Importance of medical representatives in the pharmaceutical marketing:
The first medical representative’s historical background and origin date back to the 1850s in the United States, but there is no such record when and how the first medical representative entered the Indian pharmaceutical market. [701]
[701]. Peterson, Arthur F., The Professional Service Pharmacist, Journal of the American Pharmaceutical Association, April 1949, Page-212.
The prescriptions of the doctors primarily drive the largest Indian branded generic pharmaceutical market. As such, the success of pharmaceutical companies depends on the effectiveness and efficiency of their medical representatives. As most doctors stress the usefulness of regular visits, the medical representatives should acquire updated information, scientific data, and technological changes about the drugs they promote.
For many consumers, sales executives are synonymous with the company (BenMoussa, 2005). In the pharmaceutical industry, most customers, such as doctors and chemists, consider that medical representative is the organization as he is the link between them and the pharmaceutical company.
Pharmaceutical companies employ field sales force known as medical representatives to directly visit the doctors for face-to-face meetings to promote their brand of medicines, influence their prescription behavior, and increase the number of prescriptions.
In pharmaceutical marketing, medical representatives play a vital role in the implementation of all marketing strategies successfully. The official description of a medical representative’s job is to provide product information regarding the medicines to doctors, distribute free samples, and other promotional material. The unofficial and real job is to change doctors’ prescription habits.
Employing medical representatives for promotion is a widely accepted method in the pharmaceutical industry. It is an expensive marketing practice, as around half of the amount spent on marketing goes to medical representatives (Wannza, 2000). It was found that pharmaceutical companies had invested $13.2 billion in direct marketing efforts (Parker & Pettijohn, 2005).
“The medical representative is to the ethical product what television and radio are to the consumer product” (Koekemoer, 1987: 467).
A wide range of marketing techniques is being used by pharmaceutical companies to inform and convince the doctors about their medicines. Medical representatives are the most expensive and widely used method of all these techniques (Schramm et al., 2007).
2.6 Definition of the medical representative:
A medical representative is the drug company’s employee, who regularly visits the doctors and provides information on its products (Alssageer & Kowalsk, 2012, p. 1).
Medical representatives are the employees working as marketing staff that constitutes one of the fastest-growing and the largest segment in the pharmaceutical industry (PhRMA, 2011).
The employees working in the marketing and sales department in pharmaceutical companies are called medical representatives. People who see doctors, dentists, pharmacists, and nurses with a purpose to influence them to buy, recommend, and prescribe a drug is called as Medical Representatives (M.R.) / Pharmaceutical Sales Representatives (PSR) / Pharmaceutical Company Representatives (PCR).
In the pharmaceutical industry, human resource plays a vital role. Among all the departments working in the pharmaceutical sector marketing and sales department plays a crucial role in its growth. Medical representatives act as a link between the company and the doctors, stockiest, and chemists, and ensure its smooth functioning. Along with the information dissemination, medical representatives play an active role in the physical distribution of the medicines across the channels like inventory control, merchandise delivery, the return of goods, new product launches, and support to the pharmacy. The medical representative is the pharmaceutical missionary salesperson. A medical representative is a dependable resource person to respond to the company’s products progress in the competitive market, the customer’s perception, and competitor’s marketing strategies.
The core promotional push of pharmaceutical marketing is through the medical representatives. Medical representatives are polite and knowledgeable. Before visiting the doctor, the medical representatives have to visit the nearby pharmacists to gather information regarding their prescription habits. They also collect information regarding the doctor’s family life, social interests, likes, and hobbies. [190]
[190] https://ijme.in/articles/thephysician- and-the pharmaceutical- industry/? galley=html
Influence of the medical representatives on the doctors prescription habits:
In general, the public believes that it is not practical and possible for the medical representatives to change the prescription habits of a doctor; nevertheless, it happens repeatedly though it is a complicated process.
Various studies conducted during the 1990s on pharmaceutical marketing and promotional practices emphasize that the pharmaceutical industry exercised considerable influence on the doctors prescribing behavior through their medical representative is detailing (Wazana 2000).
Though time and again the doctors disagree that the pharmaceutical industry’s promotional activities influence their knowledge of drugs, there is substantial evidence to prove the effectiveness of personal meetings with medical representatives have a vital role in shaping the doctors’ mindset on the knowledge of drugs [201].
