It's all about education - and not just reaching doctors
Twenty years ago, you could spot a pharmaceutical sales rep from 50 paces: If you saw a good-looking 20-something with one of those briefcases on wheels heading into an office building, chances were good that they were a drug company rep looking to push their products to doctors. Armed with flashy detail aids, plentiful supplies of samples, and an aggressive sales pitch, they were crucial to a drug's success.
In the past few years, however, things have changed: Pharma reps can no longer come bearing expensive gifts; doctors are busier than ever and less inclined to give up patient time for sales reps; and with more information at their fingertips, physicians have less incentive to spend time with reps in order to learn about a particular product or drug. In fact, 25% of doctors say they no longer see pharma reps in their offices, and almost as many are reluctant to take samples.
More importantly, many practices don't function the way they used to, thanks to doctor shortages and economic constraints. These days, a single doctor may be supported bya whole team of nurses, RNs, nurse practitioners, physician's assistants and other healthcare professionals - all of whom play a role in influencing the medication a patient receives.
What does this mean for the role of the pharma sales rep?
1. They must be able to educate
Spending time with reps whose knowledge doesn't go beyond the detail aid or whose only goal is to sell more product just aren't a good use of a busy doctor's time - and aren't providing any better information than a doctor could find online, more conveniently. In order to be effective, pharma reps have to be able to provide more in-depth, unbiased information.
2. They must demonstrate they can add value
A rep who stops by only to 'push' products, without regard for the overall practice goals, patient needs, or market knowledge, simply isn't adding value to the practice. Reps who can provide practical help, such as assistance with getting approvals from HMOs or educational opportunities for patients, will stand a better chance of getting through the door - and allowed to return.
3. They must reach the support staff as well
In more and more practices, it's the RNs or other nursing staff who do the most patient counselling - they're the ones who get the questions from patients about treatment plans, medications, prescription alternatives, etc., and they're the ones providing recommendations and advice to the doctors, who don't always have the time to review all the options themselves. Reps who hope to influence a doctor's prescribing behavior need to be prepared to spend time with the other people in the process.
4. They must be perceived as unbiased
GlaxoSmithKline's recent $3 billion settlement of the "largest healthcare fraud in US history", based on the sometimes shady promotion of prescription drugs for unapproved uses, highlighted a growing concern among doctors, healthcare practitioners and patients about access to unbiased information. Pharma reps need to acknowledge side effects, ongoing issues, and even the efficacy of competing products in order to be taken seriously.
So what does all of this mean for the pharmaceutical companies?
Well, many pharma companies are cutting back on the use of traditional sales reps. They say they're too limited by legislation, they aren't able to gain access to doctors, and they can't impact sales the way they used to.
However, I think that if the pharma companies rethought the way they trained, deployed and incented their reps - and thought in terms of 'support providers' rather than 'salespeople' - they might just find they had a highly effective team at their disposal.
Across most industries, the role of 'sales' has changed significantly over the past 10 years. Now that consumers have more information about almost everything at their fingertips, they no longer appreciate hard-core sales pitches or salespeople who do more selling than listening. Salespeople who provide honest answers, good advice and value-add follow-through do better - and build a better reputation for their organization - in the long run.
Big pharma is no different: Companies who strive to fully educate their sales reps (and perhaps gave them a less sales-oriented name like 'consultants') about their products, encourage them to understand the larger issues at play in today's medical practices, and provide them with the ability to add value via educational materials, patient seminars or administrative advice, may find themselves not only with better-performing drugs but improving the image of pharmaceutical companies in general.
Of course, this requires a major shift in thinking - we're not going to do away with 30+ years of traditional pharma sales reps overnight. But isn't that where change management can make a positive difference?
Change management can get derailed by the weirdest things
A few years ago I was working on a change management initiative: Implementing a new CRM (Customer Relationship Management) process within a mid-sized organization. The project mostly involved changes to the way customer inquiries and issues were managed and monitored, but the software was staying the same.
I thought the project was going quite well, until one Monday morning I checked my email to find 4 messages from the manager of the sales team.
"I can't stand this new system!" the messages said. "You never told me you were going to change the whole computer system! I thought were were using the same software as before! I can't find anything!" There were a lot of exclamation points, and the messages got progressively more strident.
I was confused, because I knew we hadn't changed the software. The project was really about providing a better customer experience and ensuring that we had a more consistent message across all touchpoints.
Luckily I happened to be on-site with the client that day, so I stopped by the sales manager's desk to ask for more information. I was glad I did.
