'The Enablers'. We develop humans into winners

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Location: Ahmedabad, Gujarat, India

We Develop Human Capital "Not to unlearn what you have learned is the most necessary kind of learning" said Antisthenes. Our passion at 'The Enablers' is to develop people. Developing human resources is more important to 'The Enablers' than getting clients. We want to make sure that people take way something valuable and useful for their lives. In our workshops, we create an environment which is conducive to learning. We encourage participants to: • Un-learn what is obsolete. • Learn what is contemporary to become futuristic. • Un-learn and re-learn, un-learn and re-learn again! When people follow these three steps, the miracle process begins - the process of excelling. With this mission, 'The Enablers' was established in January 2004 by Prof. Vivek Hattangadi. ‘The Enablers’ unlock the concealed potential in people and leverage their latent talent so they emerge as winners. In our learning sessions, the participants learn the way an excellent surgeon learns - practicing what has been learned through purposeful activities rather than merely from instructions. Our sessions are pragmatic; learning’s are doable. We have a large clientele even outside India.

Monday, January 25, 2016

Book Review: TOTAL COMMUNICATION©: THE DNA OF EFFECTIVE COMMUNICATION (By Vivek Hattangadi)

Book Review: TOTAL COMMUNICATION©: THE DNA OF EFFECTIVE COMMUNICATION

By Sapna Ullal (Creative Writer)

After a long week at work, there is nothing more inviting than settling down to a delicious Sunday brunch, with a stimulating book in hand. But what if the Sunday brunch was like a magic pill? Infused with an extra nutrient that transformed the diner into an expert communicator?

This is where Vivek Hattangadi’s book Total Communication steps in. The ideas presented here are not, per say, new, but the presentation of the chapters in the form of 10 Sunday Brunches makes it a quick and enjoyable read for the busy professional on the go. And while the food analogies in the book may have you reaching out for dhoklas and theplas, and do nothing for the waistline, they do make the reader a better communicator within 10 weeks. Less time than it takes to attend a proper communications course while keeping full-time studies or a job intact!




The chapters (Sunday Brunches) themselves are divided into many helpful sections. The “Chewing Gum” at the beginning of every chapter is a quote that breaks the ice nicely and affords a glimpse into the topics that follow. The “Digestive Aid” at the end is a fun exercise to ensure readers practice what they learn throughout the week, between two Sunday Brunches.

In an increasingly health-conscious country with a burgeoning internet-savvy population, it becomes all the more imperative for pharma managers, sales personnel and doctors to communicate clearly and effectively with their clients or patients. Unfortunately, in Indian education the focus is on STEM (Science, Technology, Engineering and Mathematics) subjects, leaving soft skills to be learnt on the job. Total Communication fills in this gap in the publishing market and helps the layman in general and healthcare professionals in particular to acquire holistic communication skills. With its witty food analogies and illustrations, the general reader too will find it a humorous and effective Sunday read.






Sunday, January 24, 2016

Manipal Journal of Pharmaceutical Sciences – Invited Editorial Patient-centered Marketing Practices for Pharma India

Manipal Journal of Pharmaceutical Sciences – Invited Editorial

Patient-centered Marketing Practices for Pharma India

By: Vivek Hattangadi 

The Indian Pharmaceuticals Market (IPM) is third largest in terms of volume and thirteen largest in terms of value, as per a pharmaceuticals sector analysis. It is highly fragmented, with an estimated 25,000 companies. However, fewer than 300 are in the organized sector. Currently, chronic therapies constitute 40 % of the market. In the coming decade, however, chronic therapies will dominate; by 2025, it may constitute 65-70% of the IPM.

Although the IPM is growing at nearly 12 to 15 %, the growth of the chronic therapy segment is over 25 %.This growth could have been healthier, but for the myopic marketing practices and the obsolete promotional tools. Doctors are averse to this. They close their minds when medical representatives start communicating. Yet, Pharma India is persisting with the traditional methods of marketing.

The New Marketing Myopia of Pharma India

Ted Levitt in 1960 coined the term ‘Marketing Myopia’. His advice was to focus on customers. And this can come only when Pharma India recognizes its true customer. Who is the customer? Is it the doctor or the patient?