[201] Ravindra Goyal, Pranav Pareek – A Review Article on Prescription Behavior of Doctors, Influenced By The Medical Representative In Rajasthan, India- IOSR Journal of Business and Management (IOSR-JBM) e-ISSN: 2278-487X. Volume 8, Issue 1 (Jan. – Feb. 2013), PP 56-60 (14-01-2009) www.iosrjournals.org .
The presence of medical representatives is visible at many hospitals and medical shops. Doctors encounter medical representatives, and their influence starts as a medical student and continues throughout their careers. [401]
[401]Gray., A. & Hoffman., J. & Mansfield., P. (2010). Pharmaceutical Sales Representatives. The Politics of Medicines (e-Encyclopaedia).
It is noteworthy to mention that many research studies have irrevocably established that medical representative’s positive attributes such as interpersonal skills, knowledge about drugs, selling skills, and friendly relationships with doctors have a significant influence on the doctors’ prescription behavior [68, 69].
- Hayes, A.F. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach; The Guilford Press: New York, NY, USA, 2013.
- Hersh, W.R.; Crabtree, K.M.; Hickam, D.H.; Sacherek, Y.; Friedman, C.P.; Tidmarch, P.; Mosbaek, C.; Kramier, D. Factors associated with success in searching MEDLINE and applying evidence to answer clinical questions. J. Am. Med. Information Assoc. 2002, 9, 283–293.
In a survey conducted by Ankush et al., 52.52% of the doctors said that medical represent atives have very little influence on them, 18.68% of the doctors said they get influenced ‘quite a bit,’ 15.65% of the doctors are ‘very much’ influenced, and 13.13 % of the doctors believe that they are not at all influenced by medical representatives while prescribing drugs according to their choice. [710]
[710] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
Fickweiler F argues that interactions between the doctors and medical representatives have been found to influence the doctors’ prescription behavior. [501]
[501] Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ Open 2017;7: e016408. doi:10.1136/ BMJ open-2017-016408.
According to Professor Howard Brody, there is conclusive evidence on two points; the first one is that without any doubt, doctors are influenced by medical representatives, and the second one is doctors re poor judges of the extent of that influence on their prescription habits. Brody further states that doctors exhibit a sense of privilege to receive gifts from medical representatives and try to rationalize why they meet medical representatives and accept gifts from them, yet justify that pharmaceutical representatives are not influencing them (Brody, 2005).
Eric De Laat et al. (2009) states that the pharmaceutical company’s promotional activities can strongly influence the doctors’ prescription behavior through medical representatives.
Most doctors believe that they are not being influenced and affected by interactions with the medical representatives; however, the same doctors consider that other doctors are more susceptible to the pharmaceutical industry’s marketing strategies than themselves. [519–522]
[519]. Alosaimi FD AKA, Qadi M, Albahlal A, et al. Physicians’ attitudes towards interaction with the pharmaceutical industry/Attitudes des médecins par rapport á l’interaction avec l’industrie pharmaceutique. East Mediterr Health J 2014;20:812.
[522]. Lieb K, Scheurich A. Contact between doctors and the pharmaceutical industry, their perceptions, and the effects on prescribing habits. PLoS One 2014;9:e110130.
[521]. Lieb K, Brandtönies S. A survey of German physicians in private practice about contacts with pharmaceutical sales representatives.Dtsch Arztebl Int 2010; 107:392–8.
In their exploratory study, Shahu Ingole and Amol Dube (2010) have investigated how doctors’ prescription habits get influenced by medical representatives’ promotional activities. 50% of the doctors agreed that medical representatives provide brief but latest updates regarding medicines that affect their prescription choice. [338]
[338]Dr. Shahu Ingole et al., “Attitudes of Medical Students towards Relationship with Pharmaceutical Company: Do We Need a Change?” International Journal of Pharma Sciences & Research, (IJPSR), Vol. 2(2), 2011, pp. 49-57.
