Oncologists, in Detail

On average, cancer docs in the US would much rather deal with pharma sales reps in person as opposed to online, and drug companies are hiring more reps to support a slew of newly approved oncologic drugs, even as reps in other therapeutic areas get pink slips. But external pressures are likely to further limit a sales rep’s access to these physicians, according to a new report.

As the New York Times’ Gardiner Harris has adeptly reported, newly-minted physicians emerging from their final rounds of a med school residency are much more likely to join up with an integrated delivery network (IDN) or chain of privately-owned clinics, than join or start a private practice. The reasons for this are numerous – private practices, for financial reasons, are being sold into aggregated networks, so basic job availability is one part of it – but importantly, lifestyle changes like the need to balance family responsibilities evenly between partners have made the prospect of working 60 or 80 hours a week to build up a private practice untenable, or at least undesirable, for many new doctors.

As a result, new cancer specialists (and many veteran oncologists) find themselves practicing medicine under the auspices of an authority higher than themselves, one with productivity measures and process requirements, in addition to policies around sales rep access. Even though 60% of oncologists say they prefer in-person visits with sales reps – 80% of community oncologists and 60% of academic oncologists say they continue to see reps on a daily or weekly basis – access is likely to continue getting squeezed, due to corporate policy or institutional mandate, according to The Complete Oncologist, a new report from MDLinx, an M3 company.

Physicians don’t like to be told how to practice medicine, and even if access to sales reps specifically isn’t what spurs a rebellion, “I think we are going to see these institution-based doctors begin to push back against the institution’s profit mandate,” says David Deutsch, global head of syndicated products at M3 Global Research. “One of the reasons [institutions] are restricting reps, in our estimation, is that it’s a time issue.” Managers at private clinics or institutions may feel that a physician ought to be seeing a patient instead of listening to a sales rep, says Deutsch. “It’s all about productivity measures in the larger IDNs, and particularly those practices that are owned by large chains that are not hospital-based, but are ‘industrial practices,’ as it were.”

While total sales rep headcounts across all therapeutic areas have slipped to around 70,000 or 75,000 – less than half of the roughly 150,000 reps working full time during the 2000 to 2005 heyday of professional sales – “fully 10 to 15%” of the current rep population represents oncology reps, a 50% increase over the last five years, says Deutsch. Pharma companies “believe they need to have more oncology reps to get more time with those doctors that they are still seeing,” says Deutsch.

When oncologists do go online, it’s probably not for a digital detail, and it’s almost definitely not for social media. According to findings in the report, 50% of the oncologists surveyed said they never use social media, and only 21% of community oncologists (and 10% of academic oncologists) said they visit online peer networks when seeking information about clinical decisions. Online, professional journals were the destination of choice for both community and academic oncologists, and communication with colleagues, in person, or by phone or email, was also cited as an important channel for clinical decision-making.

The Complete Oncologist is the result of surveys conducted with 385 oncologists. Almost half of them said they never visit pharma corporate or brand websites, and all of them see at least 100 patients per month, according to the report.