Category: Health Professionals

Insight Capsule #2: ODM “The Psychology of Engagement” 

The Use of Engagement Customization and Personalization is Becoming Increasingly Important—in Fact Essential—in Pharmaceutical Marketing in 2022 and Beyond

Developed by Health Psychologist and ThinkGen Chief Innovation Officer Dr. Richard Vanderveer

The COVID-19 pandemic has served to speed up a trend that was already well underway in terms of the pharmaceutical industry’s promotion of its products to physicians. More specifically, the practice of a marketing team carefully developing a message for their product prior to launch, then relying on pharmaceutical sales representatives (PSRs) to deliver this message repeatedly to physicians, was increasingly being seen by doctors as being both grossly inefficient and annoying.

The coronavirus brought with it mandatory office lockdowns and pharmaceutical companies pulling their PSRs from the field, thus providing doctors with a multi-month opportunity to question their previously accepted habit of welcoming “reminder details” that took up their time while bringing them no new information.

The result? Over the past 18 months of conducting our ongoing On Doctors’ MindsSM (ODM) project, we have learned that physicians have replaced this old habit with new ones. And, rather than being the homogeneous habit of old, different doctors have developed a large variety of new and different habits in terms of their engagement with pharmaceutical companies.

As a result, numerous marketing research studies, as well as reports from leading consultancies dealing with this issue, have argued that “customization” and “personalization” of pharmaceutical companies’ promotional efforts directed at physicians are increasingly necessary. But how should the industry go about delivering on these requirements?

Over the coming months, the weekly series of Insight CapsulesSM drawn from ThinkGen’s ODM project will provide answers to these questions based on an understanding of the “psychology of engagement.” But first, a clarification of terminology:

Customization: In our work, this term refers to the recognition that different physicians have entirely different preferences as to how a pharmaceutical company should be “engaging” them. As will be developed in subsequent Insight CapsulesSM, there is not an infinite variety of such expectations, but rather a manageable set of preferences that can be characterized through Physician Engagement PersonasSM (PEP) Engagements must be customized for the PEP being addressed.

Individualization: Based on the findings of our ODM conversations with physicians, we have come to understand that this term has two important meanings. For a new product launch, for example, we need to understand where a physician with a particular PEP is along the Awareness, Interest, Trial, and Usage spectrum, and adjust our engagement offer accordingly. Also, the physician needs to see the message as being specifically produced for her. A personal email from the doctor’s PSR, as opposed to just an emailed “ad” for the product, is perceived as being of much greater value.

Omnichannel: In 2022, marketing teams have a large variety of media, both push and pull, that they can use to engage a physician. Once an engagement has been customized and individualized, the marketing team must select the most appropriate channel to employ for its delivery. In fact, the selection of a promotional channel can be an important part of the customization and individualization processes.

Subsequent Insight CapsulesSM will explore each of these concepts in far greater detail and provide physician guidance as to how each can be optimized. Meanwhile, for a taste of the types of insights we are gleaning from these conversations, watch this short video clip from one of our ODM conversations.

Want to stay updated on our findings? Subscribe to receive these Insight Capsules in your inbox by clicking here.

Who Do You See When You Look in The Mirror???

Check this out. What you will see is the story of a female physician who shares with us an interesting perspective. The right question to ask is not the one presented above she avers. Nope. The right question is “How do you define yourself?” 

And by way of response to that poignant question, she offers up a checklist of her personal challenges that just seemed to keep getting longer. Like being a primary care physician, which meant that she was a “jack of all trades, and master of none.” Like being a female in a profession where sex discrimination is rampant. Like worrying about medical errors. Like office politics, and poor organizational decisions, and…

And how does all of this turn out? She quits. She walks away from the myriad sources of frustration that were increasingly making up her day. That were defining her life. 

Bottom Line. AND. In a great quote, she summarizes her current situation. If she is going to pedal hard and go nowhere, she can now say without internal conflict, she is going to do it on her Peloton. 

What a great quote for us to use as a gut check as we march into 2022!!!