Historically, doctors have had a close relationship with the pharmaceutical industry. This relation has come under close scrutiny. Articles are written in medical journals, the lay press, books are written and the social media is abuzz with this subject. Kessler says that today’s marketing practices have influenced the doctors but alienated the patients.1 It is very true to India too. The marketing practices here have inured to the disadvantage of the patients. 

A paradigm shift in marketing practices is the need of the hour. It is towards patient-centered marketing. The prime importance to Pharma India should be a patient’s health and welfare.



Patient Centered Marketing

Patient centricity means putting the needs and preferences of the patients at the centre of marketing strategy. Here are some of basics of patient-centric marketing.

Doctor-Patient Relationship

Medicine has changed a lot over the years, for the better or the worse. Certainly the technology, medications, and treatment options for diseases have improved over the years and will continue to improve. Sadly, however, the quality of the doctor-patient relationship has suffered a serious decline. The main reason is that doctors no longer have enough time to spend with an individual patient.

This is a good place for Pharma India to start. Patient advocacy groups hardly exist in India. Pharma India can initiate patient advocacy groups which can help doctors and patients come closer and develop dependable relations. Ersoy et al say that patient advocacy can help the patients obtain information which will facilitate their ability to decide or enable them to reach the sources of information.2 Shah and Garg add that such groups can be a liaison between patients and doctors in order to improve or maintain high quality of healthcare for the patients.3 These groups further can develop creative support programs or provide educational material for patients. Various services can be offered to strengthen the bond between doctors and patients.

Patient adherence

Non-adherence is a major barrier in good patient care. Lack of adherence to drug regimens is a serious health issue, especially among the elderly. Adherence is the extent to which patients follow the recommendations of the doctors on medication, diet or lifestyle modifications. Non-adherence as per the Frost and Sullivan Whitepaper can constitute many forms, including not having a prescription filled, taking an incorrect dose, taking medications at incorrect times, forgetting to take doses, or stopping therapy before the recommended time.4 Medication non-adherence is not just a serious problem in healthcare; it carries an appreciable economic burden as well.

Although there is no Indian data on the revenue losses due to non-adherence, as per Capgemini Consulting, globally the revenue loss is estimated to be $564 billion.5,6 Pharma India must realize that investing on such patient-centric activities can increase their sales revenues several-fold.

Adherence programs fail because of the heavy dependence on the busy doctors for implementation. Pharma India can develop adherence programs for their drugs. It can change the traditional marketing approach which is now embedded in the socialization of doctors. At present, the notion of crafting marketing strategy with the patient at the hub is of considerable value. Patient-centric commercial strategy holds considerable potential in generating revenue growth.7Possibly, a collaboration among competitors, which is unthinkable at this point of time, can decide the future of industry growth via patient adherence programs.

Managing a chronic disease is complex and many factors can impact successful treatment from lack of education and patient apathy, to medication costs and environment. Adherence becomes all the more important considering that the share of chronic therapies is consistently increasing and patients need indefinite treatment.

Communication with patients

Peters makes an important point: “Effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine. This is important in the delivery of high-quality health care.8
The importance of this is not of recent origin but recognized many years back. Hall et al said in 1981 that “Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of patient-physician relationship.”9
Doctor’s communication and interpersonal skills will help them get a better insight into the patient as an individual, not just the disease. They will be able to elicit quality information from the patient. This will not just facilitate precise diagnosis, but will help in giving clear therapeutic instructions and counseling. What’s more, excellence in communication will establish caring relationships with patients.

