The Role of Personal Selling in Health Care - Essay Example

Introduction I have chosen the position of a pharmaceutical industry Medical Representative (MR) for this assignment. I have an acquaintance willing to let me have a detailed inside look at this job, and significant numbers of young people seek such careers. I have interviewed people in this line of work, watched typical field operations at first hand, spoken to doctors and chemists, and studied training and reporting documentation systems in order to write this document. There are many aspects to the MR job: I have chosen the matters which I thought were most important in a capitalist framework, for the length limit specified for this report. The Role of Personal Selling in Health Care The pharmaceutical industry is highly innovative (Nonaka, & Takeuchi, 1995), with new products hitting the market at frequent intervals. Prescription products cannot be promoted through mass media or to consumers directly. Most of today’s over-the-counter products started as prescription brands. Though they are meant to cure diseases and to save lives, medicines have side-effects, contra-indications, and are dose specific. A research based pharmaceutical company is a powerhouse of new knowledge, with new discoveries cascading in each month. New launches by the competition change the comparative technical features, so MRs must know the products of other companies almost as well as their own. The technology of modern medicine will remain academic if there is no effective mechanism to bring it to clinics and to consulting rooms. This is where MRs find places in business models. The pharmaceutical business is so dependant on the sales force that some companies focus entirely on Research and Development, outsourcing the selling functions altogether. Another template is to co-market using third-party sales team to cover the doctor community more widely and intensively. Some companies are brand oriented, while others, which brand generics, emphasize corporate images. However, there is no substitute for the MR in any sector of the pharmaceutical industry. Pharmaceutical selling is not a one-way street in communication terms. The best doctors demand sophisticated and rapid responses to technical questions. The number of doctors served by any one pharmaceutical company typically exceeds 10 thousand. While media can be used to present the results of clinical trials and basic prescribing information, responses to specific requests are best serviced through MRs. The levels of computer and Internet use still vary amongst doctors, so real time communication through this route is not yet possible. MRs not only represent companies to the medical community, but they also act as the eyes and ears of organizations, bringing in feedback from doctors, and information about competitive moves as well. The distribution chain for pharmaceuticals is also served by MRs. Most wholesalers work for more than one manufacturer, so each MR has to ensure that the business interests of his or her company are protected. Each wholesaler has a team of sales people who service retailers. It is up to each MR to train and motivate the sales people employed by the wholesaler. These sales people can also provide the MR with important information about market trends. The retail pharmacy is a vital repository of information about the prescription habits of doctors in each locality. The MR has to excel in building relationships with retailers so that important new doctors who start practice in an area are covered. The retailer can also provide targeted information to help the MR gauge the impacts of calls made on each doctor. Doctors often listen to MRs without giving any inkling of their opinions about brands. Retail outlets provide authentic evidence of whether communication about a brand has affected prescribing decisions. Pharmaceutical companies have no alternative to the MR system in order to communicate with doctors and to service the distribution chain. The average MR has a small territory, which may typically be a few blocks, or even just the physical confines of a single large hospital. However, within such limited spaces, the MR is like an Ambassador and a Chief Executive rolled in to one! Though the MR position is at the foot of the organization ladder, it is a key position for a pharmaceutical company, and a parameter for competitive advantage. A Medical Representative’s Job Specification and Dimensions Since the pharmaceutical industry is relatively mature, the MR’s job follows tight specifications, with little room for ambiguity. MRs are obviously not trained in medicine, but some may not have any qualifications even in the biological sciences. MR training is therefore continuous and intense, and a primary job specification relates to the ability to memorize and deliver specific communication accurately, clearly, and without leaving anything out. I noticed a change in the personality of an MR when formal product communication starts, with a mechanical repetition of a set sales message, almost as though the person had become a tape recorder! The second job specification relates to distribution chain servicing. An MR has to book orders to ensure that wholesalers