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MORE Questions Doctors Hate to Hear and What to Ask Instead

by Dorothy Leeds

Pharm Rep Magazine, October 2004

I thought I had written all there was to write in the first article on this topic: “Questions Doctors Hate to Ask and What to Ask Instead.” But every time I’ve come across a doctor since then, he or she has had more to add to the discussion. What I’ve heard from many doctors (including the ones listed at the end of this article) is that they feel that drugs formulated for similar purposes produce similar results; therefore, it’s often the behavior of the rep that makes the difference.

The good news is that more and more pharmaceutical companies are beginning to realize the value in a questioning rather than a telling approach to selling. If you improve and increase your questions only 10% you can increase your sales over 20%. That is worth striving for. But it’s not just a matter of asking more questions – you have to improve the ones you ask as well. Which means that your questions must be well planned and well executed. I have never observed a doctor who would not respond to a stimulating question asked in an engaging way.

This is really important to Dr. Jon Strauss, a family practitioner, who wants to know that reps have a sincere interest in who he is as a person and as a doctor. So he wants reps to ask him about his children and how they’re doing. But he knows there are other doctors who don’t want to talk about personal information; it’s the rep’s responsibility to know how to treat each doctor differently.

Dr. Strauss believes that most drugs get prescribed because of the bonding that takes place between the doctor and the rep – which happens through short, repetitive, positive interactions over time. That doesn’t happen with reps who come in without an appointment, or who just start into their spiel without first asking, “How much time do you have to spend with me?” Another turn-off for Dr. Strauss is a rep who asks “What can I do to get you to prescribe this drug?” Dr. Strauss thinks it’s a fair question, but a better way to put it would be, “Doctor Strauss, I really believe in the value, integrity, and benefits of my drug. What can I do to help you see them?”

Move Away from Traditional Pharmaceutical Selling

I firmly believe that if you throw out the traditional means of selling and seek a better, more reality-based method (based of course on questions, since I am The Questioning Crusader), you will accomplish all your sales goals, win all your company’s awards, and become a useful, sought-after resource to the doctor.

What bothers many doctors is how so many reps try to avoid conflict and attempt to get agreement as they go along. They want the doctor to say yes when they ask: ”Based on what I shared today will you write Product X for your next patients with hypertension?” This technique has come from years of misguided sales training. Pharmaceutical reps are trained to get agreement so they can get the doctor to accept a final position –in other words, agree to prescribe (or prescribe more of) your drug. This technique may work once in a while, but it’s not really effective.

If you ask me those kinds of questions, I may agree to a few – but if your final question is “Will you jump off the Golden Gate Bridge?” my “yes” answer will quickly disappear. After all I am not a Pavlov experiment and am not so easy to program.

Better to ask, “What is most important to you when you make a prescribing decision?” and the stop and listen intently to the answer. Don’t assume you know what the doctor is thinking or will answer. If you want to build a trust bond with your doctor you must listen and act on his or her responses. If your doctor says, “I pay attention to impartial Journals and thought leaders,” and you bring in only your detail piece (which is not exactly impartial) why should that doctor listen to you next time when you have disregarded his/her preferences.

A doctor does not want to feel tricked or trapped into agreement. Unfortunately, doctors already get many of these kinds of leading questions from reps throughout the day. You don’t want to add yours.

Who’s Interviewing Who?

Doctors like to think of themselves as professional interviewers. That doesn’t mean they are, but they still perceive themselves as experts in this area. According to Dr. Lou Sawaya, author of Super Reps, you never want to challenge the doctor. Doctors learn to be in charge of the conversation, and to gain their patients’ trust in a short period of time. They learn how to develop the proverbial bedside manner and have been taught to use questions to get their patients to open up. These days, however, with time being so limited, they can’t (and won’t) let their patients ramble on and on. It seems logical that they are not going to look too favorably on reps who do the same thing. Therefore, if you are talking a lot and not engaging the doctor in a dialogue, he or she will tune out and turn you off. This is another reason for you to ask smart questions. Put yourself in the doctor’s shoes, trying to be polite and pleasant to the fifty or more reps (many from the same company) who are barraging him/her with too many similar statements, and with boring, uncaring, canned questions.

It’s important to make your questions appear less as a challenge and more like genuine concern. Therefore, the lead into the questions becomes vitally important. For instance, you might ask, “Doctor could you share with me your opinions on the value of treating a XXXX patient with XYZ? “Doctor, calling on your expertise, what do you consider of greatest importance in treating XXXXX?”

