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Our medical system needs more creativity. I like what this young doctor is trying out as a new approach. Read the article AND the growing set of comments below it…

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Using a very cool free web service (Pageflakes), I pulled together a portal that consolidates a bunch of pharma blogs into one easy-to-navigate portal. You can visit PharmaCentral to get a daily update on pharmaceutical news, as well as check out postings on other topics such as Training and Marketing. Enjoy!

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As Heard on The Street

This week, I was surprised to receive a phone call from a mainstream reporter (TheStreet.com), asking for my opinions on small business branding. Many of you may not be aware that, beside my full-time work consulting with pharmaceutical companies, I also do some work in the marketing/branding arena (in fact, I have a separate blog, StickyFigure, as an outlet for that – if you’re looking for my thoughts on marketing and branding, that’s the site you want to visit. This site, impactiviti.com, focuses on my pharmaceutical consulting practice).

I guess I had a lot of pent-up ideas, because I found myself, quite uncharacteristically, letting loose a stream of thoughts and words.

Here’s the article on TheStreet.com website.

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For years, I’ve wondered when the tipping point would come. The pharmaceutical sales model is under increasing pressure, from managed care mandates, from regulation, from public and political backlash, from decreased access and selling time, and finally, from healthcare professionals kissing off the whole approach.

The system is broken and everyone knows it. When you have 90,000 sales reps out chasing a limited number of doctors, with the average rep getting (maybe) about 8- 10 minutes (total) of face time with physicians each day, you have an unsustainable business model. The layoffs are already beginning to occur within Big Pharma. Pharma Sales will be forced to change; the question is, into what form? And what will make the change occur?

It’s painful to change huge legacy systems. And the pharmaceutical industry sales model is just that. In its early days, the approach of sending out sales people to interact with doctors was undoubtedly effective. And it is certainly true that no product can ever gain its place in market without some form of selling. But now, throwing more resources at an old model that has decreasing effectiveness doesn’t look like the way to go. A lot of people, and systems, are deeply invested in the approach – Impactiviti, in fact, focuses on effective sales training. But that should not stop us from asking the inevitable – what will the future bring?

I’ve thought long and hard about this and must admit that I can’t yet see a clear answer. I would welcome some commentary and dialogue on this issue, however. Let me throw out one concept, for the sake of starting discussion, and let’s engage in some brainstorming together.

Here is one model I could see emerging, initiated and driven by the marketplace and some entrepreneurial creativity:

Let’s say a large institution of some sort (HMO, multi-hospital or multi-practice group, etc.) decides to take its stand and Just Say No to pharma sales reps. The genuine value purportedly offered by these sales reps is ongoing education (esp. new information), and drug samples.

Does delivery of samples, and gathering of a signature, require a highly paid, expensively trained representative? To ask the question is to answer it.

So, that leaves us with educational and informational needs.

Now, when does a physician need new information? To over-simplify a bit, there are two main educational needs – regular “background” information on areas of specialization (new treatments, new advances, best practices, etc.) and just-in-time information for specific cases (Patient C is taking drug x for diabetes and drug y for hypertension – what should I be considering – or disqualifying – as a potential treatment for asthma in this case?)

So, an organization is set up (probably a private organization, helped initially by a major group or academic hospital) to pro-actively and efficiently deal with these needs. Instead of sales reps showing up with a frequency and on occasions that don’t map to true needs, a group of specialists is employed (or contracted) by the organization to serve as an educational and clinical resource for physicians. Let’s call this a Physician Education Group (PEG). These specialists – roughly equivalent, in education and practice, to Medical Science Liaisons currently deployed by pharma companies – are focused on therapeutic areas, and instead of being beholden to one company’s products, are instead committed to educating the healthcare professional population on the best use of multiple products.

These educational efforts can be on the “background” level (e.g., scheduling quarterly sessions to meet with individuals and groups and discuss new treatments, new drug interaction information, “black box” warnings, just-released studies, etc.), with an objective presentation of information, since the specialists are employed by the PEG, not the drug companies. But one potentially valuable service is to have these specialists serve as advisors for specific cases – a call-center could receive inquiries from physicians and route the call to a therapeutic specialist, who can provide on-the-spot, up-to-date information about specific treatments. Having a searchable database of drug information available, and the tools that most physicians simply would not be able to access in their busy practices, would make these resources quite valuable – with much less need to worry about biased or incomplete information.

Of course, physicians can also access much of the education and information they need via conferences, the Internet, and other vehicles of communication. It can be argued that the forces of information “disintermediation” will ultimately make the role of a dedicated sales representative obsolete. However, that may not be the case for non-biased specialists whose sole job is to remain current with clinical information and serve as trusted advisors to healthcare professionals. As experts independent of the pharmaceutical companies, these educators could potentially discuss off-label applications freely, and have much more productive discussions than can the currently “shackled” sales reps.