In their research article titled ‘Marketing Prescription-based Medicines: Doctors Feedbacks,’ Abhay Bora and Nilesh Berad (2011) states that doctors have admitted that their prescription habits are influenced by good product promotion and brand reminders by the medical representatives.[936]
[936] Abhay Bora and Dr. Nilesh Berad, “Marketing Prescription-based Medicines: Doctors Feedbacks,” International Journal of Advances in Management, Technology & Engineering Sciences, Vol. I, Issue 2 (IV), Nov 2011
Further studies by De Ferrari A and Mulinari S. found that medical representatives may influence doctors’ prescription behavior. [509,516]
[509]. De Ferrari A, Gentille C, Davalos L, et al. Attitudes and relationship between physicians and the pharmaceutical industry in a general public hospital in Lima, Peru. PLoS One 2014;9:e100114.
[516]. Mulinari S. Unhealthy marketing of pharmaceutical products: An international public health concern. J Public Health Policy 2016;37:149–59.
[516]Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ Open 2017;7:e016408. doi:10.1136/ BMJ open-2017-016408.
Some of the doctors do realize that exposure to pharmaceutical promotion will influence their prescription habits. [607]
[607]. Drug promotion what we know, what we have yet to learn WHO/EDM/PAR/2004.3
In a survey conducted by Ankush et al., 52.52% of the doctors said that medical represent atives have very little influence on them, 18.68% of the doctors said they get influenced quite a bit, 15.65% of the doctors are very much influenced, and 13.13 % of the doctors believe that they are not at all influenced by medical representatives while prescribing drugs according to their choice. [710]
[710] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
Most doctors are eager to meet the medical representatives to learn the latest developments regarding a given disease in medical science, also interested in receiving free samples and gifts. Thereby significant part of the literature has established the effectiveness of the medical representatives and their influence on the doctors’ prescription behavior. [1, 30, 57]
[1]. Ahmed, R.R.; Vveinhardt, J.; Štreimikienė, D. The direct and indirect impact of the Pharmaceutical industry in Economic expansion and Job creation: Evidence from Bootstrapping and Normal theory methods. Amfiteatru, 2018, 20, 454–469.
[30]. Clark, M.M.; Gong, M.; Schork, M.; Evans, D.; Roloff, D.; Hurwitz, M.; Maiman, L.; Mellins, R. Impact of Education for Physicians on Patient Outcomes. Am. J. Pediatr. 1998, 101, 831–836.
[57]. Hall, R. The strategic analysis of intangible resources. Strateg. Manag. J., 1992, 13, 135–144.
To evaluate the cost and benefit of the doctor and medical representative interaction, substantial research was carried out by Wazana. Wazana has concluded that interactions with the medical representatives impact the doctors’ prescribing practice in terms of awareness of drugs, non-rational prescribing, preference for new drugs, rapid prescribing, decreased prescribing of generic drugs, and more cost per prescription. [30,107]
[30]. Clark, M.M.; Gong, M.; Schork, M.; Evans, D.; Roloff, D.; Hurwitz, M.; Maiman, L.; Mellins, R. Impact of Education for Physicians on Patient Outcomes. Am. J. Pediatr. 1998, 101, 831–836.
[107] Wazana, A. (2000) “Physicians and the pharmaceutical industry. Is a gift ever just a gift?” Journal of the Australian Medical Association 283: 373-380.
Further, Caudill et al. [25], and Narayanan et al. [58] contend that the influence of medical representative on the doctor is directly correlated to the level of credibility and effectiveness of medical representative.
[25]. Carroll, A.; Barnes, S.J.; Scornavacca, E.; Fletcher, K. Consumer perceptions and attitudes towards SMS advertising: Recent evidence from New Zealand. Int. J. Advert. 2007, 26, 79–98.
[58]. Halperin, E.C.; Hutchison, P.; Barrier, R., Jr. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers. Int.J. Radiat. Oncol. Biol. Phys. 2004, 59, 1477–1483.
In India, in one of the studies by Bansinath et al., 56 % of the Indian cardiologists agree that medical representatives have influenced their prescription behavior [131].
[131]Bansinath, M. Sequeira, R. P. Shukla, V. K. Mathur, V. S. Brand versus generic prescribing: a perspective of the Indian cardiologists’ viewpoint. International Journal of Clinical Pharmacology, Therapy and Toxicology 1984; 22:279‐283.
