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Friday, April 07, 2006

The Medical Representative, by Kirit Fadia

Doctor &The Representative (As told by Mr. Kirit Fadia a gentleman with over 45 years as a practicing Medical Representative)

Definition

What does the word “Medical Representative” signify to a doctor?

When I hear it I first conjure up a picture of a quiet man with a smiling face and assured manners wearing a well-designed suit, with a tie around his neck and a bag in his hand waiting in a doctor’s office for that most important event-interview. The first meaning given to the word “Representative” in a concise Oxford Dictionary is –one who is fitted or qualified to represent. Here it is a pharmaceutical firm which he represents. Some call him a commercial drug traveler while others call him a detail man. He is the one who brings product into the premises of doctor. He is a link between the doctor and the product. He is the first contact with a new preparation of an average physician. He is sale promoter whose job is to sell a new product to a busy, skeptical, specialist or a general practitioner.


Representative Yesterday and Today

In the bygone days there were a very few firms and those which were there were mostly foreign and reputed. The doctor also had very little choice for prescribing. And hence, a job of the representative was very much easy. He used to visit a few important doctors in town and also used to see civil surgeons at Taluka places. In the early 40’s and 50’s doctors at times used go to the station to receive them for doctors thought that there was something magic in the Representative’s bag. Representative then had very little competition. But what is the position today? Today, he has got a very tough job and a very keen competition. He tries to see eight to ten doctors a day by appointment or otherwise, with repeat visits every month or two months. He has to call on more than four to five hundred doctors in this area, plus forty to fifty drug stores and a few hospitals. And his main job is to sell the new product to a busy, skeptical specialist or a practitioner.

Good Representative

Remember, a doctor of today is not concerned with the dress or the personality of the detail man. The other point of great importance with which a doctor of today is not concerned is how the representative puts his firm’s interest first and how he promotes the sales of the firm’s products by liberal sampling or by offering useful or wasteful gifts or by circulating the reprints or the literature claiming that ‘B’ is an improvement over A+. This you have plenty of time to learn from your firm who knows the job too well. But doctors want him to be a good member of the society. He must be welcome in society for his own sake. He should see that he is respected not only by firm and doctor but also by his associated chemists, and also by his stockist. Every one of you here must remember that neither force of character, nor attractiveness of personality can compensate for ignorance or for failure to detail a product, Personality alone should not contribute equipment in itself. It is the stock of the quacks. He must learn to cultivate test that are attainable, available and satisfying. Every one of you must define his objectives in life and live so as to attain them. Every one of you must define his objectives in life and live so as to attain them. Every representative must shake off regrets for the past, the fears of tomorrow, and start to live happily today. He must cultivate courtesy at home and outside but especially at home. He must learn to live for others, to give rather than to seek. He must learn how to learn for himself. He must acquire the power to reason and think critically. He must gain an understanding of the responsibilities of a representative. If these objectives are reached one will inevitably have built up a foundation of knowledge and also the nature of man.

ART OF INTERVIEW

It will help the representative immensely in sales promotion if he studies the doctor’s nature prior to the interview. He should, if possible, try to know the doctor’s leisure pursuits, his personality, his habits, his likes and dislikes and also the type of doctor he is likely to interview- a doctor with an eye on the price, a studious one, a quality conscious, a sporting type or the one interested in politics. For everyone knows “forewarned is forearmed”. Just as communications between the doctor and the patient must precede diagnosis so also communication. And as diagnosis precedes treatment so product introduction should precede sales promotion. What about the interview itself? One should avoid stereotype interview. It should vary from doctor to doctor, from rural to urban one and from one consultant to another. In addition, a representative must have the art of prolonging as well as cutting short the interview depending on the circumstances prevailing at that time. Prolong the interview only when you find the doctor is getting something of value. Ideally, interviews should be as brief as possible. Remember that the doctor’s time is his money, especially if he is a specialist; and many times, if it is a repeat visit and nothing new to detail, the big boss expects him to finish the interview in less than five minutes. The detail man must have answers to sharp, pointed ands even auspicious questions asked by his customer. Routine interview, if it is losing its value, remember, this may be the fault of the interviewer here it is of the representative.
In my opinion, more discussions should take place between the doctor and the representative, for information about the particular product should not be a one way transfer of data. In principle and practice at its best, it is a process in which experience and ideas of two minds meet and are sharpened. For such an interview engenders our appetite, at attitude, and at length, a habit of mind that brings steadily increasing knowledge, awareness and discrimination to its possessor. Remember, every representative must have knowledge about the product and what he is talking about or he may get tramped on every time.

