Hospitals are ground zero for the growing rep-physician disconnect

 

By Matthew Arnold, principal analyst, Decision Resources Group

 

In our U.S. physician research, we’ve been seeing the number of “No-see” physicians – those that don’t see pharma reps – creep up for a number of years, now. This year we saw a notable jump, with 2 in 5 physicians (39 percent) reporting having had no contact with pharma reps – up from 24 percent in 2018.

There are a number of factors driving this trend – surging patient volumes, increasing employer restrictions, and other demands on physicians’ time (like EHR maintenance). All of these trends impact hospital doctors particularly heavily, and so it’s no surprise that the number of physicians who work in hospitals that report not having seen reps is much higher than it is for solo practitioners and those working in group practices – at 57 percent, up from 37 percent in 2018.

So where are hospital physicians getting treatment information, then? As with physicians in other practice types, their top sources after colleagues are search engines (87 percent use search to find clinical info at least monthly), HCP websites (82 percent) and their EHR systems (81 percent). However, half of hospital physicians consult pharma websites for clinical info at least monthly, indicating that HCP-directed pharma sites remain an important info source for physicians despite the heavy gravitational pull of the EHR (in which U.S. physicians now spend, on average, 3.3 hours a day).

Hospital physicians are highly skeptical of pharma websites, with just 34 percent saying they find the information on these sites trustworthy (versus 45 percent of all U.S. physicians). However, they continue to seek out info outside of their EHRs, which often lack in-depth and up-to-date clinical and therapeutic information, and pharma websites are a surefire source of FDA-vetted info on specific treatments, even if doctors are wary of commercial spin.

In recent years, there’s been an increasing push among pharma marketers towards serving HCPs as partners in care – not just hawking products at them. For pharma websites, that’s meant ensuring a greater balance between the sort of product-centered content that has traditionally dominated these sites, and resources that add value for physicians and help them deliver care to their patients – patient education and support, for example, and in-depth scientific information.

The silver lining for pharma? Physicians are noticing these efforts. Among hospital physicians, 38 percent agree that “pharma websites are doing more to add value to both my clinical practice and my patients than they were 5 years ago (37 percent of all U.S. physicians agreed). That’s buoyed trust in pharma websites, with 45 percent of hospitals deeming these sites credible (versus just 27 percent last year).

With personal promotion on the wane, particularly in hospital settings, pharmas will need to lean more on other means of engagement, including websites and sponsored content on trusted third-party digital resources (e.g., UpToDate, Medscape and NEJM), as well as healthcare podcasts and KOL collaborations.

There’s still a role for reps, too. Physicians continue to value the rep relationship — in fact, reps have actually grown more influential with physicians in recent years. But given the increasing scarcity of in-person details, pharma commercial orgs will need to find alternate means of kindling those relationships, utilizing pull tactics and multiple touchpoints to keep them informed and engaged. And sales forces will need to maximize the impact of these increasingly-rare in-person meetings by taking physician preferences around presentation dictate format – for instance, loading rep tablets with digital KOL testimonials and product efficacy info, while arming them with printed safety and side effects info and medication guides.

As healthcare mega-mergers continue to reshape provision of care in the U.S., and physicians migrate from smaller practices into sprawling hospitals and health systems, these physicians are struggling to manage staggering caseloads while staying informed on state of the art treatments and trends in medicine. They are, in many ways, the medical workforce of the future – and pharmas have an opportunity to help them through this turbulent transition.