Berad (2013) concludes that among all other promotional tools such as samples, gifts, and CME programs, the medical representative who visits the doctors regularly and maintains good rapport is found to be the most effective promotional tool for prescription-based drugs.[343]
- Abhay Bora and Dr. Nilesh Berad, “Marketing Prescription-based Medicines: Doctors Feedbacks,” International Journal of Advances in Management, Technology & Engineering Sciences, Vol. I, Issue 2 (IV), Nov 2011, pp. 91-95.
In a significant study, 71 % of the doctors expressed that trust in the quality of the medicine and the pharmaceutical company’s image that a doctor develops is directly related to the professionalism, behavior, and degree of honesty exhibited by the medical representative representing that company.
According to Koekmoer (1987), the medical representative’s primary objective is to change the doctor’s attitude to the drug being promoted and reinforce the existing favorable attitude. Doctors see the medical representatives with the tacit understanding that they are being sent to influence them to use and prescribe their products. The meeting of a medical representative with a doctor leaves little to chance; hence the medical representatives are aptly called stealth bombers of medicine.
In a survey conducted by Ankush et al., a majority of 99.00% of the respondent doctors consider that medical representatives are rendering very useful services for them.[706]
[706] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
A study by Hayes et al. found that only 16 % of G.P.’s in the U.K. consider medical representatives’ visits as educationally valuable [135].
[135] Hayes, T. M. Allery, L. A. Harding, K. G. Owen, P.A. Continuing education for general practice and the role of the pharmaceutical industry. British Journal of General Practice 1990; 40:510‐512.
In another survey by Shearer et al., the doctors’ rated direct mail, journal advertising, and medical representatives as the three least reliable drug information sources.
In a significant study by Bucci and Frey’s involving the U.S. family practice residency program doctors, 48.3 % of the program directors consider medical representatives as a valuable source for drug information for residents and 55.1 % for practicing doctors too [136].
[136] Bucci, Kathryn K. Frey, Keith A. Involvement of pharmacy faculty in developing pharmaceutical sales representatives’ policies. Journal of Family Practice 1992; 34:49‐52.
In a study conducted by Dunn, only 10 % of the doctors in Ontario have agreed that pharmaceutical handouts are a vital continuing medical education resource [137].
[137] Dunn, Earl. William, J. Ivan. Bryans, A.M. Davis, David. Delmore, Terry. Herron, Anna. Krauser, John. Scott, David J. Continuing medical education in Ontario: a primary care perspective. Canadian Family Physician 1982;28:1327‐1333.
In a Hodges survey, 32 % of the psychiatry trainees agreed that the medical representatives provide accurate and useful information regarding new drugs [139].
[139] Hodges, Brian. Interactions with the pharmaceutical industry: experiences and attitudes of psychiatry residents, interns, and clerks. Canadian Medical Association Journal 1995; 153:553‐559.
In a significant study conducted by Pitt and Nel with American general practitioners, it was found that medical representatives, as the third, advertisements as fifth and gifts as sixth influencing factors on their prescribing decisions.
Clinical pharmacists involved in family medicine residency programs surveyed by Hume and Shaughnessy rated sales representatives and journal articles as the third most important source of drug information [140].
[140] Hume, Anne L. Shaughnessy, Allen F. Sources of influence on the prescribing practices of residents in family medicine. DICP, The Annals of Pharmacotherapy 1991; 25:102-103.
In the year 2000, in one of the studies involving resident doctors in Virginia by Sigworth et al., 91 % of the resident doctors agreed that medical representatives had influenced their prescription choice [141].
[141] Sigworth, Stephen K. Nettleman, Mary D. Cohen, Gail M. Pharmaceutical branding of resident physicians. JAMA 2001; 286:1024-1025.
Doctors are eager to meet medical representatives to learn the latest developments in the field of medical science.
In a survey conducted by Strang et al., doctors in Canada consider that product promotion as the primary goal of medical representatives. In contrast, 80 % of the doctors felt that medical representatives had overemphasized medicine’s effectiveness [132].
[132] Strang, David. Gagnon, Micheline. Molloy, William. Bédard, Michel. Darzins, Peteris. Etchells, Edward. Davidson, Warren. National survey on the attitudes of Canadian physicians towards drug‐detailing by pharmaceutical representatives. Annals of the Royal College of Physicians and Surgeons of Canada 1996; 29:474‐478.
In a study by Parish, it was found that 47 % of the doctors believe that the information provided by the medical representatives was biased as they were excessively commercial in nature [133].