Johnson & Johnson’s Support of Nurses

Check this out. As I hope is true in most of the URL’s that I send you to, there are a lot of interesting points made in today’s piece. One is a phenomenon I have observed over my over 40 years of conducting pharmaceutical marketing research. That is, companies that dedicate themselves to maintaining a longstanding and supportive relationship with a specific group of HCPs get rewarded for their loyalty with loyalty in return.

That is certainly true in the Johnson & Johnson support of RNs. My wife and virtually every other nurse with whom I have spoken is well aware of this support, they all smile when they talk about it, and those nurses involved in purchasing decisions will, whenever possible, go with the J&J product offering.

One of the greatest examples of the impact that this kind of ongoing support can have on customer loyalty and market share was demonstrated by Ortho Pharmaceuticals (a J&J Company) and their relationship with ob/gyns. I spent much of my professional life working on marketing research to position Ortho oral contraceptives. I did this work for over a decade. During this time, I learned that Ortho supported ob/gyns, in many significant ways, from their residency forward. The doctors in this specialty with whom I spoke over the years were well aware of this support. In fact, our segmentation work over found a large segment of physicians who wrote almost exclusively for Ortho oral contraceptives, not because they thought they were better than other brands. Rather, they thought they were at parity with the other products, BUT were manufactured by a company that was loyal to their specialty. 

Work we did during the same time period with pediatricians found that there was a significant segment of that specialty that was loyal to Ross Laboratories because of their support for their specialty, and as a result recommended Ross infant formulas. 

Is such bidirectional specialty loyalty still alive and well in our industry? Where? Does it still look the same? Are the results still as beneficial?

One other key thought I want to point out in this piece is that while I and others spend a lot of time thinking and talking about “physician burnout,” especially during the pandemic, a far greater burnout problem can be found among the nurses who have to take care of these patients, and other tragic cases, on a much more up-close-and-personal basis than do most physicians. This piece reports that 70% of nurses are suffering from anxiety, stress and burnout, with the result that 20% of nurses are leaving the field annually. Not good!

Bottom Line. What we have learned here then is two things. First, that a company that throws its support behind a particular group of HCPs can often reap a significant reward.

And, more specifically, we have learned that nurses, especially during the COVID-19 pandemic need, and well deserve, the kind of loyal support that they have been receiving from J&J for the last 120 years. 

Spend some time today pondering what your company can do with each of these learnings?

This is Really Pathetic!!!

Check this out. What you will find is an article reporting that female physicians, on average, make $2 Million less than their male counterparts do over the course of their careers. Sure, their work/life balance might favor the home front somewhat more than the guys, but $2 Million worth??? And this study is adjusted for hours worked!!!

And, just to round out the pathos, recall the studies I have posted here previously, that found that women actually tend to be better doctors then men. More compassionate, greater attention to detail.  My last two concierge internists have been females, and I wouldn’t have had it any other way.

Bottom Line. Beyond the inherent injustice of pay inequity, the author goes on to point out that all of this sends a very troubling message to women considering a career in medicine. And this, my friends, is the last thing we need in an era where good doctors, in fact, any doctors, are hard to come by!!!

Starbucks, DC Physicians, and COVID-19

As you all know, I have been carefully studying various approaches to convincing people to get vaccinated against COVID-19. My monthly conversations with physicians in my On Doctors’ MindsSM research project have been revealing that for many doctors, continuing to try to convince their unvaccinated patients to get the shot is now seen as a waste of their time and potentially offensive to some patients.  SO. They have stopped.

Conversations with clergy reveal that while some are willing to make a case from the pulpit for vaccination because they believe it is the moral thing to do, others want to stay clear of the political overtones that have unfortunately come to accompany this issue.

Joe Biden’s attempts, ranging from daily entreaties to controversial mandates, have at this point become old news, court cases, or both.

But here is a new one. Physicians offering to run discussion groups at coffee shops to present the efficacy and safety of the vaccines to groups of people who are not even their patients.  Interesting. Will the casual setting and the cup of Starbucks help to seal the deal? 

