Chiropractic and the Pharmaceutical Model

OK, OK, OK, put the phone down…it’s not what you think! We will be using the training and salesmanship of the pharmaceutical representative as a model and if you have a pulse, you know that the pharmaceutical industry is a gazillion dollar industry…Well, they must be doing something right. The main tenet of the drug industry at the grass roots level has been and currently is teaching, anchoring its position with research, respect and persistence. Let’s look at each one of these individually. Teaching – Pharmaceutical representatives are trained to be experts in the products they represent and, therefore, arm themselves with the tools necessary to convey those messages to their targets. They NEVER ASK FOR A DOCTOR TO PRESCRIBE. Instead, they establish themselves as experts and a primary resources to help with problem areas of practice. It is important to realize that they not only provide information that the health professionals can understand, but also provide patient information as well. They give the offices resources to educate their patients.

Anchoring the Position with Research – Pharmaceutical reps will NOT present to a medical office without research that “sells” their product. The product is customized to the particular practice. They don’t drop off a pharmaceutical catalog. What they provide is targeted, researched and highly effective. Even in these times when they are so legally restricted, they are still finding success. The point is their teaching is not based on rhetoric, stuff they learn in school, a seminar they went to or the fact that they BELIEVE the drug works…They present research that is based on the scientific model. Interestingly enough, they also present patient education materials that are based on research as well. This completes the representative, provider and patient circle. Everyone plays their part and they are all important.

Respect – Respect for the barriers in place in the clinical office setting is the starting point to building any relationship with the office and the provider. Understanding that he/she is a guest and it is a privilege to be there is a very important concept for a representative. Understanding the chain of command in a medical office is the best way to show respect and ensure success long term. Moving through the chain of command and never forgetting to acknowledge these key people is as important as any one part of this process. Don’t forget that if a physician trusts these people to be the first faces that patients see every day, he/she will certainly trust their opinions of you.

Persistence – This is the key…always remember that this is a PROCESS, a process that is built on education and mutual trust. Persistence is required to create something that is built to last. Otherwise, you are just like every other pandering salesman out there….building a house of cards. If done right, this will create relationships that will stand the test of time. Plan your work and work your plan!

With these tenets out of the way, let’s talk about getting into the office. Here are the key items to always keep in mind. This is actually from a recent discussion with a VERY successful pharmaceutical representative in the WNY area. The entire time you are engaged with the MD, you are ALWAYS PROVIDING EDUCATIONAL MATERIALS TO THE OFFICE FOR THE MD, FOR THE PATIENTS AND LEARNING AS MUCH ABOUT THE PRACTICE AS POSSIBLE.

Step 1:

When looking to start a relationship with the office, the gate keeper is your first task. Getting to be accepted and gaining the respect of the gate keeper is important to the rest of the process. Without that, you are dead in the water. The gate keeper or gate keepers are the front desk personnel. They are the people you see when you walk into the office and talk to when you call the office on the phone. Generally speaking, they get CRAPPED on all day and deal with angry patients and phone calls. Treat them with respect that is genuine and from the heart. Respect their positions and the trust that the physician (your primary target) has given them.

Step 2:

Meeting the office manager. Once you are “IN” with the gate keepers, your next target is the office manager. The office manager is the direct link to the MD. The office manager will ultimately control whether you actually get a meeting with the doctor.

Keep in mind that based on where you live, your current relationships with the office and how “GOOD” you are will all determine how fast or slow this process moves. I have offices that I called ONCE and scheduled a lunch…Each office is unique. Remember that in each of these steps you are asking questions and allowing them to TEACH you about the office and the problems that they face.

Step 3:

Meeting the MD – Ok, now you have made it. The office manager has allowed the lunch to take place and now you can meet the doctor. We are always discussing the National Research Initiative to promote cooperative spine care in the area. You are looking to provide PEER REVIEWED MEDICALLY INDEXED (use those words, they mean a lot) musculoskeletal research for the office and its patients. You have been talking to the office staff for the last 2-3 visits and have an idea of what their frustrations are. Is it auto cases that they HATE, injured workers and the paperwork, chronic headaches and too many pain medications? This is the target…The research you have access to will provide them with answers.

THAT IS IT! NOW THEY KNOW WHO YOU ARE AND THE STAGE IS SET. Consider the following:

It takes 3-6 visits to the office before you get face time with the MD over lunch on a COLD CALL relationship.  In cases of PATIENT CARE, you will be able to talk to them immediately, that is why I suggest using patient information to communicate.  The pharmaceutical rep does NOT have that luxury.

You must provide a COMPLIANT and ORGANIZED report with research for the MD.  NEVER, NEVER, NEVER…EVER provide only a “summary” to the MD.  That will be the end for you, many consultants suggest that however it is WRONG and will destroy your relationship. More on that further down the road.

Your or staff needs to visit on a ‘regular”  basis.  Typically, for me, if the medical doctor is referring I just send reports. If there’s a dip in reporting then I will send a staff member but eventually I will need that MD one on one. It may be quarterly or maybe two times per year but it has to be doctor to doctor at some point.  You are ALWAYS bringing patient reports, CV and any supportive research.  It should be (at the beginning) related to your patient and not just “stuff.”

Your reports have to be timely, concise and based on current published peer reviewed research.