[133] Eaton, Gail. Parish, Peter. General practitioners’ views of information about drugs. Journal of the Royal College of General Practitioners 1976; 26:64‐68.
In a New Zealand study, Thomson et al. found that the doctors meet the medical representatives to learn about new and existing medicines [134].
[134] Thomson, A. N. Craig, B. J. Barham, P. M. Attitudes of general practitioners in New Zealand to pharmaceutical representatives. British Journal of General Practice 1994; 44: 220‐ 223.
The director of the Pharmaceutical Manufacturers’ Association of New Zealand agrees that though the medical representatives are biased towards their own brand of medicines, they are useful as a good source of product information (New Zealand Medical Journal),
Compared to the senior residents, most junior residents believe that medical representatives have a valuable role in the teaching of medical education. [510] 501
[510]. Hodges B. Interactions with the pharmaceutical industry: experiences and attitudes of psychiatry residents, interns, and clerks. CMAJ: Canadian Medical Association Journal, 1995;153:553.
[501]Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ Open 2017;7:e016408. doi:10.1136/ BMJ open-2017-016408.
Doctors are susceptible to the influence of pharmaceutical company’s promotional activities since they are overworked and underappreciated. Cheerful and charming medical representatives with gifts and sample drugs appreciate the doctor’s work; provide them with much-needed respite and sympathy that ease their burdens.
Fugh-Berman A, Ahari S (2007) Following the script: How drug reps make friends and influence doctors. PLoS Med 4(4): e150. doi:10.1371/journal.pmed.0040150
In their research paper titled “Marketing prescription-based medicines: Salesperson’s Feedbacks,” Abhay Bora and Nilesh Berad (2013) concludes that among all other promotional tools such as samples, gifts, and CME programs, the medical representative who visits the doctors regularly and maintain good rapport found to be the most effective promotional tool for prescription-based drugs.[343]
- Abhay Bora and Dr. Nilesh Berad, “Marketing Prescription-based Medicines: Doctors Feedbacks,” International Journal of Advances in Management, Technology & Engineering Sciences, Vol. I, Issue 2 (IV), Nov 2011, pp. 91-95.
Alternatives to M.R.
In a survey conducted by Ankush et al., two doctors consider that emailing literature and drug information can be alternatives for medical representative visits. Still, there was a negative answer if they regularly checked their email.[709]
[709] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
In pharmaceutical marketing, personal selling through medical representatives is a crucial factor for the company’s success. To date, there is no other alternative system found that can replace personal selling and the medical representatives in the pharmaceutical promotion, even in other industries as well. [702]
[702] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
Personal attributes and professional skills of a successful medical representative:
Though the medical representative job is rewarding, it is challenging and mentally demanding. Since it requires hard work, one should be physically fit and mentally sound. To succeed as an excellent medical representative in the highly competitive pharmaceutical marketing environment, one should be committed, attentive, responsive, punctual, presentable, mentally alert, expert communicator, and be an extrovert.
An ideal medical representative should have high educational qualifications, the ability for extensive traveling, flexibility, emotional stability, cultural empathy, and work effectively. The medical representative is the company’s image and acts as the link between the doctors and chemists.
The medical representatives should travel and work very hard from early morning to midnight. They should visit different doctors, nurses, pharmacists, and administrative staff at different hospitals at the appointed time. They should have complete knowledge about human physiology and pharmacology to answer the questions from the doctors. They should have command over product knowledge, communication skills, problem-solving skills, selling skills, self-discipline, self-motivated, honest, and trustworthy. They should safeguard the corporate image of the company and act as a brand ambassador.
In a survey conducted by Ankush et., most doctors consider the following qualities in order of preference are essential for an ideal medical representative: regularity, sincerity, short detailing, good education, good product knowledge, courteousness, pleasing personality, and salesmanship. [708]
[708] Ankush et. al. A survey on doctor’s expectations from the medical representative in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
An ideal medical representative’s virtues can be classified into personal attributes and professional skills, as mentioned below.