From a business perspective, it could also make sense for an independent company to set up this type of approach as a service business, contracting with healthcare organizations to serve as the clearinghouse for updated drug information and on-demand education. I’d be quite surprised if someone doesn’t run with that concept in the near future…all it would take is the critical mass of a large provider organization to decide that it will make the break with the past, and move in a new direction.

To make it work, mechanisms would need to be in place to ensure objectivity on the part of the medical educators. There is also the key question of funding – who pays for all this? One way to go is to require any drug company whose product is going to be at all discussed as a treatment to pay (x) dollars per product annually, to cover the cost of employing these experts, and having them know the product well enough to discuss it. Pay-to-play, as it were. If the potential audience of healthcare professionals were large enough, and other forms of access to that pool severely limited, would it be worthwhile for every pharma company to participate? That’s an open question.

Benefits:

– a step toward ending the expensive and unwinnable sales rep “arms race”

– movement toward greater transparency in the promotion of drugs

– creation of an environment where truly advantageous and superior medicines “win” on clinical merit

– less reason to fault doctors and drug companies for questionable prescribing practices

– better clinical decision making based on sound clinical advice

– waiting rooms with patients instead of sales reps

– ultimately, potential for positive change in the cost of medicines, as inefficient and costly marketing practices are cut back

Question Marks:

– is such a structure a sustainable business model? Will it have enough field and industry support?

– will doctors be motivated to use such a service?

– is the doctor-rep-drug company relationship dynamic truly dispensable, or is that unrealistic?

– what new forms will “selling” take, since it is inevitable that ANY business must grow utilization of its products in order to thrive?

– could this model co-exist with a classic selling model – a dynamic marketplace made up of access/no-access physicians? (this seems to be happening already)

– what about samples?

Freely admitted, the above concept is quite simplified, and any number of details could be (should be) different in the outworking. But something will change. Certain modus operandi are good and useful for a season – when conditions change, the model will be forced (kicking and screaming) to change as well. For how much longer is the current model sustainable?

What do you think? Feel free to click “Comment” above and share your thoughts.

(For more on the topic, Are Pharma Sales Reps Necessary?, with a lot of back-and-forth, some extracts from Cafe Pharma, and a bunch of comments, see this posting on John Mack’s blog).

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It was going to be a long time in the airport last night (weather delays), and I noticed in a bookstore a title that I’ve been intending to pick up for months.

I am, at core, a branding and marketing guy. I love analyzing logos, taglines, market positioning, ad campaigns, etc. And this book, by Marty Neumeier, is definitely on my wavelength.

The book is simple, a quick read, and very engaging. It’s all about differentiation – a similar message to that preached by Seth Godin. Here’s a little taste of the book, focusing on strong and weak brand names…

Highly recommended if you think about branding and marketing!

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I stumbled across this page today, and it provides an interesting follow-up to my earlier post about Moving from Concept to Strategy. While the author (Todd Follansbee of Webmarketingresources.net) is speaking specifically about web page design, the 10 steps he outlines correspond rather well with the approach I seek to take in mapping out training initiatives.

Long before “building”, you need to have a thorough blueprint. This is as true with websites as it is with training initiatives. I’d adapt his 10 steps as follows:

1. Interview

2. Brainstorm

3. Logically organize

4. Map the user experience

5. Storyboard

6. Review and refine

7. Design

8. Develop

9. Launch

10. Collect feedback and refine

What is often deficient in the development of training programs is a robust and creative approach to steps 1-6. Sometimes it’s a matter of only a small number of days of up-front work; but this will make or break the rest of the project. Those are the steps where, in many cases, Impactiviti can provide the most value.

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After almost 20 years of “career” jobs (and, of course, other “get by” jobs before that), I finally ventured out on my own in the middle of 2006. I’d thought about such a move for many years, but did not feel ready – until late 2005, when it dawned on me that the ONLY way I was ever going to have a tailor-made opportunity to harness my strengths and run in my desires was to…well, tailor-make it myself. No-one else was going to do it for me – an employer’s agenda will always trump my ideals.

So, what are the lessons I’ve learned thus far? Here are 10:

1. Have a clear, yet flexible vision. Know what it is you are pursuing, make sure that you can articulate it to others…but be aware that the market may, as you start to promote what you’re doing, point you in some different directions. These variations on your dream may, in fact, be the most lucrative course. My initial business model – providing high-level consultative sales expertise for my provider network, while also providing fee-based consulting service for my client base – is meeting clear market needs. But I’ve already seen a couple of new, complementary avenues open up that are variations on the theme. I like to plan and anticipate and map out EVERYthing – these months have convinced me that I am not, in fact, in charge of the universe, and sometimes a new direction comes from left field – or at least from shortstop! Be ready to evolve.

