There’s a popular Norman Rockwell painting in many physician offices today of a kindly MD with a stethoscope on the heart of a rag doll to reassure a young patient that all will be fine. Almost as iconic as that image, is the tradition of pharma reps calling on physicians.
More than half of all physician offices in the U.S. continue to be visited by pharma reps and other medical vendors. The approach – created to ensure that valuable education and services such as free medication samples are provided to physicians – has been a standard operating procedure for healthcare for several decades. The reasons are simple: it is a particularly convenient way for doctors to receive timely, strictly FDA approved information from the pharmaceutical industry. Most interactions tend to happen in bite size visits of 10-20 minutes, making it convenient for busy physicians, as they don’t have to take time away from the office to receive the information.
Some practices consider closing rep access
Despite the value reps strive to provide, some physician practices are considering closing or limiting access. But instead of physicians with “no see” rules – what about exploring ways to create “right see” policies for pharma reps and the medical practices they strive to meet with? Such steps are important for medical practices of all sizes, especially larger medical groups that may have thousands of rep visits across their network each year.
One way to look at pharma rep visits is that, essentially, medical practices pay for the rep-provided education and services by allocating administrative staff time to manage the sometimes hundreds of educational interactions that happen each month. Individual medical practices and larger medical groups are often willing to cover such expenses because the education and services that reps provide is important to the medical practice and, ultimately, that value finds its way to the patient in the form of better care.
Research supports the premise that doctors who see reps do have better outcomes. A 2012 report in the Journal of Clinical Hypertension concluded that physicians who do not see reps were four times slower to react to positive information about new products and studies, as well as to negative information about recalls and adverse effects, compared to physicians that routinely see reps.
Call the shots when it comes to rep scheduling
While it is well understood that all reps are not created equal (not because some reps are pleasant and others aren’t; but rather because not all products carried by all reps are equally relevant to all physicians), it generally doesn’t occur to the practice that they can control or regulate the rep-physician interaction. This tends to lead to an all-or-nothing reaction: either the medical practice sees reps and it’s a near free-for-all in terms of scheduling, or the practice shuts down to all reps (becomes ‘no see’).
But there is a middle ground. The medical practice is the customer, right? They should be calling the shots. The logical extension of this is that medical practices should implement and enforce a rep visitation policy that ensures reps are in your practice when you want them and on your terms, not simply when you fit into their schedule.
Today, medical practices can take advantage of online calendaring technology that communicates their rules of engagement to reps (i.e. what time slots they can visit the office each month and how frequently then can visit the physician per month/quarter based on their relevance to the practice). Perhaps most importantly, technology can systematically enforce these rules. Until recently, medical practices had no way of making sense of such a system in a world where reps just showed up unannounced, lined up at the patient counter and rep scheduling was done by administrative staff via a paper calendar.
Cloud-based technology “fixes” this.
Technology platforms exist today that make it possible for physicians to gain control over this rep interaction at no cost to the practice. These systems learn a practice’s hours of operation, holiday schedule, physicians on staff, designated rep time slots and rep visitation protocol (which reps can visit when), and “webifies” it all such that reps can then self-schedule subject to all of these rules.
This approach to rep scheduling means everything is on autopilot. Not only is the medical practice now controlling the flow of reps, it is also no longer spending administrative time scheduling (and rescheduling) all of these appointments. Just like other online scheduling sites (think hotels, airlines, hair salons) managing the pharma rep process can now be automated, while at the same time completely enforcing the physician’s rules of the road.
Sunshine Act and pharma reps
The finalization of rules for the Sunshine Act affect all medical practices that see reps. Therefore, it makes provider and pharma rep policies even more relevant and necessary. It’s important to note that the Sunshine Act doesn’t discourage practices from seeing reps, nor does it say that reps can’t bring in lunch (or other “transfers of value”). Rather, the Sunshine Act is focused on bringing transparency to the relationship between industry and physicians. So, if a rep visits and brings a modest lunch (or other transfer of value), the financial threshold is $10. For example, if the meal exceeds $10 per person in the office that participates in the meal, then the manufacturer is required to report the event to CMS. Using technology to record all rep visits means the office has a built-in mechanism to go back and investigate a particular rep meeting, and if erroneous data was reported by the pharmaceutical company, provide the supporting data to contest the report.
Develop a sensible strategy
Rep visits remain one of the most sensible strategies to provide education, updates and the latest research and information to providers. In addition, the complexity of the market today – from the rising price of some generics – to promising, yet complex new drug introductions, means there is a vital need for physicians to continue these rep interactions and obtain the necessary education and information from a number of reputable and reliable sources.
Medical offices can now ensure they are in control of this process and that it fits in with their goals by developing policies and guidelines – using technology – and remaining committed to any system that helps providers improve quality and outcomes for patients.
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Jay Goss is CEO of RxVantage, which enables busy medical practices to better manage and control the relationship they have with the sales reps that call on them.