Hard Sell: The Evolution of a Viagra Salesman (6 page)

In the army, when a drill sergeant conducted a class on tossing a hand grenade, he expected each soldier to follow his instructions precisely. Nobody could say, “But throwing it sidearm feels more comfortable.” The army knew best, period. Researchers had spent hundreds, perhaps thousands of hours perfecting every technique used by soldiers in battle, and accommodating individual preferences was simply not an option. Everybody did it the same way, regardless of whether they had been through basic training in Georgia or Colorado. Uniformity saved lives.

Likewise, at the University of Pfizer, the individualizing of sales presentations was not encouraged. Pfizer had spent countless hours and tens of thousands of dollars accruing market research to help determine the most effective way to present the advantages of our drugs over the competition. Following the formulation of the sales strategy for a particular drug, Pfizer’s brain trust created the accompanying detail, which was then presented to managers and trainers, who memorized it and subsequently taught it to their sales reps. The script in Atlanta was the same as the
one in Denver. This uniformity may not have saved lives, but it did ensure that the Pfizer message—the thoroughly studied, tremendously expensive message—was consistently delivered.

Several years into my career, a colleague pointed out another benefit to hiring military officers, one that I had never considered. “They want guys who are used to taking orders,” he theorized. “Pfizer needs to push its message exactly the way it was intended. Who better to do that than people who are used to following instructions perfectly?” It was not lost on me—the fact that a free thinker such as myself had not considered this theory was the exact reason Pfizer had hired me.

For starters, we learned that an Initial Benefit Statement, or opener, such as, “Dr. Brown, how would you like to get thirty percent fewer phone calls in the middle of the night from angry mothers?” was key to grabbing a physician’s attention and engaging her in a discussion. Obviously, everybody would like fewer interruptions at three
A.M.
, so she would be likely to respond affirmatively and then ask how that could be achieved. The trainers constantly emphasized “features to benefits” in our selling, meaning taking the positive aspects or advantages of our drugs and highlighting the impact they could have on the patients and the doctor in everyday life.

For example, Zithromax caused 33 percent less diarrhea than Augmentin, then the leading antibiotic for ear infections in children. This was an advantage we
had
to get
across to physicians. However, just because we clearly saw that benefit did not mean every doctor would automatically transfer that feature to her own practice. We were instructed to constantly ask ourselves, “So what?” meaning, “So what does that mean to a nurse or physician?” A physician might hear “thirty-three percent less diarrhea” and think, “Okay, that sounds good,” but not necessarily make the connection between less diarrhea and fewer phone calls in the middle of the night. However, when told she would get 33 percent more sleep during nights when she was on call, that doc would think, “That sounds great! Zithromax can help my practice.” Most benefits revolved around saving a physician or her staff time and hassle or saving mothers time and hassle, which normally then resulted in the former as well.

Having garnered a doctor’s attention with a snappy IBS, we shifted our focus to efficacy, or how well a drug worked. When all was said and done, if a doctor didn’t consider a drug as effective or better than its competitors, he wouldn’t use it. Fortunately, we had solid data demonstrating that Zithromax, Zoloft, and Diflucan were equal to or superior to the other drugs in their respective classes. The trainers taught us to emphasize the trade journal in which a study had been published, the medical school or research group that conducted the trial, and the number of patients involved (larger numbers meant stronger data and were more convincing).

Once we had gained a doctor’s agreement that the drug worked, we highlighted safety advantages as well
as concerns, if there were any. We were reminded time and again that it was absolutely critical to inform medical professionals of any patients who should
not
be given one of our drugs, as well as any potential problems due to drug-to-drug interactions. Our credibility was everything, Bruce told us, and trying to hide something from a physician because we were afraid it might keep him from prescribing our product was not only irresponsible, it would also ruin us in the eyes of the customer.

Finally, we would explain the dosing schedule to the physician, since an incorrect dose could be ineffective or, worse yet, harmful. Then, being true “closers,” we’d ask for the business. Every once in a great while, the trainers informed us, we’d get it without objection.

Unless a drug had been universally hailed as a panacea for a particular ailment or disease, doctors rarely agreed to start prescribing it in their “next ten patients.” Cautious creatures of habit, physicians stuck to the products they had been trained to use during their residencies and with which they had subsequently grown comfortable. Having studied biology, chemistry, and so forth for years, doctors developed a scientist’s natural skepticism and learned to question the validity of findings and doubt the results of pharmaceutical trials, especially those sponsored by the maker of the drug in question.

Physicians, then, often had issues and questions, aka objections, that the sales reps had to be able to answer satisfactorily before the physicians would be willing to
prescribe the drug. Most of these were legit, but some were merely smoke screens designed to conceal the real reason the doctor refused to use the drug, i.e., he was sleeping with the Bristol-Myers Squibb woman. Of course, some physicians just enjoyed busting the balls of a new rep, so they asked ridiculous questions (“How will Zithromax affect my patients with Lou Gehrig’s disease?” As panic sets in, “Uh, Doctor, aren’t you a pediatrician?”) or raised nonsensical issues (“I don’t like the color blue, so I can’t prescribe any Pfizer products”). Regardless of the motivation behind the objection, successfully handling it was the biggest part of a drug rep’s job.

Not surprisingly, Pfizer had a formula for doing just that. When faced with an objection (“Once a day dosing for just five days? That’s the silliest thing I’ve ever heard of. I’m not going to use Zithromax because of it”), we were to do these six things in order: Listen, clarify, empathize, provide proof, verify, and trial close. Faced with an objection to a drug that had been on the market for a while (if the product was new, obviously few people would have had the chance to try it out), a rep initially asked, “Is this something you’ve seen or heard, Doctor?” This determined whether the doctor had actually used the drug or if a competitor had planted the concern. It was far easier to handle the latter as opposed to an objection prompted by a physician’s personal experience.