The personal attributes of a good medical representative:
- Honesty
- Trustworthiness
- Value relationships
- Emotional intelligence
- Sociable and friendly
- Good interpersonal skills
- Maintain good rapport
- Well mannered
- Polite and gentle
- Be patience
- Creative skills
- Positive attitude
- Self-confident
- Self -disciplined
- Self-motivated
- Pleasing personality
- Good educational qualification
- Good English communication skills
- Good listening skills
- Good persuading skills
- Professional outlook and behavior
- Willingness to meet different types of people
- Punctual and Time management
Professional skills required for a successful medical representative career:
Act as a vital link between the doctor and company
Represent the corporate image of the company
Regular visits to doctors
Good product knowledge
Good knowledge of medical terminology
Good detailing skills
Being the right source of information
Give the complete and correct information to doctors
Enhancing scientific knowledge of doctors
Answer queries with full details
Select the right drug for the right doctor for promotion
Well accepted by the doctors and customers
Read the doctors and customer’s mind
Handle different types of doctors and customers
Build a cordial relationship with doctors and customers
Value the doctor’s time
Motivate the doctors for more prescriptions
Act as a stimulus for prescription generation
Value addition to doctor’s practice
Ability to work under pressure
Ability to handle adverse situations
Ability to take challenges
Willing to work hard
Have good analytical skills
Have problem-solving skills
Ability to generate prescriptions
Ability to achieve sales targets
Ability to travel extensively
Ability to prepare effective tour plans
Judicious utilization of promotional materials
Follow management instructions
Ability to explore new opportunities
Ability to learn quickly
Ability to work independently
Ability to organize seminars
Ability to make an effective sales presentation
Ability to handle competitors propaganda
Ability to persist with the assignment until it is completed
Should know how to handle objections
Should have a science background
Professional dress code and grooming
- Practice professional ethics
- Dedicated to work
- Loyalty to the organization
- Act as brand ambassador
In their research paper titled “Influence of Pharmaceutical Promotional Tools on Doctors’ Prescribing behavior: Neeti Kasliwal and Ispita Bansal (2013) have identified critical factors which influences the prescription behavior of the doctors, which includes: medical representatives’ personality traits, product knowledge, new drug information, and rapport with the doctors. [341]
[341]Neeti Kasliwal and Ispita Bansal, “Influence of Pharmaceutical Promotional Tools on Doctors’ Prescribing behavior: an Exploratory Study, in Indian Journal of Marketing, Aug 2013, pp. 23-34.
According to Salovey and Mayer (1990), Emotional Intelligence (E.I.) is a newly classified type of intelligence that affects job performance workers.
Salovey and Mayer (1990) defined E.I. as “the ability to understand emotions and feelings in oneself and others and to use this understanding as a way to direct action.”
E.I. reflects three critical abilities of a person, i.e., appraisal and expression of emotions, regulation of emotions, and the utilization of emotions.
While I.Q. is stable and unchangeable, E.I. skills can be improved through learning and regular practice (Golema1998).
Medical representatives work in a marketing environment where social and emotional skills play an important role in their success. Medical representatives’ performance is directly related to their capability to manage social and emotional problems.
Marketing professionals require high emotional intelligence levels to maintain a high level of motivation to face problems in a highly competitive environment. (Brown, Cron, & Slocum, 1997).
In one of the in-depth research conducted by Deeter – Schmelz and Sojka (2003), it was found that to be effective, and high-performance marketing professionals habitually and unknowingly adopt E.I. techniques.
Further studies by Cote, Christopher, and Miners (2006) found that EI is a predictor for high-level job performance.
In their meta-analysis to assess emotional intelligence’s influence on performance, Rooy and Viswesvaran (2004) found a positive correlation between E.I. and work performance.
To encounter failures, a medical representative should have high E.I., be flexible, and able to solve emotionally threatening conditions that are part of life for a salesperson.
Extensive studies conducted by Kidwell, Hardesty, Murtha, and Sheng (2011) with sales executives, found that E.I. is positively related to better sales performance and revenues. Sales executives with higher E.I. from the insurance and real estate sectors generate higher sales revenue and very good at retaining customers.
Jennings and Palmer (2007) have observed considerable improvement in sales performance and revenue generation by the participants in their E.I. development program conducted by a pharmaceutical company. Sales performance with revenue and the E.I. of the participating medical representatives of the E.I. development program were measured before and after the E.I. development program and compared with a control group that was not given the E.I. development. The participant medical representatives E.I. have been enhanced by a mean of 18%, while the control group’s E.I. decreased by 4%. The total sales performance and revenue of the participant medical representatives have improved by an average of 12%, compared to the control group.
