I spent a number of years working as a hospital representative early in my career and quite frankly I loved the environment. Early summer was always the most fun as the residents or house officers were moving on to new jobs either in the community, across the country or to other parts of the world. As I think back to those days twenty some years ago, I can’t help comparing the physicians I grew up with with the ones starting practice today.
Too often we tend to think of physicians as statistics based on how they prescribe and what deciles they fall into. We don’t really take the time to analyze them deeper and really try to understand their world and how it has changed over the years. I think the physician today is dramatically different than the physician of twenty years ago. My concern for marketing is that so much of what we do today is exactly what was done in marketing twenty years ago. It might be worth taking some time and really thinking about the physician we see today and how we might change our approach.
The first thing to always consider is the financial aspects of being a physician. Take a look at the income chart in the attached blog for 2011. Keep in mind that this is not just about new doctors but all of them. Note that most primary care physicians we work with make well under $200,000 per year. When you consider the huge debt that most physicians carry coming out of training, money must be a significant burden. Add to this the concern of running a business that includes meeting payroll, making lease payments and purchasing vaccines and other supplies and you can see the context of your physicians’ world.
This financial situation is a change over what used to be when Marcus Welby was in practice. Physicians often were motivated to go into medicine because they immediately became the most respected and often among the most highly compensated in a community. As this change was taking place, there was a high degree of bitterness and confusion by those physicians who entered the profession with motivating factors that are now difficult to attain. This blog points out that this is now changing as those entering medical school now have a much clearer idea of what they will face when they leave their training. The blog points out that the newer physicians want to help be a part of healthcare reform and really care for their patients.
Trying to go beyond the obvious becomes a little more fun and quite a bit of time should be dedicated to this type of work. There is a lot of concern about work/life balance with those now going into medicine and that is why so many are taking “employee” or “salary” positions rather than setting up their own practice. The impact of the “hospitalist” specialty is huge in that so many young internists are opting to just work in hospitals rather than do any office work. On the flip side of this, the office PCP tends to never go to the hospital and this helps control their schedules. The downside of this, for the community physician, is the hospital is where so much of the peer-to-peer discussions used to take place in the mornings before and after rounds. Now the office physician feels more isolated and they get more of their information from the Internet and other sources rather than their local peers.
Once considerable time is spent analyzing, it is important to think of what this means to the industry. I wonder how much hidden jealousy there is of the reps who call on physicians. They now make almost as much money and flaunt it by wearing suits and driving nice cars. The physicians see the reps limited medical training, short hours, freedom to roam around the city and carefree attitude and this must often get in the way of the desired scientific interaction. Also, note that today’s physician cares about patient care and time spent with reps gets in the way. Physicians also put a high value on their personal time and again the time spent with reps interferes. Many view the drug companies as having tons of money and think they are more aligned with their shareholders than with their patients. When physicians were at the top of the earnings world, this issue may not have been as important as it is today when physicians are struggling to stay ahead.
Next time somebody starts a targeting analysis by looking only at prescription activity, stop the process and start to explore the other issues. Ask about the difference between older and younger physicians, between rural and urban practices, men and women physicians, those in groups and solo practice and salaried vs. non-salaried physicians. Understanding customers is a complex and exciting challenge, especially now that that our primary customer group is changing so much.