maintain agreed inventory levels, interact with the sales people of wholesalers, and collect prescription information from retailers. An MR has to also provide product information to all tiers of the distribution chain, announce promotions, and organize shelf displays for over-the-counter products. The average MR can call on 9 General Physicians, 4 retail pharmacies, and one wholesaler on a typical working day. Numbers fall if busy consultants have to be met, or if a territory is dispersed over a large area. Half a day of each week has to be set aside for meetings with colleagues and the supervisor, to review work and to make tactical plans. A rush of new launches could mean that about 30 days in a working year are allotted to training. This is apart from about a month of initial training on starting a career. MRs can excel by planning their visits to clinics and to shops in such a manner that they are able to make 10 or 11 calls in a day instead of 9, or meet 5 pharmacists instead of 4. This calls for a great deal of self-motivation, and for detailed area and customer knowledge as well. Each doctor may have a specific time of day or day of the week ear marked for MRs. Retailers do not like MR visits during peak foot fall hours. Hence an MR has to considerable juggling to get a full day’s work done. The daily report is an important part of an MR’s job. It is structured in to a form, but can still take some effort at the end of a hard day to complete. It is a major instrument of control and feedback for a supervisor. Skills and Regulation Communication is the most important skill for an MR. They all know how to speak and to present themselves, otherwise they would not be hired, but companies invest heavily in providing them with advanced inputs for this skill. MRs are especially good at handling objections, can build strong working relationships, and specialize in presenting voluminous technical information succinctly and persuasively. I could not find any concerted attempt by companies to instill other skills in their MRs. They are sometimes used as ushers and in menial positions during medical conferences, but this acts more as a break from routine rather than any valuable or sustained professional development. I broached the matter with supervisors I met, but found that they are averse to broadening the scope of an MR’s job, as they feel that it will distract attention from short-term sales objectives. Communication with the distribution chain is very different to generating prescriptions. The MR role in selling to the distribution chain must be the reason for the health care industry focusing field teams so closely on communication-related skills (Bowersox, & Bixby Cooper, 1992). An MR has to excel in both technical and commercial aspects of the position. Self-regulation dominates pharmaceutical selling. All written product claims have to be substantiated by peer-reviewed and independently published clinical trial data. I was told that not all companies follow such norms, but was not able to verify the matter. It is known that some companies offer doctors extravagant gifts and loads of free product samples. However, there are no formal rules to govern this activity. I feel that it is an area where allegations are difficult to prove as well. It may not matter much with proprietary molecules, but the affinity of doctors to brands of generics is a matter for suspicion of unfair practices. Service is a very important element of an MR’s job. Since competition is intense, companies with even the best brands cannot afford to be complacent. Doctors and distribution chain members demand and receive diligent responses to their professional requests. I noticed that MRs respond to all requests from key clients with alacrity, and make careful notes of all their comments. They leave no stone unturned when it is a matter of customer satisfaction, and are able to handle even the most impatient and aggressive doctors with aplomb. Career Development All the supervisors I met started their careers as MRs. I am told that all National Sales Managers are also promoted through the ranks. MRs without qualifications in pharmacology and business management do not have many opportunities to move in to staff positions in marketing. The specialized nature of the job does not impart any experience which is useful in other industries. Pharmaceutical companies do accept people with experience in other kinds of selling, but the remuneration and incentives in the industry mean that it is largely a one-way street. I saw a number of MRs and supervisors in the field who have been in the profession for all of their careers. There is considerable employee turnover within top companies, since smaller and newer players feed off the best people trained and developed by the top companies. There has been a flush of biotechnology and medical device manufacturers flooding the market of late, so the demand for successful MRs is very high and they can dictate their terms to a large extent. The average MR can expect a promotion to a supervisory position within 3 years. I feel that the supervisory role is not as clear as that of an MR, because I found that they do not say much during joint calls. The MRs can be quite