Muerte de la Visita médica...?

No es quizás el momento más adecuado, a pocos días del "Dia del Trabajador", pero el artículo es un reflejo claro de la situación...
No solo en los EEUU sino en todas partes.


Most prescription pharmaceutical and therapeutic devices are marketed through “details.”
Traditionally, detailing involved a personable, well-dressed professional visiting a physician’s office sharing news, clinical results and product samples with a physician. The meetings involved a good amount of banter and were part of a cordial relationship.



In the modern era, detailing became sophisticated and personalized, where very compelling messages were tailored for specific doctors.
But somewhere along the way, there was a counter-reaction to detailing, and it has become a lot more difficult.



1. -Looking back, we saw the first wave of doctor resistance starting in the late eighties and nineties, maybe earlier. This seemingly-principled action from certain doctors criticized the relationship and generally revolved around the idea that patient care and the doctor’s integrity were compromised when the doctor is getting pens, pads, free lunches and much more from detailers— and taken to extremes and made famous in the recent movie “Love and Other Drugs.“ There is a history of abuses— doctors listening to drug information as the detailer gases up the physician’s car— but these early “detail rejecters” were on the fringe. As commentary, we would suggest that in cutting off the line of communication with the pharmaceutical manufacturer, these doctors lost more than they gained. The percentage of doctors who ended relationships for this reason is assuredly in the single digits.

2. -The next wave of detail resistance started in the nineties and continues to this day. The driver of this wave was the intrusion into clinical practice by managed care companies in the name of cost-containment, which has resulted in increased doctor workloads and intense pressure to complete clinical tasks quickly. Insurers started looking very closely at doctor billings and set firm reimbursement rates. They also brought into play multiple models for reimbursement, and in some markets started managing the healthcare delivery process with integrated delivery networks, where the insurer is the doctor’s employer. At this point, there is hardly a consumer out there who cannot tell you the difference between “in-network” and “out-of-network.” As doctors’ workloads increased, detailers have become less welcome in their offices and in hospital hallways – nothing personal, pure economics.
So now we see offices where detailers are invited to drop off samples with staff, but see doctors only within a specified time period, or not at all.

3. -A third wave in the battle against detailing is happening within the hallways of pharmaceutical companies. We know, for example, that ten years ago, there were about 40% more detailing representatives than there are now. The doctor-to-rep ratio has gone from 6-to-1 to 10-to-1. At the same time, as we are seeing doctors decreasing access, there is quite a bit of evidence that when a doctor sees a rep, it is for less time – in our surveys, we see a little more than half of the consummated discussions last four minutes or less.
That the number of detailers has decreased shows that pharmaceutical companies have accepted that there are alternate marketing channels. Even where there is not an alternate channel readily available, sometimes the best solution is to keep marketing dollars in pocket. The third wave is exactly that: the requirement that detailing’s ROI is demonstrable and clear, in an environment where that ROI is probably decreasing.

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