Category: Physician Mindset

Insight Capsule #1: ODM “The Psychology of Engagement”

–Calibrating Promotional Spend–

Many of our clients are uncertain how to calibrate their promotional spend in the new, personalized / omnichannel paradigm of pharmaceutical promotion.

Discussions held with many of our client partners prior to the beginning of our first quarter 2022 conversations with physicians revealed substantial amounts of confusion and concern about the future of pharmaceutical promotion under a new and developing paradigm. For example, one practical issue on clients’ minds is what plans they should be making for the return of in-person promotion when the future impact of COVID variants remains uncertain.

Additionally, clients aren’t sure which Key Performance Indicators (KPIs) they should be chasing. Surveys have found that while most physicians still favor in-person detailing, a sizable minority prefer virtual details or a hybrid combination. Should physician “preference” be the driving factor here? Are we trying to optimize the increasingly popular concept of “CX” (customer experience), or maybe even trying to develop “customer loyalty?” Does customer loyalty even exist in pharmaceutical marketing, and what does it buy you? Clients are bandying about terminology like “corporate image” and “share of mind.” Where do they fit in? Clearly, clarity on these and related issues needs to be achieved for a company to get full value out of the new promotional paradigm. 

Upcoming Insight Capsules will begin to clarify physicians’ thinking on these important issues. 

On Doctors’ Minds V2.0: The Psychology of Engagement

Understanding the New Paradigm of Personalized, Omnichannel Marketing

In late 2020, ThinkGen initiated its On Doctors’ MindsSM project (ODM) V1.0. The purpose of this project, which continued through much of 2021, was to update our clients, and ourselves, on the kinds of impact that the COVID-19 pandemic was having on office-based practitioners in high-value specialties.  “Conversations,” i.e. “Open Mic” recording sessions with sample physicians, were conducted to allow the doctors an opportunity to identify for us the various ways in which the coronavirus was having an impact on them. The final set of findings from V1.0 can be found by clicking here.

In 2022, as we enter what some are calling the “endemic” period, when we learn to live with the various variants of COVID as we do the flu, ThinkGen is launching ODM V2.0. Here, the focus is on “The Psychology of Engagement.” More specifically, it is generally agreed that the pandemic simply hastened a process that was already underway, i.e., the death of the “one size fits all,” and/or the “reach x frequency” models of pharmaceutical promotion. Numerous trade press articles and reports from major consulting firms have highlighted significant differences in what kinds of information individual physicians want and how they want it delivered. Various pundits have observed that pharmaceutical promotion must now be “customized,” or even “individualized,” with “omnichannel” marketing replacing a homogenized reliance on “A Message” being consistently delivered by a pharmaceutical sales representative. The use of artificial intelligence (AI) is being invoked as a way, perhaps the only way, to accomplish this customization. But what decision rules will be fed into the AI machinery, and with what desired outcome? 

Note the use of the term “engagement” here.  It is purposefully vague and all-encompassing, covering live presentations, the use of digital media, loyalty-building exercises such as promotional dinner meetings, etc. It also connotes the extent to which a physician is “attached” to a particular company. 

Facing what amounts to an entirely new paradigm in pharmaceutical marketing, ThinkGen is once again working with our clients to explore these issues on an ongoing, in-depth basis. As with V1.0, this work is being done on a multi-client basis at no cost. Quite simply, all our clients need to get an understanding of the Psychology of Engagement as it is being recast in 2022, and so do we.

Results of the project will be emailed out to you on a weekly basis in the form of brief “Insight Capsules.” Expect the first one to drop in your inbox in the next few days. Curated videos of our conversations with physicians will be provided as appropriate, with full integrative reports being produced quarterly. Our first quarter ODM is going to cover three medical specialties that are of greatest interest to our clients at the present time: oncologists, neurologists, and dermatologists. We are speaking with 10 HCPs within each specialty over the next few weeks and offering an “open mic” opportunity for them to weigh in on the topic of engagement. 

Want to have your own personalized debriefing with the ThinkGen researchers having these conversations?  Send a note to Kathy O’Connell at to arrange a time. 

If you are not already enrolled to receive these Insight Capsules in your inbox, you can enroll 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!!!

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!

“Hazardous” Yes and No Questions

Check this out. What you will see is a great riff by a psychiatrist on how hazardous yes and no questions can be to a relationship. Or even to a conversation.  So many times when you get a curt yes/no response, what the responder actually means is “Yes (or no), but…..”

The plot thickens. Ask a person a series of yes/no questions, and the thought process behind the answers becomes more and more stilted. And more and more information gets left on the table.

AND. It is fairly easy to see that repeatedly being subjected to that kind of prosecutorial questioning can have a negative effect on interpersonal relationships. 

Over the course of my 50-year career collecting information from physicians for my pharmaceutical company clients, I have increasingly moved from “interviews” to “conversations” for exactly the reasons talked about in this article. Only by using phrases like Dr. Adelman is recommending (“Talk to me about….” “Catch me up on…” “I’m all ears”) can we understand the whole story that the discussant wants to share with us. Only by using these phrases can we understand the salience of individual themes to the discussant. What comes up first? What gets talked about the longest? And by listening carefully to the story being told, we can also understand its overall emotionality, as well as the emotions engendered by various parts of the story. 

Bottom Line. If you really want to understand what someone is thinking, don’t ask them questions. Let them talk!

“Connecting” With the Vaccine Hesitant Patient

Check this out. What you will see is a really well-written piece on how a physician can have a meaningful conversation with a patient who is hesitant to get vaccinated herself, and/or is hesitant about getting her children vaccinated. The message here is a simple one, but it is lost on many of the physicians with whom I have conversations in my On Doctors’ MindsSM project.

