean cruise. Although he is a seasoned traveler, he had no experience with cruises, and decided to engage a “consultant.” He called a travel agent who specializes in cruises, and got access to information and insight that it would have taken him hours or even days to uncover on his own. As for the flight to Miami for his family of five? He booked that himself online.

As Clayton Christiansen observed in a June 2006 Harvard Business Review article, we all have “jobs” that we need to get done during the course of a day. Jobs like information gathering, communication, purchasing, relaxing, etc. To get these jobs done, we “hire” various “contractors.” My friend had the job of conceiving, planning, and booking a family vacation, and he hired various resources to get the job done, including a travel guide, a travel agency, and an online travel site. For some jobs, he needed good customer service, and for others, he needed good self-service.

Similarly, physicians have numerous information gathering and processing jobs that they need to get done in the course of a week. Understanding those jobs and balancing the right customer service and self-service response is part of the pharmaceutical sales role.

The typical physician has four information jobs that need to be performed: inform, inspire, reassure, and support. These jobs correlate to the behaviors all of us exhibit as we move through a buying process. Traditionally, the primary-care sales representative was hired to do all of these jobs, with some occasional marketing support. But with that traditional role going away, we need to reconsider each of these jobs and hire the optimal set of communication channels to meet those needs.

Inform Me
Primary care physicians need to stay informed on new developments that impact their practice. Given their broad scope of clinical responsibility, this is one of the jobs they need accomplished on a regular basis. The typical way they get this job done is to scan the customary professional channels, most of which are self-service. A new product or indication, updated clinical information, or a new patient compliance program will be found through self-service channels such as conferences, journal ads and wraps, media reports, search engine results, e-mail, social media, e-detailing, from online ads and Web site sponsorship, and through conversations with colleagues. Targeted awareness building activities through these non-personal, self-service channels is the most efficient way to inform and raise interest and curiosity.

Many franchises have begun to build their own physician email databases of opt-in professionals, and this can be one of the most effective and efficient ways of informing existing customers about new developments and gauge interest. Curiosity causes people to raise their hands with questions, and good self-service informing channels include a response mechanism-usually an invitation to visit a special Web site, make an inquiry to the call-center, or make an appointment with a sales representative to learn more.

Inspire Me
The need for inspiration starts when we are piqued by new information. We realize that we have a need to be filled. Sometimes we have been living with this need for a long time (will someone please find a solution to…), and sometimes the realization hits us out of the blue (I really need an iPhone app that…). The promise of a new solution needs to be vetted.

Whether it’s pulling out our wallet or contemplating a change in behavior, we have an emotional need to be convinced, even excited. Physicians, after becoming aware of a new or improved therapy, have the same need for inspiration.

Delivering inspiration is generally where sales teams have excelled. Time and money have been invested in naming, positioning, and tagline development, and agencies have been engaged to come up with inspiring creative for the sales aid. All the primary-care sales rep needs to do is get the two minutes in front of the physician to show off the impressive charts and read the compelling claims. But what may be inspirational at the agency is not necessarily what a doctor would consider “inspiring.”

Inspiration is framing the promise in light of a primary-care physician’s specific practice and need. General product claims are just that-they are one-size fits all messages that are rarely exciting or practice changing. But when there is information about a product that is tied specifically to information about the prevalence of a disease in a geographic area, or a certain patient type, then suddenly the product claims are relevant-and inspiring.

Unique insight into disease prevalence in a geographical territory is the type of value-add information that will make the product claims and the sales representative relevant to the physician.

Reassure Me
Product claims that ask me to change behavior are always suspect. We might revel in the inspiration, but the closer we get to actually deciding to start or increase prescribing behavior or change our treatment practice, the more that questions and doubts arise. The physician may ask: Why is this new product better than my customary therapy? What facts do I have at my disposal to make an informed decision? What do the doctors I respect think about it? How good are the patient outcomes? Will it achieve its claims with minimal side effects? Is it covered by insurance?

In this phase of the buying process, professionals actually don’t want to hear more inspirational selling messages. In fact, this is when doctors are ready to throw eager sales representatives out of their office. It’s an important transitional period when only hard data will suffice.

This stage is ideal for a robust self-service process. When a physician wants reassurance and access to data, they want it on their own terms. The last thing they want is a sales person breathing down their necks. They want to be able to review the data and draw their own conclusions. Creating a secure professional Web site that physicians can use to review clinical data is an important tool to support the customer during this critical buying phase.

Support Me
Once a physician has made the decision to support a new therapy regimen for a set of patients, selling moves to support. In fact, how pharmaceutical marketers provide support will often dictate whether or not there is a gain or lose share of wallet. If marketers provide strong support for a physician’s practice (in terms of how the physician defines his or her need), and the product performs as promised, then it is more likely that the brand will enjoy loyalty.

Support doesn’t necessarily require personal customer service to deliver samples or patient education materials. An easy-to-use self-service process will get the job done, and is generally preferred. An integrated online self-service section of the professional Web site with ordering functionality is what most physician offices look for.

Right Service, Right Time
The typical primary care physician has many information jobs to do in the course of a day. With the press of a heavy patient load, those jobs often go unfilled. The typical sales representative tries to provide information or inspiration, but it’s not always the right type of information at the right time. A strategic approach looks at the specific information jobs the physician needs accomplished and aligns the right channel.

Understanding the specific information jobs that physicians need filled, when they need them filled, and the types of media and communication channels that they prefer hiring to do those jobs will lead to a more comprehensive and integrated approach to sales. An integrated sales approach that respects the value and timing of both good customer service and good self-service will deliver a much more effective customer experience for the physician, and those brands that embrace this approach will find that their sales teams are (once again) relevant in the primary-care physician’s practice.