Most doctors are eager learners. This is why the first question they will ask you is: ”What’s new?” That should give you a clue. They’re not asking about your personal life, and they don’t want you to start reciting all the plusses of your product. Their question is your cue to have something new about your drug(s), something important and relevant to that doctor. The only way you come by that information is by asking questions so you know what is valuable to that doctor. Come right out and ask, “What knowledge and information can I bring that will be most helpful for you?” “ What do you do to educate yourself?

It’s not enough to simply recite facts about your drug. When Dr. Strauss hears a rep delivering the marketing message of a drug, he’ll often ask, “How do you deal with the fact that your competitor says the same thing?” He doesn’t want to hear reps denigrate the competition; he’d rather hear the features as objectively as possible. He suggests reps avoid questions like, “Why would you prescribe our competitor’s drug when it is known to do XXXXX?” Much better to ask, “What do you feel are the most important benefits of our drug in relation to our competitor’s?”

Become an Educational Resource for Your Doctor

With all the new FDA rules and regulations, providing education is your greatest advantage – the best way to gain the competitive edge.

Recently I was talking with a teaching physician in a university in New York, Dr. Robert Bobrow. He firmly asserted that he never sees reps because they are only concerned with the company line and are never objective in their presentations. In the very next sentence he said that he appreciates the research that pharmaceutical companies provide. He does like to learn about new indications and might talk to rep about these indications. This type of information is less objectionable to him. Another example of asking questions in order to get time with hard to see or no see doctors.

Doctors dislike reps who don’t take the time to find out which are the sources the doctor appreciates. Some good questions to ask are:

  • “What are the sources you value?” “Which are the ones you value least?”
  • “Which thought leaders do you respect?” “Which one don’t you respect?”
  • “What types of studies do you feel provide you with the most convincing information?”
  • “Which parts of our company message do you feel are most/least helpful?”
  • “How can I support your educational concerns?”

Become an information source for your doctors. You will be listened to, your company’s message will become more valuable in the minds of your doctors, and your prescriptions will increase. Come in with new information or a new slant. Be sure you have asked your doctor what sources he/she values and which experts they rely on. Then look for information from these people and sources and bring them to the doctor’s attention on your next visit.

Keep It Real

Drs. Sherry and Howard Sussman both told me that they, like many doctors they know, are annoyed by reps who ask them unrealistic questions. For instance, a rep will follow up on a previous visit within two weeks and ask the doctor: “How is the patient on Drug X doing?” when the drug takes at least a month to prove its effective. That simply shows you don’t know enough about your drug. Better to ask the doctor, “What will you be looking for over the next month in the patient on Drug X? If the drug meets your expectations, in what ways could that impact your other patients with similar symptoms?”

Another thing doctors don’t like is when reps make unrealistic demands on them. Dr. Sherry Sussman relates a story of a rep who came into her office and said, “Here is the survey we have prepared for your patients.” Dr. Sussman knew nothing about the survey. Apparently, the rep had asked her partner about it, but had never bothered to ask Dr. Sussman. Then, to add insult to injury, he insisted that she read it right then and there and give him her approval! That is obviously not a good way to win friends and influence your doctors. A few simple questions could have save the situation: “Dr. Sussman, have you spoken with your partner about the survey we proposed? If not, can you look it over and get back to me as soon as possible?”

Finally, Dr. Sussman’s husband, Dr. Howard R. Sussman, told me about two competing reps. During a conversation with one rep, Dr. Sussman mentioned a particular book he was trying to find. The rep promised he would get the book for him. At every visit he made the same promise. Six months later, a new rep from a competing pharmaceutical company came to see Dr. Sussman and asked, “Is there anything I can do for you that would of help in your professional development?” Dr. Sussman mentioned the same book, and it was on his desk the next day. It was this rep’s perceptive question and subsequent follow through that made the difference for Dr. Sussman.

Why are questions so important? Because according to the Accel Report, pharmaceutical companies have invested more than 18 billion dollars in the 90,000 pharmaceutical reps that are currently out there seeing doctors. Unfortunately, the Report also states that less than EIGHT percent of those reps are memorable to physicians – and many experts claim this is an inflated figure - that it’s really closer to four percent! If you want to be among those memorable few, you must come prepared with new information and data. You must step outside the box and constantly seek ways to outshine your competition, please your manager and your marketing departments and convey their message, and build your value in the mind of the physician. And most important, you must use questions well and wisely.


  Dorothy Leeds
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