2. Act. This lesson flows from 1. above. If you have 80% of your offering/message/direction mapped out, grab it by the horns and get out there. The other 20% probably won’t show up until you’re rubbing shoulders with your target market, and starting to make noise. It is more important to show your face than to have everything in place. Once I knew I was going into business for myself, I drew up a list of everything that I figured had to be done, and just did it. Yes, I had to reprint my business cards a few months into it once my message was refined (and once I decided to add a landline and not just live off my cell #), but by then I’d already gotten the ball rolling. Cards are cheap. Delay is expensive.

3. Network. A lot. Believe that your professional colleagues want to see you succeed, and don’t hesitate to ask them to help. I send out a regular stream of e-mails and cards, and make lots of phone calls to those who will provide support and referrals – the most valuable business development resource of all. If you haven’t built up goodwill over the years, and don’t have a real or virtual Rolodex of cheerleaders, you’re probably sunk as far as succeeding in your own (or any) business. On the dark days – when nothing seems to be happening – I take comfort in the fact that I can rehearse the names and faces of many people who are actively wanting to see me succeed.

4. Help others. Give of what you have – your time, your knowledge, your connections. When you help others with their needs, they will go to extraordinary lengths to help you. I’ve been able to help people make connections with others (including potential employers) and find needed resources with no financial return expected – but I fully expect that this commitment to help my clients and partners and other colleagues will not be in vain. For some of my partners, I’ve “given away” my business and marketing expertise to help them refine their approach – and I know that, in return, there is tremendous loyalty built up over time.

5. Take full advantage of cheap and free communications. One of my first acts was to launch a blog (using WordPress), and write articles of interest (granted, not everyone is a writer – I thoroughly enjoy working with words). Then, very inexpensively, I began a weekly e-newsletter using Constant Contact (the “Friday Collection”) which goes out to my target audience with news, resources, and links – and, with continual repetition of my business identity. I invested the grand sum of $50.00 to have a “caricature” made of my face, which now appears on the newsletter and on all my e-mails. Each of these initiatives has been a tremendous success, with very little invested except time and creativity. Free press releases, announcements in trade magazines, posts on other blogs – the methods for gaining exposure are legion, and increasingly, free.

6. Be an expert. You have to have some area of expertise for people to pay attention to your signals, over the level of background noise. Be sure that what you do, or offer, is narrow and specialized enough that you are not an also-ran. And demonstrate the trappings of expertise by writing articles, doing book and conference reviews, and interviewing thought-leaders – all tactics I’ve employed on my blog.

7. Take great care in establishing your brand identity. Your logo, tagline, and message to the market are your best foot forward – unless people can quickly grasp who you are and what you do, and have something memorable to hang it all on, you’ll have trouble maintaining traction. It goes without saying – so I’ll say it – that you’ll need to research available names according to URLs available on the internet, and also look into trademarks. It took me many weeks to settle on “Impactiviti”, a completely “clean” word, which I could absolutely own. Be sure that you have a talented graphic designer help you create the logo – there are even on-line services for this now, which will help develop a logo for a fixed price (shameless plug: I do provide branding services as well – see www.impactiviti.biz).

8. Join. Be part of professional organizations, go to local meetings, volunteer your time. Be involved, and help get your clients involved. Consider professional networking platforms, such as LinkedIn. Starting a new business can be lonely – help stave off the danger of isolation-induced discouragement by getting side-by-side with others. In my case, I’ve been able to join a local chapter of a training organization, and help clients and partners get more involved, for networking and even speaking opportunities.

9. Target your best opportunities for initial business. It’s probably not the “world at large.” More likely, it is clients you already know and have worked with. While you want to get your message out to the broader marketplace, your first business is probably going to come from those with whom you have a track record. My wiring has always been to try to reach everyone – it’s a discipline for me to focus on a handful of my closest colleagues. But, of course, it is the people I’ve already cultivated over time that are most open to hear from me, both clients, and others who can provide referrals.

10. Don’t be afraid to be plain, transparent, and open. People respect authenticity. No, you cannot do everything – if someone asks you about something that is “to the side” of your sweet spot, as tempting as it might be to grasp at any business, simply admit that it’s not in your repertoire but see if you can find another resource. Ask people for help – I often have run ideas past a handful of my partners and clients, before they go “out” to the public, for input and critique – and have found great responsiveness as I allow them a transparent look into my thought processes.

11. And now, a bonus entry – be fully prepared to fail. Now, by this I don’t mean give in to pessimism, or be guilty of bad planning. It just may be that your business idea simply won’t fly – and that won’t be the end of the world. Count the cost up front, run a “worst-case scenario” exercise, and launch the business without desperation – there is a serenity that comes from having already considered the “what if” possibilities. I am quite convinced that other doors will open if this one closes, and it is easier to be patient when you’ve planned for the possibility (likelihood!) that revenue may not come as quickly as you’d like. The greater failure would be not trying – and many entrepreneurs did not hit the target the first time out.

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