It turned out that over the weekend (typically a slow time), the IT team had made some changes to the look and feel of the back-end of the CRM system, to make it more consistent with the front end of the website: They'd added the company logo, changed some fonts and colors, and added a background image to the login page. Nothing about the functionality had changed: Users still logged in the same way, entered the same information, and navigated through the same screens.
The problem? The IT team hadn't told anyone that they were making the changes over the weekend, so when the sales manager called up the CRM system on that Monday morning and saw an unfamiliar background image, and was then faced with a system that looked different, she panicked.
The lesson? When people are in the midst of a change initiative, they can feel more insecure and uncertain than usual, because they know they're going to have to learn to work - and be successful - in different ways. That kind of stress can lead them to misread information (mistaking new colors and fonts for a whole new system) and then over-react (sending 4 panicked emails). This is why it's crucial to communicate - and keep communicating - even the smallest details, throughout the process. If the IT team had simply sent out an email on Friday saying they'd be making some cosmetic changes to the CRM system, the sales manager would have been prepared for what she saw on Monday.
BONUS LESSON: Your sales team can be your most effective allies in a change management initiative - but they tend to be emotional engaged, so it's extra-important to manage their experience throughout the process.
Sometimes it takes a physical change to spark a behavioral one
The countries of the former USSR are in a difficult period: They know they need to hange, but are caught in the grip of hundreds of years of often-difficult history. History is frequently a barrier to change, but a country isn't like an office: You can't just buy some new office furniture, paint the walls and invite everyone in for a lunch'n'learn when you want to signal - and foster - a major change of direction.
But maybe you can do other things.
Last month, Georgia - the one in Asia, not theone in the US - unveiled its brand new parliament building in Kutaisi. The new building has been described as a "sci-fi bubble" and represents a deliberate departure from Soviet-era architecture (a Soviet war memorial was, in fact, demolished to make way for the new building).
The whole point of the $83 million structure, uniquely modern in its landscape, is to be a tangible expression of Georgia's commitment to moving past its Soviet history and towards a more global, independent future. Ramaz Nikolaishvilli, Georgia's Regional Development and Infrastructure Minister, said: "We don't want our children's taste to be ruined by communist architecture. We want beautiful buildings and we want the next generation to grow up with good taste. This will help them live in a better and more dignified way."
Of course, the project hasn't been without its difficulties: Demolishing the war memorial caused injuries; there have been cost and deadline overruns; and there are plenty of detractors who think the building is both ugly and a misuse of public funds in what should be a time of austerity.
Is the big risk going to pay off in big results for Georgia? It's probably too soon to tell, but early signs suggest that bold moves like the new parliament buildings, combined with other efforts to remove Soviet-era reminders are helping Georgians to see themselves as independent, entrepreneurial, and ready to compete in a global economy - all of which will put it ahead of other former USSR countries in the long run.
Lessons for change management practitioners
What is motivation, and what happens to it during a business transformation?
MOTIVE noun \ˈmō-tiv : something (as a need or desire) that causes a person to act
Motivation is simply the drive that moves us to take an action. These drives might be physical (to have a drink of water when we're thirsty); intellectual (to read a book when we're bored); or emotional (to call a friend when we're feeling sad). As humans, we're motivated to do what we believe is in our best interests. Sometimes that results in positive achievements; sometimes in (retrospectively) stupid mistakes.
Our beliefs about what our beset interests really are can make motivation in times of change particularly challenging for an organization. When a new direction is announced, and involves potentially painful changes like reorganizations, staffing changes or business process restructurings, a quite complex web of motivations can arise:
Employees may feel their 'best interest' is simply to survive the change
Department managers may feel their 'best interest' is to keep delivering results at any cost - and to survive the change
Senior leadership may feel that their 'best interest' is to avoid being blamed if the promised results don't happen - and to survive the change
But how do you keep an organization moving forward when motivations are evolving, and so many people are going into 'survival' mode?
Establishing new direction
As a leader during a business transformation effort, establishing a new direction doesn't mean simply announcing a new strategy and then walking away as if the business will just continue as usual and the changes will magically appear. It means putting a process in place which encourages and supports each individual as they define wha the new business direction means to them.
This isn't 'touchy-feely, sing kumbaya' stuff. It's about helping employees understand their role in the transformation, how it will affect them, and what they can do to move forward - because it's only by helping them understand these things that the business change will achieve the ROI that it should. After all, it's the people in the equation who make or break a transformation.
