A busy medical practice is simply just that. It can be very busy; extremely busy at times. The phones are ringing, patients present for treatment, nurses from the hospital and nursing home are paging, phone messages must be returned, lab reports and X-ray reports must be reviewed, and employees must be monitored. There are so many things happening simultaneously in a medical practice and it takes a very attentive physician to be able to digest everything simultaneously. While all processes are monitored, the key group not to forget is the patients in the office.
Enter the pharmaceutical reps. These relatively young and eager professionals have one thing on their mind. They must see the physician and nurse practitioners/physician assistants so that they can promote their product. In the end, pharmaceutical reps are simply salesmen and saleswomen. The newest agents are all available and each can improve treatment for lipids, acid reflux, stroke prevention, fracture prevention, etc. When the drug reps enter the office they want to show off their brochures, review articles, and leave their sample medications. How can a busy medical practice monitor the above activities, allow the providers to care for the patients, and not disrupt the busy work flow?
In my practice, I have chosen to carefully discipline the pharmaceutical reps that call on our office. The reason for such disciplining is to produce the desired behavior that will detract as little time and attention from the practice as possible. In the early days of my practice, I would sign for samples and meet with reps almost anytime they came to the office. As the years progressed, I became busier and busier. More patients were treated and as a result, more prescriptions were written. As the practice became busier, I became a more attractive target for the reps. It was not uncommon for me to meet with five to six reps per half day. "Just five minutes of your time doc," was the popular phrase that was given to my staff in order to meet with me. As I finished a brief visit with a rep one day, one of my patients waiting on me voiced her disgust to me as I walked in the room. She politely informed me that she was in a hurry to get to work and that she did not feel she should have to wait while I conversed with the rep. That conversation really got me to thinking about our process of dealing with pharmaceutical reps.
The first change in our work flow was to visit with reps only during the 11 a.m. to 12 p.m. and the 4 p.m. to 5 p.m. blocks. The appointment schedule was not very busy just before lunch and near the end of the day. However, as I continued with seeing the reps during those times, I found that not only was my lunch time being abbreviated, but I was getting home later and later each day. I chose to modify the work flow a bit and ask that the reps leave their computers or tablets with my nurse during those times and I would sign for their samples. It didn't take the reps long to figure this out and they informed my staff that they must see me sign in person. This process turned into a very brief face-to-face encounter with the pharmaceutical reps again winning the battle. They were still being able to see and speak to me and they were getting signatures very quickly.
I had to modify this process. My staff was instructed to tell the reps that I would sign for the medications, but they would not be able to see me sign in person. This work flow allowed me to sign for samples in batches and disrupt very little time from my daily activities. Further, if the rep wanted a face-to-face meeting, they were informed that they must make a lunch time appointment and cater a lunch for the staff. Initially this did not produce the results I was after, however with persistence and due diligence, I was able to modify their behavior and they quickly started scheduling lunches.
After just over nine years in practice, my work flow is disrupted only minimally by the pharmaceutical reps. Our office has a nice catered lunch at least three to four days out of five, and the reps are very happy to work with us. Patients do not see reps in the office and they do not perceive that my attention is shifted. The staff is happy too, because the days that we have lunches catered allows them to spend a few extra minutes at their desks during lunch and also be free from having to either buy lunch or bring a lunch to the office.
However you choose to deal with pharmaceutical reps, keep in mind that they are trying to make a living just like you. The samples and coupons they bring to the office are very helpful for my patients and I choose to offer small portions of my time to them in return for what they can bring to the office. Whatever method for dealing with reps you choose, just make sure that you do not disrupt your office work flow. An efficient policy for dealing with reps will keep both parties happy and in the end, your patients will benefit.