Emotional Intelligence (E.I.) is receiving researchers’ attention from marketing, human resource management, psychology, and organizational behavior.
Though there are considerable research and studies on emotional intelligence on the sales executives’ performance in various fields, there are no further studies in the field of pharmaceutical marketing and, in particular, concerning the medical representatives. [950]
[950]Kholoud S. AlDosiry, Othman H. Alkhadher, Elsayed M. AlAqraa, Neil Anderson. Relationships between emotional intelligence and sales performance in Kuwait: Journal of Work and Organizational Psychology, 32 (2016) 39–45.
In their research paper titled “Influence of Pharmaceutical Promotional Tools on Doctors’ Prescribing behavior: Neeti Kasliwal and Ispita Bansal (2013) have identified critical factors which influences the prescription behavior of the doctors, that includes: medical representatives’ personality traits, product knowledge, new drug information, rapport with the doctors, free drug samples, and CME program sponsorships.[341]
[341]Neeti Kasliwal & Ispita Bansal, “Influence of Pharmaceutical Promotional Tools on Doctors’ Prescribing behavior: an Exploratory Study, in Indian Journal of Marketing, Aug 2013, pp. 23-34.
In their paper titled “Physicians’ perception towards promotional tools offered by pharmaceutical industry: A Comparative Practicing Status-wise Analysis,” Girish Taneja and & Usha Arora (2007) states that doctors in the private service give more importance for promotional tools such as personal gifts and sponsorships, whereas the doctors in the government service accord importance for the personality of the medical representative and free medicine samples.[342]
[342] Girish Taneja & Usha Arora, “Physicians’ perceptions towards promotional tools offered by Pharma Industry: A Comparative Practicing Status-wise Analysis,” ICFAI Journal of Marketing Research, Vol. VI, No.8, Aug 2007, pp. 7-18.
In a study conducted in the state of Haryana in India, the doctors have agreed that regular visits by a medical representative with good personality as the best promotional tool.[936]
[936]Girish Taneja. Asia-Pacific Business Review Vol. IV, No. 4, October – December 2008, pp. 82-95. ISSN: 0973-2470.
In a study conducted by Ajay Gidwani, 35% of the doctors agree, and 4% of doctors strongly agree that medical representatives’ pleasing personality is an essential factor.[904]
[904] Ajay Gidwani, Assessment of doctors’ perception towards medical representatives, INDIAN JOURNAL OF RESEARCH. Volume-7 | Issue-11 | November-2018 | PRINT ISSN No 2250-1991.
In a study conducted by Ankush et al., a majority of 65.15% doctors consider that a medical representative with a B. Pharmacy degree will have the better product knowledge to provide better scientific information than other degree holders.[713]
[713] Ankush et. al. A survey on doctor’s expectations from medical representatives in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
In a survey conducted by Ankush et al., most doctors agree that a medical representative with the right product knowl edge can only provide correct scientific information. Doctors think that meeting a medical representative with no proper product knowledge is a waste of time and just a formality. [704]
[704] Ankush et. al. A survey on doctor’s expectations from medical representatives in Karnataka state. Int J Cur Res Rev | Vol 7 • Issue 8 • April 2015.
To make every visit impressive, the medical representative should have profound product knowledge that being reflected in the detailing supported by better soft skills and develop a good rapport with the doctor.[903]
[903] Ajay Gidwani, Assessment of doctors’ perception towards medical representatives, INDIAN JOURNAL OF RESEARCH. Volume-7 | Issue-11 | November-2018 | PRINT ISSN No 2250-1991.
In a study conducted by Bahlol MM in Egypt regarding personal qualities required for medical representatives as perceived by the doctors, 41.4% of doctors consider sociability, 25.4% cite sincerity, 23.6% state convincablity, 6.6% insisted friendliness, and 2.1% point out attentiveness as important personal qualities required for medical representatives. A majority of 86.9% of doctors agree that medical representatives have tried to build a friendship with them.[914]
[914]Bahlol MM, Lagutkina TP. Analysis of medical representatives’ activities directed to physicians in Egypt. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (1): 17—23.