In a country like India with diverse cultural and ethnic background at times, through non-verbal communication, the quality of interaction between doctors and patients can certainly be better. 10

Pharma India can assist the healthcare givers in this field; especially the nursing staff which needs to be educated in communication with patients. Language is often a barrier in effective interaction. Mandal and Basu in their article in ‘The Telegraph’ of 30 August 2014 reported that: “Doctors and CEOs of some hospitals acknowledge that language is a problem that sometimes nullifies the nursing skills these caregivers possess. For patients, it can be a nightmare trying to convey something to a nurse for whom Bengali or Hindi might as well be Greek. A nurse short on language skills becomes a liability especially while handling a patient in pain.”11

Communication does not mean just words.  In my book on “Total Communication©:The DNA for Effective Communication”, I have pointed out that “Many doctors may not really understand the incredible impact and importance of body language as this subject is never taught in medical schools”.12

Are the medical professionals good listeners? One visit to a medical college hospital will tell you how much time a doctors has for the patients. In this milieu, listening to patients is improbable.  Empathy and Emotional Intelligence are very important while treating patients. Empathy has been the subject of thorough study in human sciences. Carl Rogers says that empathy is one of the necessary conditions of a functioning care giving relationship. The attitude of comprehending their feelings and emotions and seeing things from their point of view helps the medical professionals to be more effective in caring for patients.13

This ‘healing touch’ of empathy in communication can be handled by the patient advocacy groups. Once again, Pharma India could offer their services to doctors, especially the upcoming ones.

Handling side effects

Medical science has not advanced to that extent that it has been able to develop and produce drugs which are devoid of side effects. Patients with chronic ailments have to live with them. The emotional distress due to side effects is difficult to handle. What are those side effects which are inevitable and how to live with them should be an area of concern for Pharma India. Patients can learn about the importance of adherence to medication, side effects management through videos produced by the manufacturing company. Pharma India can address specific topics of concern to patients, with the goal of advancing the knowledge of patient needs—for example, managing side effects. This group can also address the challenges faced by caregivers in caring for patients with side effects. For instance, a patient who is undergoing chemo therapy, a caregiver at home, may not know if the signs of distress are treatment or cancer related. Lack of information about the side effects can result in confusion and distress for the caregiver and the patient.

Geriatric attention

While the Indian ethos respects the senior citizens, advocacy groups for such patients are non-existent. Many caregivers may not be sure of what's going on with their elderly parent's health. There is no one who can take the time to explain to them. Falls are common and the leading cause of injuries among people. Senior citizens have the right to information about their health and the right to be treated with dignity and respect. The doctor may genuinely be concerned about such problems but may not have the time and wherewithal’s to handle this. For Pharma India this is an opportunity to assist and build relations with doctors. 

Conclusion

From the retrograde marketing practices, can Pharma India transit into patient-centric marketing? The established commercial model needs more than just a revolution –a paradigm shift is required. The traditional model of pharmaceutical selling by demonstrating product efficacy to prescribers is being challenged. Today, the medical professionals have to face knowledgeable, engaged and internet savvy patients who can confront them and challenge their reputation. Pharma India must have at its heart the development of genuine partnerships between doctors and patients. It should nurture advocacy groups that prioritize healthy patient outcomes. It is also essential that doctors avoid putting their personal interest, or the interests of pharmaceutical companies, before those of the patients.