The punchline is, while most doctors try to convince such patients of the vaccines’ safety and efficacy by talking “science,” this doctor’s interaction with this patient, over several different occasions, is actually the right way to do it. Sure, the practitioner has to be patient (pun intended) enough to penetrate the diffuse “I’m just going to wait and see” objection that so many patients offer. BUT. This patient’s reason for eventually breaking down and following the doctor’s vaccine recommendation, “You saw me for me,” is genuinely profound. Understanding a patient’s psychological backstory here is essential to communicating at a meaningful level that often, as in this case, has nothing to do with the “science.”

Bottom Line. So what we actually have here is a special case of Salesmanship 101. Listen carefully before you start talking. Patients recognize the hackneyed, and to them irrelevant, science-based standard speech that many doctors have developed about the COVID-19 vaccines, and just tune it out.

There is a general principle here that merits some consideration!

Can Physicians Change Vaccine Hesitant Patients’ Minds??? Nah!!!

Check this out. What you will see is some mildly interesting stuff concerning telehealth. Skip over that and go to the section on VACCINE HESITANCY. 

There you will find some interesting numbers. More specifically, you will see that 52% of physicians believe that they need 2-3 conversations with patients to change their minds about vaccinations, BUT 67% of physicians believe that most patients’ minds can’t be changed. 

Put together, these numbers would support what I have been telling our On Doctors’ MindsSM subscribers based on my recent conversations with physicians, and that I also noted in a recent post.  That is, almost a year into vaccine availability, many doctors are largely giving up on evangelizing the COVID-19 vaccines with the unvaccinated. Why? In summary, they see time spent on these efforts as wasted, and they simply don’t have the time to waste. Put another way, doctors believe that anybody who hasn’t gotten vaccinated after a year is not likely to do so in the near future, no matter what their HCP says.

Bottom Line. The plot thickens. It should be noted that with the approval of new booster protocols and pediatric vaccinations, this whole dance is going to start up all over again. 

My bet? People that are already “fully vaccinated” should be ready to get their third shot. No problem.

On the other hand, how people will feel about getting their munchkins vaccinated will be interesting to watch. New objections? Same old? We shall see! 

Practicing at the “Top of the License”

Check this out. We have done versions of this riff before. Doctors complaining that while NPs and PAs are exhorted to practice at the “top of their licenses,” MDs are increasingly relegated to grunt work. But this time around, the complainant is an anesthesiologist, who wonders why in Europe, anesthesiologists always have an assistant in the OR, while in the US it’s a solo act. 

SO. Here’s the part that confuses me about this. Unless I am missing a point, the establishment of the role of the certified registered nurse anesthetist (CRNA), with multiples thereof working under the supervision of an anesthesiologist, is one of the best examples of the leveraging of physician time with which I am familiar. Check in at our local surgi-center for a procedure, and you get a quick interview with the MD. Into the OR you go, and the CRNA is the one who is hitting you with propofol. Makes sense. Well leveraged. 

Bottom Line. In years to come, it will be fascinating to continue to watch the shifting of roles amongst physicians and other medical professionals. Hopefully, the focus will remain on efficiency and safety of patient care, and politics will be left by the wayside!

A Time for Doctors to Shine???

Check this out. What you will see is a physician author describing physicians as going through Kubler-Ross’s five stages of grief in terms of their professional autonomy and compensation. Over the last couple of decades, doctors have increasingly been forced to cede their power, and much of their incomes, to stronger forces. Insurance companies, medical systems, etc. Early on, we saw doctors in the first stage of grief. Denial. Doctors denied that their lives were being tampered with, and they stayed silent. Mentions of physician “unions” were rebuffed. 

Over subsequent years, the doctors predictably marched through the other stages of grief. So now they are where they are. Interestingly, as COVID-19 looked like it was passing off into history, doctors believed that this would be an ideal time for them to recapture their pre-grief former lives. Not so fast! Many of our citizens are facing difficult financial times as a result of the pandemic. Small businesses are struggling to stay open. AND. Many Americans are mindful that among developed countries, the US has the least cost-effective healthcare system on earth. Not a great time for doctors to be asking for more money and more autonomy.

Bottom Line. SO. Dr. Pearl is suggesting that American physicians move on to the last stage of grief. Acceptance.  No, not acceptance of the fact that our healthcare, and doctors’ lives, will continue to get worse and that there is nothing to be done about that.  Nope. Acceptance of the realization of what is broken, e.g., an uncoordinated fee for service system. And making the commitment to fix the problems. 

Then, and only then, will physicians and patients be able to stop grieving!

Industrialized Medicine

Check this out. What you will see is a psychiatrist, who specializes in helping physicians and their organizations deal with “complex personal challenges,” asking his colleagues a question. Are they “healers” or are they “widgets.” According to Dr. Adelman, the trend over the last 50 years toward “industrialized medicine,” where doctors’ workflows are controlled by corporations rather than by their own wills, has caused there to be so much “coming at them” that they are like Ethel and Lucy in the chocolate factory. They just can’t keep up. They become unable to do “their best work.”

A powerful quote from Adelman’s post:

Malaise sets in when you realize that you have become an almost inanimate object.  This is ‘physician burnout,’ which has been conceptualized by some as a form of moral injury visited upon us by industrialized medicine.

Bottom Line. The move away from being a healer and toward being a widget seems inexorable. This is not likely to get better in coming years.

My question? Then what will “worse” look like in years to come???