In a study conducted by Ajay Gidwani, 27% of the doctors agree, and 7% of the doctors strongly agree that the medical representatives’ scientific knowledge is an important attribute.[905]
[905] Ajay Gidwani, Assessment of doctors’ perception towards medical representatives, INDIAN JOURNAL OF RESEARCH. Volume-7 | Issue-11 | November-2018 | PRINT ISSN No 2250-1991.
In a study conducted by Bahlol MM in Egypt concerning educational qualification for medical representatives, 97.3% of the doctors consider that there is a need for higher specialized education for medical representatives.
Aligning management vision with the ground realities of the market, in particular, synchronize the behavioral aspects of the medical representatives, and doctors will synergize to give better results.[916]
[916]Bahlol MM, Lagutkina TP. Analysis of medical representatives’ activities directed to physicians in Egypt. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (1): 17—23.
According to Shakti Chakraborty, Group President, Indian Region Formulations, to promote complex specialty drugs to specialist doctors pharmaceutical industry needs the services of professionals with better communication and convincing skills; the management graduates can learn fast and promote the drugs better, compared to general graduates.
Pfizer, Abbott, Cipla, Torrent, Ipca, Lupin, Glenmark, Mankind Pharma, Hetero Drugs, Sun Pharmaceutical, and Dr. Reddy’s Laboratories are hiring pharmacy and management graduates as medical representatives by paying higher salaries.
Out of India’s more than six lakh medical representatives population, around 6 % are qualified with management education.
In a survey conducted by Ankush et al., a majority of 65.15 % doctors favored a bachelor in pharma cy, 6.06 % preferred science graduates, and 1.01 % of the doctors consider matriculation as a minimum qualification for the job of a medical representative. [705]
Since medical representatives are the most potent marketing tools, they are costly to be trained and retained. Most of the pharmaceutical companies spend much of their time and energy on medical representatives’ recruitment, selection, and training. Hence it is essential to optimize their services by proper management and care.
To make every visit veffective, the medical representative should have profound product eryknowledge reflected in the detailing supported by better soft skills and develop a good rapport with the doctor.[903]
[903] Ajay Gidwani, Assessment of doctors’ perception towards medical representatives, INDIAN JOURNAL OF RESEARCH. Volume-7 | Issue-11 | November-2018 | PRINT ISSN No 2250-1991.
In a significant study conducted by Hodges’, 35 % of psychiatry trainees have agreed that discussions with medical representatives do not influence their prescription behavior. In a survey by Sergeant et al., 34 % of the Canadian family residents agreed, and 43 % disagreed that medical representatives influence their prescribing habits. In a different survey by Strang et al., it was found that medical representatives have influenced a majority of 70 % of the Canadian doctors’ prescription habits.
The more number of contacts that a doctor has with a medical representative, the more likely that the doctor prescribes new medicines with little therapeutic advantages that cost more than those other drugs that are already accessible (Chren et al., 1994).
According to Sigmund Freud, individuals are not entirely conscious of their motives; hence they cannot explain their actions. Following Sigmund Freud’s theory, doctors may not be fully aware of their unconscious motives and cannot explain their actions. (Solomon et al. 1999 pp. 112-113).
Therefore, it can be concluded that a considerable part of research and literature has long-established the influence and impact of medical representative on the doctors’ prescription behavior [10, 16, 70].
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- Herzenstein, M.; Misra, S.; Posavac, S.S. How consumers’ attitudes toward direct-to-consumer advertising of prescription drugs influence ad effectiveness, and consumer and physician behavior. Mark. Lett. 2004, 15, 201–212.
In general, the public believes that it is not practical and possible for the medical representatives to change the prescription habits of a doctor; nevertheless, it happens repeatedly though it is a complicated process.
In India, more than 100,000 medical representatives are pursuing and promoting pharmaceutical products to the doctors. [32]
[32] Corstjens, M. (1991) Marketing Strategy in the Pharmaceutical Industry Chapman & Hall: London.
Demand for the medical representatives to grow dramatically:
According to a makency report, by the year 2020, the pharmaceutical industry needs more than 3,50,00 well-trained medical representatives to promote the medicines for an estimated 9,40,000 doctors. The medical representative and the doctor’s ratio will go up by 0.31- 0.37 from the previous lowest of 0.10 of the year 2005.