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  #1  
Old 03-21-2012, 11:11 PM
Anonymous
 
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Default What are most annoying rep characteristics?

I've been around a long time and more and more docs are deciding to eliminate or restrict their interactions with drug reps. What are the things that reps do that are the most annoying and/or offensive to physicians? What pitfalls, questions, or types of statements should we avoid?
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  #2  
Old 03-26-2012, 07:18 AM
DrDave DrDave is offline
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Posts: 512
Default Re: What are most annoying rep characteristics?

I want to preface my response by saying that the reps who call on me are a generally likeable group of folks. Consequently, I would reframe this question - what is a selling mistake reps consistently make? Also, different doctors have different expectations, so I want my answer to apply to a large group of prescribers, not just me. With that in mind:

It can be exasperating if a rep continues to sell based on a piece of information that I have clearly communicated is not important or not compelling to me. I intended the preceding answer to be general enough to apply to any doctor, but to explain further: for me, this information is usually what is called "intermediate evidence" - some sort of data that requires a leap of faith to translate into a positive patient outcome. I use the following convenient recent example because it illustrates both what I mean and why it's important to me.

For quite some time, the Novartis reps would point out that Tekturna and later Valturna had beneficial kidney effects because, among other things, it reduced protein in the urine. After indicating that this was not important to me multiple times, I began responding "I'll remember that the next time a patient complains about the protein in his urine." I gave multiple examples of how, over the last 50 years, we have misinterpreted what intermediate markers mean to the detriment of our patients. I think it eventually clicked, so the proteinuria argument went away in my office, but it took a long time. It was like they believed if they said it enough times, I would eventualy buy it. I realize that repetition has a place in selling, but not in this way IMO. (In the end, of course, when the outcomes trial was done, it turned out that the decreased proteinuria did not translate into patient benefit and Valturna is no longer available).

I hope that is helpful. Thanks for your post, and sorry for the delay!
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Respectfully,

Dave
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  #3  
Old 03-27-2012, 02:06 AM
Anonymous
 
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Default Re: What are most annoying rep characteristics?

Thank you Dr. Dave. You're always helpful.
I have a couple of follow up questions please.
What do you think about reps negotiating or asking for a certain number or type of patient?
How much, if ever, do sincerity, depth of product/disease state/managed care knowledge factor in?
How often do you think we are just throwing out a script?
Thank you.
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  #4  
Old 03-27-2012, 08:19 PM
DrDave DrDave is offline
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Default Re: What are most annoying rep characteristics?

The "next five patients" hard close type of language is something I haven't heard for some time, although the more general "will you try it, get some experience" is something I hear from time to time. I personally dislike it because I think it exploits a flaw that physicians have had for decades - believing that somehow the small N of their personal experience carries the same weight as a well-designed RCT. I'm not sure most physicians feel similarly, though, and, presumably, it still works on the flawed ones!

"Sincerity" is a subjective perception that can burn you if you rely on it alone (I'm sure Bernie Madoff came across as a sincere guy to a lot of people), but depth of knowledge in the areas you cite is important, hard to fake and does matter, at least to me.

Your reference to scripting applies to my previous answer very nicely - emphasis on proteinuria was clearly a case of sticking to a script rather than listening to my perspective and trying to accommodate it in the message. Hardcore. unrelenting scripting happens, but, actually, not as much as it did years ago. Unfortunately, the reps who are capable of deviating from the script in a meaningful way are now constrained much moreso than years ago, so their only alternative is to refer me to a MSL or say nothing at all when a clinically relevant but non-approved topic comes up.

Thanks again for your post!
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Dave
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  #5  
Old 03-28-2012, 03:57 PM
Anonymous
 
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Default Re: What are most annoying rep characteristics?

Really glad to hear you discuss the small "N" that doctors see in their own practice. I go over a 1a guideline and hear back (from a doc doing something completely different and even off label), "Well, that's not what I see in my practice. My results are fine and my patients are doing well. So, I see no reason to change." It is tough and I have come right out and said that maybe we should just throw out the guidelines and all the RCTs and their evidence so that all doctors can just do whatever they want based on their own individual experience. Usually, I do get some who get upset, but often they suddenly get it and realize that evidence-based medicine is here for a reason. Thanks, Dr Dave!
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  #6  
Old 05-03-2012, 09:45 PM
Anonymous
 
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Default Re: What are most annoying rep characteristics?

Quote:
Originally Posted by DrDave View Post
I want to preface my response by saying that the reps who call on me are a generally likeable group of folks. Consequently, I would reframe this question - what is a selling mistake reps consistently make? Also, different doctors have different expectations, so I want my answer to apply to a large group of prescribers, not just me. With that in mind:

It can be exasperating if a rep continues to sell based on a piece of information that I have clearly communicated is not important or not compelling to me. I intended the preceding answer to be general enough to apply to any doctor, but to explain further: for me, this information is usually what is called "intermediate evidence" - some sort of data that requires a leap of faith to translate into a positive patient outcome. I use the following convenient recent example because it illustrates both what I mean and why it's important to me.