References

  1. Kessel M. Restoring the pharmaceutical industry's reputation. Nature Biotechnology. 2014 Oct; 32: 983–990  doi:10.1038/nbt.3036.
  2. Ersoy N, Altun Y, and Beser A. Tendency of Nurses to Undertake the Role of Patient Advocate. Eubios Journal of Asian and International Bioethics. 1997; 7: 167-70      
  3. Shah K and Garg S. Patient advocacy groups: Need and opportunity in India. PerspectClin Res. 2011 Jan-Mar; (2)1:  4–7 
  4. Frost and Sullivan Whitepaper. PATIENT NON-ADHERENCE: TOOLS FOR COMBATTING PERSISTENCE AND COMPLIANCE ISSUES.  Available from www.frost.com/prod/servlet/cpo/55342907.pdf
  5.  Forrisier T and Firlik K. Estimated Annual Pharmaceutical Revenue Loss Due to Medication Non-Adherence. Capgemini Consulting. 2012 Nov. Available fromhttps://www.capgemini.com/resource-file access/resource/pdf/Estimated_Annual_Pharmaceutical_Revenue_Loss_Due_to_Medication_Non-Adherence.pdf
  6. New England Healthcare Institute, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease. 2009 August 12. Available from http://www.nehi.net/writable/publication_files/file/pa_issue_brief_final.pdf
  7. Rao, SK. Generating growth through patient-centered commercial strategies. Journal of Medical Marketing. 2012 0(0) 1–11 --------DOI: 10.1177/1745790412450170 mmj.sagepub.co. From http://www.crai.com/sites/default/files/publications/generating-growth-through-patient-centered-commercial-strategies.pdf
  8. Peters, M. The Price Paid for Modern Healthcare. Available from https://www.linkedin.com/pulse/price-paid-modern-healthcare-michael-peters
  9.  Hall, J.A., Roter D.L., and Rand C.S. J Health SocBehav. 1981 Mar; 22(1):18-30
  10. American Association of Orthopaedic Surgeons. Patient-Physician Communication. Avilable from: http://www.aaos.org/about/papers/advistmt/1017.asp
  11. Mandal, S. and Basu, J. News in ‘The Telegraph’, Calcutta.   Available from:  http://www.telegraphindia.com/1140830/jsp/calcutta/story_18775077.jsp#.VYYr5Pmqqko
  12. Hattangadi, V. Total Communication: The DNA of Effective Communication. Bangalore: Pothi; 2015.
  13. Kohut H. Introspection, empathy and psychoanalysis; An examination of the relationship between mode of observation and theory. J Am Psychoanalytic Assoc7:459–483, 1959


Copyright of this article with: Manipal Journal of Pharmaceutical Sciences – Invited Editorial "Patient-centered Marketing Practices for Pharma India" 


Monday, April 21, 2014

White Paper on Good Marketing Practices [GMaP]

The Enablers a pharmaceutical consulting firm in pharma marketing announce the release of the White Paper ‘Good Marketing Practices for Pharmaceutical Industry Worldwide’.

Here is the Executive Summary.

Executive Summary

“This White Paper from The Enablers is to help the pharma industry restore its past glory and the dignity of the profession of pharmaceutical selling. This in turn can attract talent. The challenge is immense as the country has around 24000 pharma companies of which only about 330 are in the organized sector.

While every pharma company is entitled to promote its products and build brands, pharma companies should not divert the marketing budgets for brand building to other forms of sales promotional activities which can raise some eyebrows. The current pharma marketing practices in India replicate the practices adopted by the western world, from where modern medicine has evolved. This does not exclude some of the unhealthy marketing practices in vogue in the western countries as is evidenced by R. Moynihan in the British Medical Journal 326: 1189-1192 (2003) and A. Wazana in JAMA 283: 373-80 (2000). This calls for a 1800 change. Some of the issues which need to be addressed immediately are ‘transactional marketing’; ‘disease mongering’; misleading product promotion; and irrational drug combinations.

Pharma marketing strategies have not changed substantially in the last fifty years. Pharma marketers keep on doing what they have been doing for half a century. Time is apt for a change or else become extinct. Pharma marketers need to look at newer and modern strategies and apply the principles of evidence-based and patient-centric marketing. The critical objective should be to eliminate the practice of insanity in pharma marketing.

Pharma India should be conscious of its special position in the healthcare services in India, and should conduct its marketing & sales activities in a truthful, honest and trustworthy manner.

This can be done by adopting Good Marketing Practices as discussed in the White Paper.”

You can download the entire White Paper, from our website by logging into:


Vivek Hattangadi

Wednesday, April 24, 2013

Preview of the book “PHARMA FIRST-LINE LEADER TO CEO: THE ROADMAP TO SUCCESS”


Over 95% of the time of a First-line Leader (FLL) in the pharmaceutical industry is spent in working along with medical representatives. This also means that a pharmaceutical company should invest substantially to make joint field work effective and thus develop his team of medical representatives. If 95% of the time of an FLL is spent in joint field work, then 95% of the investment on an FLL should be for making joint field work effective. As a corollary, 95% of the training efforts by an organization on an FLL should be to develop him to make effective joint calls. If this is not happening, it needs immediate attention.

But unfortunately says the management guru Kermally Sultan “Some organizations do not want to accept that all managers need continuous training and support in relation to their function of managing people”. (1) They do not realize that those adept in the skills of managing people are the ones who are delivering today while preparing to be the CEOs of tomorrow. People-managing skills can be acquired through training.