Removing barriers
The number of barriers the organization faces depends on the nature of the business change. Barriers to change can be as simple as ensuring everyone in a specific department has adequate education in a new technology, or as complex as inspiring an entire organization to buy into a whole new strategic vision and approach to the marketplace. Either way, they need to be taken seriously.
Engaging the individuals who are involved in or creating the barriers is the first step to easing them. You can motivate a department to become engaged in a new technology by helping them understand how it will make their work lives easier; you can motivate an organization to become engaged in a new strategic vision by helping them understand how it will drive their long-term career goals and security.
Providing support
A key role for leaders is to provide support to the team as they change the way they operate on a day-to-day basis. Supporting individuals means listening, empathizing, and concentrating on their progress through a change. By providing assistance, feedback and counsel, you're helping them to see that their 'best interests' really do involve moving forward with the changes - and that helps keep them motivated to continue.
Remember: Support may also involve reiterating why a change is being implemented, what the goals of the change are, and why the timing of the change is important. This will help drive motivation.
Good leadership = Good motivation
People need leaders to lead, especially during a time of change. Sounds simple, right?
Except that 'announcing' a change isn't the same as 'leading' one. Leadership during a change requires a leader who is actively and visibly engaged during the entire process; someone who is seen to be removing barriers, providing support, and communicating the process in a credible way. When leaders do this, individuals become more and more motivated to work towards a goal which doesn't just benefit 'management' or 'the company', but their own best interests as well.
6 ways to get ahead of the problem
It's every CEO's worst nightmare. You're in the midst of a change initiative, but you've had to make some tough decisions, and a few people have been asked to leave. But you're sticking to the plan, and you think things are going as well as can be expected. You can see the light at the end of the tunnel.
Then one of your best clients calls to say that they're worried about next year's contract and thinking about reducing their spend with you. You reassure them that everything is fine - and you think that it is. But then you hear from a supplier who's wondering if you're still going to be paying your invoices on time, and expressing concern about their long-term relationship with you.
You're perplexed - until you happen to call a former colleague with whom you've stayed friendly and he greets you with, "What the hell is going on over there? I hear you won't be around this time next year!"
And suddenly you discover that a couple of employees involved in the change have been more confused and disgruntled than you realized. They've been spreading the word, and it hasn't been positive. They've been so vocal, in fact, that the word on the street is that your organization is on a collision course with disaster - and that's starting to make your clients, suppliers and other stakeholders nervous.
So what do you do, before someone forwards a confidential email to the competition, or, worse, decides to pen an op-ed about the state of affairs in a daily newspaper?
Managing change communications in a crisis
1. Don't panic. When you start hearing negative rumors from a couple of different sources, you can start to think that 'the whole world' is saying you're about to capsize, or that your entire workforce is staging a mutiny. Chances are, things aren't that bad, and you've probably caught it early. So don't go into full-on crisis mode until you've had a chance to speak to your senior management team and get an accurate assessment.
2. Don't look for scapegoats. You're probably feeling betrayed and angry, but looking for someone to blame, fire or castigate is only going to exacerbate the problem. What's really happening is that you're getting negative feedback about the change - you're just not getting it through the most productive channels. But negative feedback can be a good opportunity to gain insight about how the change is being implemented - so instead of looking for someone to blame, look for the opportunity the situation is providing you to improve the change.
3. Help employees to see the big picture. When quite a few of your employees are speaking to outsiders in a negative way, it's usually a good sign that they don't really understand why the changes are happening or why they're a good thing for the organization. So you probably need to beef up your messages about what these changes mean for the long-term health of the company.
4. Help employees to see the little picture. If the source of the negative messages is a handful of people or a specific department, it's likely that those people or that department is feeling disengaged from the change or that they're being shortchanged in some way. Arrange for one-on-one (or one-on-small-team) mentoring and communication to help thosse people understand their role in the changes and how their full participation is important.
5. Be as honest as possible, as often as possible. I've said it before and I'll say it again: During a change process, it's virtually impossible to communicate too much or too often. The more honest information you can share with employees, the more likely they are to 'get' the reasons for the change, and the less likely they are to spread negative messages outside the organization.
6. Revisit your communication plan. It's always better to prevent a crisis than to have to address it after the fact - that's why every change management initiative should have a well-defined communication plan built into the overall strategy. However, if you find yourself facing challenges, don't just go into defensive mode: Revisit your communication plan and make adjustments (more communications, additional channels, refined messages) as required.
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