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| February 2007 | ||||||
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What’s it Like to Be a Physician?One of the things that makes me nuts about pharmaceutical marketing research is that we spend so much time studying our products, and so little time studying our customers. Compare this allocation of focus with that of our brethren in consumer research companies, who spend much of their marketing research effort getting an understanding of the customers, their segments, etc. In fairness, there is a significant difference between the pharmaceutical and the consumer businesses that these marketing researchers service. In the pharmaceutical industry, we are typically handed a developmental or launched product with a fixed profile of efficacy, side effects, etc., by our colleagues in clinical development or in licensing and acquisition. There is usually little we can do to change this profile, so we are left mainly to help assess its sales potential, assist in the development of a story that will optimally communicate this profile, etc., and with all of these activities under increasingly tight regulatory supervision. In other words, we are literally involved in the marketing research business. Our colleagues in consumer goods, financial services and other areas are in a different situation. In those settings, they actually get to do market research, i.e., to determine the wants, needs, motivations, etc., of their customers and the segments thereof, and then to help design products that actually meet these needs, either through modifications of existing products or the design of entirely new products from a clean slate. That having been said, those who have been following any of my recent writings and speaking engagements have heard my lament that the pharmaceutical industry, as a whole, is woefully devoid of a body of knowledge concerning basic customer issues, choosing instead to make assumptions on such matters. Having spent most of my life doing pharmaceutical product marketing research, I am increasingly impressed and concerned about what we, as an industry, don’t know, and especially about what we don’t know about our customers. In fact, we have become less and less interested in such information over the years. About three decades ago, when I started in this profession, pharmaceutical marketing researchers were spending a significant amount of time dealing with studies having to do with the “psychographics” of their customer base. Typically done to support advertising efforts, study after study was conducted that came up with brilliant findings like “Dermatologists are significantly more likely than General Practitioners to want to paint a picture than to sail a boat.” Such findings were typically used to direct advertising agency staff members charged with creating advertisements for medical journals, one of the three major promotional media at the time (the others being detailing and direct mail), to use a more artistic motif in creative elements directed at Dermatologists, and a more sporty motif in communicating with General Practitioners. Whether such differentiation ever mattered nobody really knows, but in any event, little marketing research is being done in support of it at the present time. Frankly, I always considered such work a little goofy, since its only possible benefit was the more targeted direction of the creative artwork involved in ad design. Moreover, it focused on such isolated components of physicians’ attitudes, interests and opinions that it never provided us with a holistic picture of the customer, his or her needs and how to better meet them. The one thing I did like about this type of work, on the other hand, was that it did focus, albeit rather anemically, on the customer rather than the product. About 20 years ago, I received funding from a pharmaceutical company to conduct a project that was a pharmaceutical marketing researcher’s dream. Together, with my client, I generated a topical guide for a relatively large series of individual depth interviews that allowed physicians to talk about things we never let them talk about when we are doing product research. The interview began by asking them how they decided to become a physician. Some, we found, had planned to enter this profession from an early age. Even decades later, I remember the comments of one physician who decided to become a physician – and a dedicated and excellent one at that – when as a young boy he watched a doctor save his brother from a potentially fatal condition. Another doctor, on the other hand, made the decision as she pondered what major to choose in college. She knew she wanted to make money, and she reported that deciding between going to business school or entering a pre-med program to accomplish this goal was virtually a toss-up. Medicine won, but only by a hair. As one might expect, the balance of the interview revealed that, while still practicing reasonable medicine, this physician was far less knowledgeable and dedicated than the respondent mentioned previously. We also learned through this research that there were several different types of decision-making styles exhibited by physicians, and that they were important to keep in mind when approaching the physician with promotional materials. The Scientist made prescribing decisions based on his or her own review of the scientific data available concerning a product, and took special interest in understanding a product’s mechanism(s) of action. While this type of decision-making style was exhibited by only about a quarter of the physicians we interviewed, and as one would expect was more prevalent among specialists than primary care physicians, this is the doctor that to this day most pharmaceutical marketers believe they are marketing to and most patients believe they are being cared for by. Wrong! Most physicians, we learned through this work, are Modernists, who allow other “opinion leading” physicians to vet information about products for them. They are called Modernists because they tend to look around them, discover what treatments are being recommended in summary articles and employed by their colleagues, and to prescribe accordingly. Most such physicians have little interest in the pure science underlying these treatment interventions, proudly announcing that they are “clinicians first,” and learning only enough about the mechanism of action of a drug to use it appropriately. Most doctors we found, reasonably enough, pursue this decision-making style. Finally, we encountered the Traditionalist, who made prescribing decisions based primarily on promotional inputs received from pharmaceutical companies. More specifically, these physicians relied heavily on information provided to them by “detail men” (the terminology used at the time), and often responded to marketing research questions about products by parroting back the exact wording used in detail presentations. They tended to keep their lives simple by utilizing only a relatively small armamentarium of drugs, and were loath to try new products until it became clear to them that virtually everyone else was using them successfully and safely. Not surprisingly, they had little knowledge of the science underlying these products, and were often unable to identify their generic names. About a quarter of doctors were found to operate in this decision-making mode, and as one would expect, primary care physicians were overrepresented in this group. Often, they had entered the medical profession as a good way to make a living, and pursued such channels as continuing medical education only to the extent required by their state licensure boards. But that was 20 years ago. As this is being written, most of the pharmaceutical industry has never heard of, or has forgotten, the importance of this customer understanding. Moreover, the growing importance of group practices, managed care, etc., let alone the greatly increased number of therapeutic modalities available, have made it essential to update this information. To successfully market pharmaceutical products in 2007 and beyond, questions about our customers that we need to know the answers to include:
Richard B. Vanderveer, Ph.D. Group Chief Executive Officer GfK U.S. Healthcare Companies 
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