Excerpts from the book:


Preface

The most exciting characteristic of the   pharmaceutical industry in India is that many CEOs have started their careers as humble medical representatives. By the time they became first-line leaders, the ambitious amongst them dream of reaching the top. This book is a guide for such forward looking people!

When I started writing this book and shared it with a few close friends, the first question which was thrown at me was its title – why ‘First-line Leader’ and not ‘First-line Manager’? Are the terms managers and leaders synonyms?

Many, many years back, when Eureka Forbes was strongly promoting their vacuum cleaners, I observed that the immediate ‘bosses’ of the sales representatives were called ‘Team Leaders’ and since then I have a strong opinion that the managers is not the right terminology – it is  leaders.

What’s the difference, a few may ask? – Read in this book which will be released very soon.

Perhaps the most inspiring chapter is Chapter 13, the stories of pharmaceutical legends; short autobiographies of luminaries who made it to the top - after starting as medical representatives, including the first person who the author knows has risen from a medical representative to managing director.

There is no gender bias in my books. In my previous book, “WHAT THE PHARMA CEO WANTS FROM THE BRAND MANAGER”, the main character was addressed as ‘she’ / ‘her’. This time I have used the masculine gender. I hasten to add that in my career spanning over thirty years, the best first-line leader with whom I have worked was a lady!

The book has been written in a unique style – the entire book is in the form of a conversation between a budding First-line Leader Vinod Kamat and his Mentor. The lessons which the Mentor gives are the take-home messages for the reader.   

Prologue to the book
We all know that in 1999 India won the Kargil war against Pakistan. The sacrifices of the jawans and officers set many a young heart on fire. One of them was Vinod Kamat, the only son of his parents. Vinod, who was then barely 13 years old, declared his intention to join the armed forces via the National Defence Academy route and serve the country. His mother was in a state of shock when she heard this. She spared no efforts to dissuade him from taking up this risky career.  However Vinod was firm; nothing could shake his determination. He studied hard for the entrance examinations and passed with flying colors. No sooner had he received a call for an interview than his mother went on a hunger strike to dissuade him from attending it. After she went for three days without food or water, Vinod’s stand softened and he bowed down to the wishes of his mother.

He joined Bhavan’s College, Andheri, Mumbai to pursue B.Sc., but his heart was not in studies. He scraped through B.Sc. examinations with just 37% marks. And who would give him a decent job with this ‘brilliant’ academic record?

His first job was as a shop-to-shop salesman selling medicated cough drops introduced by a well-known FMCG. His customer audience included retail chemists, general stores, grocery shops and even ‘pan-bidi-wallahs‘. Selling the stuff packed in polythene bags, he was accompanied by a cycle-rickshaw puller carrying the wares. A chance encounter with the regional manager of Capella Pharmaceuticals changed his destiny. While in the field and working at retail chemists, this gentleman spotted his talent and invited him to join Capella Pharmaceuticals as a medical representative; he was offered Ahmedabad as his headquarters. Vinod was delighted and accepted the offer. Capella Pharmaceuticals was a very fast growing organization which had acquired licenses to market some of the top brands of various MNCs. Vinod decided to excel in this company with an ambition to reach the top and become a CEO one day. (Suggestion: If Capella Pharmaceuticals is still a major company, please mention it here.

Unfortunately for Vinod, his district manager at Ahmedabad was a new incumbent.  His behavior was more like that of a super-medical representative. Vinod could neither get any guidance from him nor learn anything from him. Day in and day out he bragged about his success stories as a medical representative. Vinod and his colleagues often heard him saying, “If I were you, I would have done this, and I would have converted this doctor to our brands. I converted a key opinion leader, Dr. Sharma, to our brand within three visits.” Instead of leading the team forward, he was boasting about his successes all the time! 

