Oct 1, 2005 By:
Jane Y. Chin Pharmaceutical Representative
Trainers have told me that teaching sales representatives how to do a
"clinical sell" remains their top priority. A critical part of teaching
this is helping representatives communicate clinical data. In my last
column, I suggested that on a short clinical call, representatives
should cut the canned speeches, pick pertinent points and rank research
results.
Representatives who execute these suggestions may soon be rewarded with
a physician's objections to the clinical study they've presented. I say
"reward" because when you engage physicians in a meaningful dialogue,
an objection gives you more information on the factors they consider
when making decisions than enthusiastic head-nodding (which may just
mean they want you out of their office as soon as possible).
Now that your physician has taken the time and effort to disagree with
you -- perhaps rigorously -- about the clinical study you just
presented, what should your next steps be? Here are four steps you
don't want to take:
D -- defend.
E -- extrapolate.
A -- assume.
F -- make false comparisons.
These behaviors are what I call acting DEAF to customers (I have
written about this elsewhere: "Art of Medical Science Liaising," August
1, 2005, www.mslinstitute.com). Each
mistake is all too easy to make, especially when we feel a discussion
is wandering beyond our control.
Don't defend the study
The fastest way to invite hostility is to defend the study, because in
essence, this implies that the physician was wrong in his objections.
Here is an example of an objection with a few possible responses:
Doctor: This data is not
significant. The p value is
0.3.
Representative (response one): But
here it says the data has a favorable trend.
Diagnosis: Bad response. The
representative discounts the doctor's objection by presenting a weak
defense that invites an objection about the study design and
accusations of statistical manipulation.
Representative (response two):
You're right, it is not statistically significant. What do you think
about the claim of a favorable trend?
Diagnosis: Better response.
The representative does not defend against the doctor's objection.
However, the representative is asking a question that can still invite
objections about study design and statistical manipulation.
Representative (response three): You're
right, it is not statistically significant. Based on this data, what
would you conclude about the utility of this drug?
Diagnosis:Best response. The representative
does not defend against the doctor's objections or redirect the doctor.
Instead, the representative asks a question that invites the doctor to
share how he interprets the data.
Objections that ensnare representatives into defending the study
include questions about the study design, patient population or sample
size, statistical significance, and statistical versus clinical
significance.
Don't extrapolate
When I was a sales representative, one of my products was an
antidepressant. Those of you in neuroscience can appreciate how
notoriously difficult cause-and-effect relationships are to pin down in
the nervous system. Consider what happened when I tried to extrapolate
results from basic scientific concepts:
Jane: Doctor, this drug binds
this receptor and acts on that receptor, and it would likely have this
effect. What have you seen in your clinical practice?
Doctor: Well, I see [something
different from Jane's expectations].
Jane: But this drug binds
here; wouldn't you theoretically see this?
Doctor: Yes, theoretically.
This scenario shows an extrapolation from the theoretical to the
clinical. Other extrapolation danger zones include portraying clinical
study results from a small number of patients as applicable to entire
patient populations and drawing imaginary "efficacy lines" from interim
study results (despite the possibility that an interim trend may
ultimately plateau and the study may not meet its primary endpoint).
When you are describing a clinical study with a small patient
population, you can gain more credibility by pointing out that the
results are based on a small sample size and therefore no conclusion
can be drawn to a representative patient group. This may seem
counterintuitive, because companies are likely to prepare us to defend
our study against misinformation spread by the competition. Present key
parts of a clinical study in a balanced manner, and invite physicians
to interpret the study's relevance for themselves. This takes the
stress out of constantly being put on the defensive, lets you enjoy the
scientific dialogue and ensures that your products are used on the
right patients.
My next column will tackle assumptions and false comparisons.
Jane Y. Chin has a doctorate in biochemistry and experience in sales and medical affairs. She coaches reps to be more scientifically confident in communicating with physicians. For more information on how Chin can help sales teams improve their effectiveness, contact her at jane@pharmrepclinic.com or through her Web site, www.pharmrepclinic.com.
Articles by Jane Y. Chin
ADVERTISEMENT
Survey
The more people talk about healthcare reform the less consensus there is, what do you think of current efforts to reform the system?