EXPECTATIONS OF DOCTOR FROM THE REPRESENTATIVE

The doctor expects from him, besides knowledge of product, judgment and skill, a capacity to understand members of medical profession, appreciation of different outlooks, experience of the world, last and above all, a right sense of values. The doctor expects him to come at the appointed time or when he is a bit free of his patients. He also expects the representative to know his job well. Whether he does it or not it is very difficult for any representative to assess. The doctor expects him to tell the truth and not the half-truth of the product. In 99 out of 100, the doctor’s opinion about the representative will be enhanced if a representative stresses benefits as well as the dangers of the new drug. Every representative should see that he does not add his own personal problems and create more problems to the doctor. Rarely, this helps sales-promotion. A representative can have and express an opinion, but he should see that he avoids useless and provocative arguments. Remember, at times, you may win an argument but lose the customer. The doctor expects him not to criticize other doctors, for it raises the suspicion that it is a chain reaction. He should give technical details depending upon nature and interest of the doctor. He should stress the product in which the doctor shows his interest and not the drug on promotion list. He should never slight a doctor. The doctor expects him to carry out the intelligent market survey and communicate the firm. He should also communicate to the firm the type of products the doctor needs. The doctor may be your friend, but he expects him to be given a proper respect in his office, and especially, in front of his patients. The representative, by qualification, should not be another doctor. Because by nature, a doctor is an individualist, if another doctor tries to tell him how he should practice, a barrier is set up between the doctor and the detail man and the selling job is likely to fail. The doctor expects him to supply ordered drugs in stated time. If, for one reason or the other, there is a chance of delay, it is the representative’s job to inform the customer in time. It is a tragedy if the doctor has to put a board requesting the representative not to ask for the order. Remember the doctor will put the order if you have drugs of his need and if the detail man has patience. Please do not press for an order, at times the doctor gets irritated. Remember, he has problems to solve before placing the order. As there are many products of similar nature with more or less the same composition, a representative should avoid comparing his firm’s product with that of others. Today drug houses want to promote the sales of their own particular brand of drug, and they either rename the official preparation or they will re-introduce the same with some minor modifications which are claimed to be superior. So, it is the opinion of the medical profession that a representative should first tell the official name of the product and then the proprietary name given to the same by his firm.

Medical Knowledge

Another very important question than baffles a representative is how much medical knowledge should he possess? If one wants to answer to this, one should keep in mind Kipling’s famous jingle- It says “I had six trust serving men (they taught me all I knew) their names were: What? Why? When? How? Where? And who? What is the product? What is the dose of it? Why to use it? When to use it? How, where and who should use it? The one who has the answers to these on the tip of his tongue at the time of the product introduction may venture to call himself a well-read and well informed representative.


Prescribing and Practice

Where once, the practitioner had little but advice to give his patients, he now has at his disposal a wide range of effective drugs. Rarely is his counsel unaccompanied by a prescription. Choosing drugs is therefore a large part of a practitioner’s business. Selecting not only the agent which is most appropriate to the condition but one of the many virtually equivalent preparations in which it may be marked. The doctor of today has and apparent predilection for proprietary preparation and hence to boost the sales promotion every representative should try to discover not only what the practitioner prescribed but why? Some of the external factors are likely to be important in determining the practitioner’s choice for drug includes, amongst others the various sources of therapeutic information such as medical training, consultant’s advice, discussions with colleagues, text books, journal and postal advertising, representative hammering etc. Some other factors which determine the doctor’s choice of drug include reputation of the firm, quality of the product, the price, reminders about the drug safety of the product, or as stated by Morrell, a drug whose probationary period is over, the one of its kind, doctor’s interest either in the firm or the representative and the intimacy of detail man with the practitioner. As there are many products of comparable nature with varying composition the doctor is many times baffled as to what to prescribe and here the personal relations sometimes comer to the aid of a detail man.


Conclusion

Remember, man will always feel the need for drugs, a means to escape from stresses of life and lubricant to ease contact with his fellows. The experience of human predicament and the need felt for aids coping with it may now possibly be greater than ever before. This has been stated long ago in a different way by Sir William Oster. He had said “The desire to make medicines is perhaps the greatest feature which distinguishes man from lower animals”. And as long as man exists, the disease, the drug, the doctor and the detail man and his firm exist. And as well as exist, let us all, the doctor, the drug firm, the detail man come together and use all our knowledge to try to defeat discomfort, disease and death and safe guard the man’s health against side effects of drugs which we use on him, for society asks of medicines more foresight in the appreciation of hazards of mankind and more humanism in design of our therapeutic programme both for individual and the community.

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