Bottom Line. Think about this one for a minute. If we have learned anything about the vaccine-hesitant over the last year, it is that simply talking “science” is unlikely to convince them to get their shots. And that’s true whether the people talking science are scientific experts or even their own physicians.  Why would these physicians, well-intentioned though they might be, be more successful using the same approach?

But wait! There actually is a possibility of a good outcome here. Think about it for another minute. Those people who would be willing to show up for such discussions must have at least a modicum of openness to getting vaccinated. AND. In good old “peer influence group” fashion, a skilled moderator might be able to facilitate these people talking each other into getting vaccinated by exploring and overcoming their shared objections. That might work.

As long as these doctors are smart enough not to just “talk science!!!” 

Things You Might, or Might Not, Guess About Medical Malpractice in 2021

Check this out. What you will see are the findings of Medscape’s surveying more than 4300 physicians in nine specialties concerning their experiences with, and attitudes toward, medical malpractice. Why do I think we should care about this? Simple! Over the course of my career, I have had the opportunity to speak with many physicians about their experiences with medical malpractice. What I have heard from these doctors, our customers, is that being sued is an experience that has a profound effect on the physician defendant, often for a protracted period of time and not infrequently forever. Trust me. When a doctor is in the throes of a malpractice suit, we are going to have a real challenge in gaining her time and attention for our “important” drug promotion communications.

Every one of the pages contained in this report is of interest, but some really stood out for me. For example, on page 2 we see that slightly over half of the doctors surveyed had been named in a malpractice suit at some point in their careers, typically in concert with other defendants. Scrolling forward to page 3 reveals (you probably would have guessed this one!) that lawsuits are significantly more likely for specialists than they are for PCPs. Page 5 also deals with common sense, in that it points out that surgeons are the most likely targets of litigation. Brief and impersonal interactions with patients, complicated procedures and high expectations (especially for plastic surgeons!) combine to lead to this outcome. Page 13 is really scary and at least to me, somewhat surprising. There we learn that two-thirds of malpractice cases take longer than a year to resolve. In some cases, much longer! Doctors left in suspense for way too long!

And, surprise! Although many pundits, including me, predicted that the COVID pandemic would lead to a raft of malpractice cases, e.g. “failure to diagnose,” NONE of the doctors surveyed reported having a suit filed for a “COVID related allegation,” and 87% of doctors reported no concerns about such legal action.

Bottom Line. Just as they always do, this Medscape study provides important backstory insights as to what is going on in the minds of our physician customers. Read the whole thing. It will only take you a few minutes. Then contemplate what these findings might mean to the mental health of our physician customers.

That might take a little longer!

The Death of “Watchful Waiting”

You have probably heard the old saying, “Cancer isn’t one disease…it’s hundreds of diseases.” All true.  All very different. And prostate cancer certainly is. About one in eight men will have prostate cancer at some point in their lives, with an average age at diagnosis of 66. There’s another old saying. “Men are likely to die with prostate cancer, but not of it.”  Well, that’s not exactly true. Prostate cancer is second only to lung cancer in causing death in men. Nonetheless, because of a carefully developed risk assessment system based on Gleason score at biopsy, guidelines have long recommended “watchful waiting” as the most appropriate treatment for low-risk cancers. Think about it. How many other cancers have guidelines that begin with “Don’t treat?”

But check this out. What you will see is that the NCCN has now changed its guidelines for managing low-risk cases to give equal weight to watchful waiting, radiation, and surgery. This shift in guidelines is interesting in and of itself, because it is unclear why it is being made and why now. Even more fascinating is the reaction of prostate cancer experts, the most vociferous of whom are seeing this as a return to the draconian days of the past AND as providing license for widespread, often unnecessary, surgery and courses of radiation therapy. The impact of such interventions on quality of life, e.g., surgery frequently resulting in impotence, is one of the reasons that watchful waiting seemed like such a good idea in the first place.