opinionated and do not necessarily implement any pointers from supervisors. A supervisor may act as a guide for a trainee, but since the MR’s job is so tightly specified, there is relatively little of substance for a colleague from outside the territory to do. The managerial positions are meaningful because operational control, budgeting, and resource deployment issues are decided at this level. There seems to be some unnecessary hierarchy in this part of the organization, with managers for Zones, Areas, and Regions. It is common for managers to come in from other companies. Most organizations seem to undervalue their own supervisors. The managerial position does not involve much field work, though I did occasionally meet some of them at wholesaler offices. They are also very visible at medical conferences. The industry does not seem to have any structured way of teaching new managers the skills they need to handle job differences from their supervisory days. It is best for an MR to build his or her career by excelling in Services Marketing (Payne, 2002). The intensity, comprehensiveness, and updating of training provides adequate resources for even average people to do well on the job, and to qualify for financial incentives, and recognition in terms of promotions as well. I saw that MRs are liked and respected by doctors, the trade, and by their colleagues. It seems to be a satisfying job, with prospects of relatively light work once you become a supervisor. There are many times of the day when doctors and sellers are busy, but when MRs are free. They while away their spare hours on the job, and I never found any inclination towards self-development or for developing a second career. The working day of an MR is intense in bursts, with many empty intervals in-between. Employers show no initiative in encouraging MRs to broaden their career prospects. Gender Issues I did not come across a single case of discrimination against women. You see them in nearly equal numbers in most parts of the market. Many trainers and product managers are also women. However, for some reason, most wholesale enterprises are managed by men, with women only at the back end on computer screens. I am not sure if this is because of any bias or because of the small sample I encountered. Conclusions Systematic pharmaceutical selling is about half a century old. The growth of generics and drugs which have gone off-patent, the entry of many new competitors, and options of Internet and PDA use by doctors should have brought many changes in the pharmaceutical industry, but this has not happened. The MR’s job may be a function of burdens of experience, knowledge, and success in a rapidly changing environment (Barger, & Kirby, 1995). Managers insist on operations being conducted as they were when they were MRs, and seem to resist change. Much of personal selling can be in a time warp in the 21st century, and this seems to be the case with pharmaceutical selling in large measure! It must be that large margins in products allow companies the luxuries of large teams of people in the field. The MR role is clear when it comes to new research being brought to market for the first time, but I feel that doctors entertain selling stories on matured brands mainly to get samples and gifts! Similarly, almost all the things I saw MRs do in wholesaler offices and in retail pharmacies can be done on the Internet. There are adequate promotion avenues and job security for MRs, but they are all extensions of the same job. It is very difficult for an MR to change his or her vocation, though companies are always on the look out for the best people with the competition. This is not a good position for people with ambitions of working in different jobs and learning varied skills. However, the pay is good, and the work load decreases as you gain in seniority. The innovative nature of research based pharmaceutical business puts the MR’s role at a big premium. Companies with break through products may reach the good news to doctors through journals and scientific meetings, but the product life cycle and sustained profitability depends on the communication reach and effectiveness of the sales force. Since companies may face periods during which their product development pipelines are less than full, the capabilities of MRs to keep doctors prescribing existing products is an essential cog of risk management (Kahneman, & Lovallo, 1994). The industry consensus is for many new molecules and bio-technology brands to be launched in the foreseeable future, so there is plenty of scope for MRs! References Barger, N. J. & Kirby, L. K. 1995 The Challenge of Change in Organizations: Helping Employees Thrive in the New Frontier, Davies-Black Publishing, Palo Alto, California. Bowersox, D. J. & Bixby Cooper, M. 1992 Strategic Marketing Channel Management, McGraw-Hill International Editors Kahneman, D. & Lovallo, D. 1994 Timid Choices and Bold Forecasts: A Cognitive Perspective on Risk Taking, in Fundamental Issues in Strategy, eds. Rumelt, R. P. & Teece, D. J. , Harvard Business School Press Nonaka, I. & Takeuchi, H. 1995 The Knowledge Creating Company, Oxford University Press Payne, A, 2002 The Essence of Services Marketing, Prentice-Hall Read More