For quite some time, the Novartis reps would point out that Tekturna and later Valturna had beneficial kidney effects because, among other things, it reduced protein in the urine. After indicating that this was not important to me multiple times, I began responding "I'll remember that the next time a patient complains about the protein in his urine." I gave multiple examples of how, over the last 50 years, we have misinterpreted what intermediate markers mean to the detriment of our patients. I think it eventually clicked, so the proteinuria argument went away in my office, but it took a long time. It was like they believed if they said it enough times, I would eventualy buy it. I realize that repetition has a place in selling, but not in this way IMO. (In the end, of course, when the outcomes trial was done, it turned out that the decreased proteinuria did not translate into patient benefit and Valturna is no longer available).

I hope that is helpful. Thanks for your post, and sorry for the delay!
If the FDA reads this don't be surprised by a call. This is the type of off-label promotion that companies rarely put in writing but is discussed openly at meetings freely amongst themselves. Given the opposite outcomes shown in the CT, I expect civil and government suits to be filed.

Good luck
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  #7  
Old 08-10-2012, 03:03 PM
Anonymous
 
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Default consequences for doctors who think they are entitled

Are there any organizations that a rep can contact about some physicians offices that think they are above everything and can treat reps horribly? For instance, I know first hand that a physicians office keeps their reps company credit cards on file. When a rep complained about it, the office manager told her that "it doesn't bother any of the other reps". When I told them it bothered me. They called my boss and kicked me out over a "lunch situation" but would not give specifics. I think this is very wrong and they are still getting away with it. The last I heard another rep called in sick to this office and they went ahead and charged a lunch to her credit card! Audacity!

Subsequently, I know of another office that has a lunch every day. The office staff complains about the lunch the physicians are rude and evasive and don't want to talk about product. Many reps stopped calling on this office. This office was so rude to me and complained so much about the food, which I thought was incredible and most of my other offices always compliment me on this caterer. When asked if I wanted to have another lunch with them, I responded that I didn't think this lunch went well. As a result of my comment. The office manager emailed my company and complained about me and I got written up.

I have since lost my job, to these incidents. Some offices think they are very entitled and don't realize the harm they do to someone's career> all they care about is their "right" to be fed.

Thankyou for any organizations you can tell me about so I can report these offices.
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  #8  
Old 08-12-2012, 08:42 AM
Anonymous
 
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Default Re: What are most annoying rep characteristics?

Wow, Im a former Rep. I've experienced some bad raps from lunches that went sour, due to no fault of my own. One time I called to cancel a month in advance and the staff person did not relay the message. I was 'banned' from doing lunches in the office due to no show. Now you KNOW the staffer was never going to admit any wrong doing. Another time, I went to the office for the required 'orders' at the set time, went to pick up the lunch and all the requirements. (water, diet pop, mountain dew blablabla). Went to get the lunch and it was not ready. I waited and tried to call the office to tell them their was a delay. I brought it to the office and they rudely informed me that their lunch was over now and I could wait in the lobby - after giving them their food bc the Dr. was busy now!

I cut both offices out of my routing and called it a loss. The Drs still wrote bc they were above that and probably unaware. I made sure to send my obligatory thank you card and apology directly to each Dr so they became aware of the rudeness of their staff (in a round about way). I get them back by encouraging community to NOT go to those practices. It's been sufficient.

I realize loosing a job is another thing and encourage you to begin a website or organization to defend the rights of reps to be treated humanely. You had the passion for sure! You are not alone and Im sorry that this has resulted in termination. . Moving forward, when you get your next job be sure to document these type of interactions with HR and your manager ahead of time, just to be proactive and let them know in advance. You will have a record, be transparent and if theirs any opportunity to build a case for EEOC, you've done it!
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  #9  
Old 08-13-2012, 04:40 PM
DrDave DrDave is offline
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Join Date: May 2006
Posts: 512
Default Re: What are most annoying rep characteristics?

I always cringe when I read such accounts of unprofessional behavior on the part of my colleagues, but I certainly believe you. I have seen it first hand and heard it second hand from many trustworthy sources. A few years back, we had another thread on this subject you might want to check out-

Outrageous Behavior

But, to answer your original question, I do not believe there is any organization that would address this type of behavior. State medical boards, specialty boards, hospital credentials committees and employers typically make and enforce policies regarding how physicians interact with patients and co-workers, not salespeople. I suppose you could report a disruptive (the term commonly used in credentialing circles referring to behavioral issues) physician to his employer if s/he has one, although that has other implications. If my employer, a hospital CEO, got such a complaint about any of his employed physicians, I feel sure I know how he would solve the problem - ban field reps from the campus so he doesn't get any more complaints.

Although I feel that physicians (and people in general) should treat everyone with respect and civility, your comments suggest that there is a pharma problem, too. If a company consistently hires reps whose integrity they later question (IE, they believe the physician they don't know over the rep they do), administration needs to be asking serious questions about its processes. If the hiring process is sound, I would think that the default response should be to support the rep, not the physician. Part of that support should be absolving the rep of any responsibility to go back to an abusive office.

In the end, I am baffled by this behavior from my colleagues - avoidance, hostility and disrespect suggest that the physician-rep relationship is not a valuable one for them. In any other walk of life, would such physicians engage in a relationship they disliked in order to get a free salad from Chipotle?

If you said we physicians are an odd bunch, I'd say you're right.
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Respectfully,

Dave

Last edited by DrDave : 08-13-2012 at 08:32 PM. Reason: Clarification
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