Bottom Line. Sort of an interesting discussion, actually. What you see reflected in the comments in this piece are two extremes. More conservative doctors are upset that this change in guidelines will make it more difficult for them to convince men to rely on watchful waiting. At the other extreme, there is a concern that this guideline shift will permit money-motivated practitioners to greatly enhance the profitability of their practices by pushing patients toward getting interventions they may not need. The result of all of this? Something tells me that we have not heard the last word on this one! 

The Impact of “Full Ride” Medical School

Want a good smack in the face with some good old-fashioned common sense? Check this out. What you will see is an article that reviews the impact of NYU’s Grossman Medical School giving, starting in 2018, all current and future medical students free tuition. A generous move for sure, and one likely to attract medical students who otherwise might have gone to the Harvard’s and Georgetown’s of the world. But how about the expressed purpose of the move, i.e., to attract more students who will feed into primary care, and to attract a more ethnically and socially diverse student body? 

Read the piece and think about it. A free ride looks just as good to me if I am going into one of the lucrative specialties, like dermatology or radiology, as it does if I am headed for primary care. Free tuition did nothing to shape the direction of NYU graduates’ specialty choice. Zero. Nada.

Similarly, as long as metrics like GPA and MCAT scores are the primary selection criteria used nationwide, and minority applicant pools remain stagnant, free tuition does little to increase the diversity of the medical profession overall. Sure, more minority students may be drawn to the free tuition at NYU, but only at the expense of other schools. 

Bottom Line. Much talk is heard about “unintended consequences.” Civilians killed in air raids on military installations, etc. But how about “intended consequences?” Shouldn’t somebody be looking at a generous but expensive program like free medical school at NYU and ask the question, “How is that going to make happen what we want it to make happen?” 

How indeed?

What are the Appropriate Boundaries for a “Concierge Practice???”

Ah, to be a concierge internist in Boca Raton, FL. Yup. The website for one such physician is the source of the swipe art pictured above. Idyllic, right? But maybe not so fast! Check this out.

In a Boca Raton concierge practice, you are likely to encounter the kind of patient talked about here. A patient closing in on 90 years of age who apparently had a bad fall, didn’t know why and wanted to come into the office to get “checked out.” Understandably, the physician believed, and explained to the patient several times, that “checking out” here was going to require imaging, and thus a trip to the hospital. Not surprising that the patient didn’t want to go to the hospital during a pandemic, but sometimes you gotta do what you gotta do. 

Here’s the punchline. The patient wants his concierge fee money back because the doctor was not living up to his contract, which promised “same day” office visits for “acute” situations. Somehow, the line of reasoning that said that heart attacks, automobile accidents, possible brain injuries, and similar cases were not the kinds of acute problems that were under discussion here was lost on this patient. 

Bottom Line. Once again, this discussion had me scratching my head. On one side, we have “contract wording.” On the other side, we have “rational thinking” and “common sense.” Somehow, which of those should be the primary consideration in a situation like this seems obvious.

But apparently not!

The Ethics of “Placebo-Controlled” Studies

Funny thing. When we hear the term “placebo-controlled study,” the methodological purists amongst us generally think that is a good thing. After all, without a placebo control arm, how would we know whether benefits apparently produced by a therapy were, in fact, actually placebo effects. But check this out. What you will see is a situation in which the circumstances of “placebo control” raise significant ethical questions. Why? Several reasons. Most tellingly, because the study participants were disproportionately “disadvantaged” inner city children of color.  AND. Because the placebo control involved withholding a standard treatment for patients with Vitamin D deficiency. AND. Because the study lasted almost a whole year, with standard therapy being withheld for this entire time for the control group. 

Bottom Line. Think about this one for a couple of minutes. The real kicker here is that this research could have been done without the placebo control arm. The reason it wasn’t?  It would have taken longer and been more expensive. 

The right question, as posed at the end of this piece, deals with how the heck institutional review boards at several major institutions signed off on this research. Exactly the kind of unethical research such boards are intended to prevent. 

How indeed!!!