Vinod realized the limitations of his immediate superior. He was career conscious: – “I couldn’t join the armed forces; I will make a career in selling, which is also tough and challenging,” he said to himself. Capella Pharmaceuticals was growing rapidly and his growth prospects here appeared very bright. Instead of leaving Capella Pharmaceuticals, he began searching for someone who could guide him as a mentor and found one in his father’s friend, who was the National Sales Manager of a large Indian multi-national pharma company based at Ahmedabad. We shall refer to him as Mentor (with a capital M) here. Mentor became his constant guide. Vinod sought Mentor’s help and advice frequently to help him excel in his chosen profession.

Mentor taught him many things – and the most important one was on his accountability as a medical representative. Said Mentor to Vinod, “As a medical representative you have many roles and responsibilities; but you are accountable for results: to achieve value-wise, brand-wise targets every month, month after month.”

“Accountability,” explained Mentor, “means being liable for rewards or punishments for the tasks assigned to you. Some of the responsibilities can be shared even with your district manager, but accountability can never be shared.” 

Time and again Vinod continued to get guidance from Mentor. Despite having a weak superior, he worked on sharpening his skills.  He worked very hard and displayed his leadership qualities during cycle meetings, new product launches and other developmental programs. He came into the limelight and within four years was called for an interview for the position of district manager, as the first-line leaders in Capella Pharma were designated. After a grueling four hour interview he was selected and posted at Pune.

Vinod went to share his success story with Mentor. It was then that Mentor said, “The job of the First-line leader (FLL) is the most important position in the hierarchy of any pharmaceutical company, whether in India, Bangladesh, Pakistan, Nepal or the USA. A company is as strong or as weak as its First-line Leaders (FLLs). Over 95% of the time of a First-line Leader (FLL) in the pharmaceutical industry is spent in working along with medical representatives. This also means that a pharmaceutical company should invest substantially to make joint field work effective and thus develop his team of medical representatives. Pareto’s Principle is highly visible here,” went on Mentor. “If 95% of the time of an FLL is spent in joint field work, then 95% of the investment on an FLL should be for making joint field work effective. As a corollary, 95% of the training efforts by an organization on an FLL should be to develop him to make effective joint calls. If this is not happening, it needs immediate attention.” Mentor continued to coach Vinod.

The lessons Mentor gave Vinod are narrated in this book. After reading this, today’s FLL should be able to spend his time very constructively during joint field work which eventually will be the roadmap to success.

Note: The term CEO in this book is generic – it symbolizes the person at the top who leads the organization – irrespective of the designation.


Reference 

1)   Kermally Sultan. (2004) Gurus on People Management, London: Thorogood Publishing Ltd.



Pharma First-Line Leader to CEO: The Roadmap to Success


Tuesday, April 23, 2013

Developmental Philosophy and ‘PHARMA FIRST-LINE LEADER TO CEO: THE ROADMAP TO SUCCESS’


What is ‘DEVELOPMENTAL PHILOSOPHY’? It recognizes that although some people seem to be born with different abilities, or more natural gifts: everybody can develop higher levels of performance, given the right encouragement and support!

Having learnt that the most important role of a First-line Leader is to develop his people, how do you go about?

You will find the details in the book I have written: ‘PHARMA FIRST-LINE LEADER TO CEO: THE ROADMAP TO SUCCESS

What’s more, one can learn from four pharma stalwarts who have risen from medical representatives to become CEOs and MDs! Their autobiographical sketches are in the book ‘PHARMA FIRST-LINE LEADER TO CEO: THE ROADMAP TO SUCCESS’, which I have authored.

The book features the autobiographical sketches of 

1. Mr. C.M. Hattangadi - Medical Representative in Pfizer to Managing Director of Parke Davis and later Executive Director and CEO of Piramal Group of Industries.

2. Dr. Ganesh Nayak - Medical Representative, Cadila Labs to Executive Director & COO, Zydus Cadila. 

3. Mr. Hariram Krishnan - Medical Representative, Searle India,, to Managing Director, Galderma Inc. 

4. Mr. Shyamal Ghosh - Medical Representative, Sarabhai Chemicals to Executive Director, Sun Pharma, Bangladesh. 

This book which I have written is now available in India and abroad through uRead.com. Moreover uRead offers a discount of 10% to readers in India.

Please log onto: 


All the best!