Why Visits with Reps Cannot Be Education

Sarah Taylor, one of the drug reps cited in my August 29 post, is as noted the author of a handbook for reps. The handbook offers a number of interesting observations, but what particularly struck me was the most definitive example, to date, as to why a visit between a physician and a drug rep cannot be "education." Indeed, if the rep tried to be an educator, she'd be fired, indicted, or both.

Taylor advises reps who want to rise to the top of their business (that is, to win a coveted award for most sales) to go to the medical library and read all the articles they can find about the drug they detail and its competitors. But--here's the rub--the reps cannot mention the content of these articles during a detail, unless the article is part of the standard package supplied to the rep by the firm. If, for example, the article mentions any off-label uses of the drug, both the company and the rep could be prosecuted by the Feds for mentioning it.

Let's suppose that the rep goes to the library and reads an article (not in the company packet)that shows that the competitor drug may have fewer side effects than the company drug, but the rep also notes several methodological flaws in that study design. The next day the rep is detailing Dr. Smith, who likes to argue, and Dr. Smith mentions that same article as evidence that he should use the competitor drug instead.

What is the rep to do? Taylor suggests a script like: "Yes, I did read that article and understand your concern, but if you look here at our product circular, our Phase Three study with over 3000 patients showed..." (p. 32) In other words--impress the doc with your keeping up to date on all the latest science, then change the subject. But the rep cannot get into an actual discussion with the physician of the pros and cons of the methods of that article--which is precisely what a truly educational encounter would focus on.

Now, one might object here--whose fault is this? The fault lies with the drug industry's favorite bogeyman, the FDA. They are the ones that impose these crazy rules that muzzle the reps, especially that bit about off-label marketing (which I admit is a very fragile basis on which to distinguish good from bad uses of a drug). And this objection might indeed have some validity. But notice what the industry's mantra is. It is not: "We would love to have our reps be educational when they see physicians, but unfortunately this is not allowed by current FDA regulations." Rather, the mantra is, "When our reps see docs, it's education, not marketing." It's the industry itself that claims that these visits are educational, under the current regulatory regime.

While we are on the subject, a few more tidbits from Taylor:

• Yet more evidence of the fallacy of "education" (as if more were needed--what is the rep to do when he is having trouble getting up enthuisiasm to keep detailing the same old drug, when there are no new data, nothing really new to say at all? Taylor's answer--read a lot of motivational literature!
• Just because you visit the office, Taylor warns, don't be misled into thinking that you have achieved a "detail." She advises: "Poor reps count signatures [for leaving samples] as details; mediocre reps count 'something accomplished' [like maybe educating the physician?] as a detail; successful reps count 'something sold' as a detail." (p. 16)
• As an example of how 'something accomplished' like informing the doc does not equal 'something sold,' Taylor is a great believer in the absolute need of the rep to "close." She argues that if you work at it, you'll find a way to phrase the closing so that it does not sound heavy-handed. Example: "Something like, 'Have I shown you today that Product X is a great choice for elderly patients with high blood pressure?' does not go far enough. You must ask directly for the business. To that last sentence add, 'Great! Then will you please prescribe Product X for those elderly patients we discussed today?'" (pp. 57-8)

Taylor S. Secrets of successful pharmaceutical salespeople. Gig Harbor, WA: Taylor Presentations, 2004; available for $14.95 at www.TaylorPresentations.com