The first step—listen—seemed fairly obvious, but it was an important reminder to chatty salespeople to shut
up and pay attention to the customer. Chock full of data and hell-bent on dispersing
all
of it, many reps, especially new ones, continued talking even after being interrupted by a medical professional. As a result, they missed hearing a crucial objection that would preclude the guy from prescribing the drug whose data spewed from the rep’s mouth Dick Vitale–style.

Having listened effectively to an objection, the salesperson then had to clarify what he had heard: “So, Doctor, what is it about Zithromax’s unique dosing schedule that worries you? Are you worried that your patients won’t receive enough medicine to cure their ear infections?” Pfizer cleverly trained us to answer just about every possible objection, enabling us to extract specific concerns from nonspecific comments.

If the doctor agreed that, yes, he was concerned that the two-year-old he tried Zithromax on would remain sick and that he’d have to deal with her mother
again
, the rep had to empathize with the problem. “Well, Doctor, I can understand why you would be concerned about that. Obviously, getting your patients better is your primary goal, as it is for Pfizer. Admittedly, Zithromax’s revolutionary dosing schedule of
just
once a day for
only
five days [subtle plug for the drug’s biggest advantage over its competitors] has raised some eyebrows here in the States, where everyone is used to twenty or even
thirty
doses with
older
agents. But if I can show you efficacy data that proved to the FDA that Zithromax works as
well in otitis media patients as your current gold standard Augmentin with
one-third
of the doses, would you like to see that?” This normally prompted something sounding like “Humph.”

Pulling out the detail piece and flipping it open to the “efficacy” page in one smooth motion, the salesperson then explained the trial design and the results. Having provided proof, Johnny Drug Rep moved to step five—verifying. “Doctor, have I addressed your concern that Zithromax’s unique dosing schedule of just once a day for only five days will not provide the efficacy you are looking for in your otitis media patients?” If he said no, then the rep asked more questions to drag out the true objection. Perhaps the rep did a poor job of presenting the data, or maybe this was just a smoke screen. Either way, more probing was needed. If the doctor agreed, though, it was time for the close: “Doctor, given Zithromax’s demonstrated efficacy, strong side-effect profile, and ease of dosing, will you prescribe it first line in your next ten ear infection patients?”

Which was exactly how the trainer posing as a rep finished his detail demonstration with the other trainer posing as a doctor. Closing a physician is vitally important because of a factor unique to pharmaceutical sales compared to sales in other industries. When a Xerox salesman leaves a customer’s office she either holds in her hand an order form for two new copiers or nothing. She always knows whether she made a sale or not. The same
goes for surgical equipment or steel or software. Drug reps, however, walk out the door without knowing if they’ve sold any of their products. Doctors agree to write prescriptions for Drug X, but there’s no contract signed, no check written. Only weeks later will a drug rep find out if the physician kept his word to prescribe a drug. (Pharmaceutical companies pay hundreds of thousands of dollars to third-party firms that gather sales data from the nation’s pharmacy chains; reps get detailed reports informing them how many prescriptions—of their own drugs, as well as those of their competitors—each doctor has written in a particular week. Many physicians are unaware that their reps have access to this information.) Without the standard business agreement, then, a rep
has to
close a doctor in order to establish some sort of commitment that can be followed up on later.
Now, Doctor, last month you agreed to try Zithromax in your next ten otitis media patients. What stopped you from doing so?

Shortly after seeing how a pro did it, we received our own vis aid. Idly flipping through the laminated pages, I had no inkling as to how familiar I would become with the data they contained. Just as army trainees learn to disassemble and reassemble their M-16 rifles while blindfolded, we could turn without hesitation to any page of the vis aid and regurgitate the verbiage we’d been taught. I began dreaming at night about detailing trainers playing the role of doctor, and I wasn’t the only one. Again and again, we detailed each other; people rehearsed over
lunch, in the hallways, even in the bathrooms. No one wanted to blow it on camera.

The use of videotaping as a training tool was still relatively new to the pharma industry in the mid-1990s. With the red light on, reps detailed trainers playing doctors, and later they rewound the tape and critiqued the performance. When asked what the taping sessions were like, a fellow trainee with previous pharmaceuticals experience said with resignation, “It’s gonna suck.” Reports of fitful nights of sleep increased dramatically.

We had to pass another unnerving obstacle first, however: detailing our manager in front of the team. We were scheduled to divide into our respective districts on a Sunday night. Up until then, I had yet to sweat detailing in front of a group. So I was quite surprised to feel knots in my shoulders as I walked into our district’s meeting room. This discovery made me even more nervous; dating back to the second grade, I had never gotten rattled by speaking in public.

In 1978, I was selected to appear at a Board of Education meeting and read my one-page “essay” on the purchase of Manhattan Island. On the drive there, my parents kept reminding me, already a loud child, to “speak very, very loudly, so even the people in back can hear.” The message stuck. The room was packed with parents, but there were twenty open seats in the front, reserved for the readers. Each chair had a sign with a student’s name on it. We walked over to take a look and
JAMIE REIDY—EL DORADO ELEMENTARY
was taped to the chair on the far left, front row. I was going first.

Standing onstage, holding my essay written in large block letters, I stared at the crowd while a nice woman adjusted the microphone for me.
Microphone?
My parents had not anticipated the use of a mike, but it was too late to deprogram their eight-year-old speech giver, who had been told to speak very loudly, and, by golly, he was going to do as he was told. “THE INDIANS SOLD MANHATTAN FOR SEVENTEEN DOLLARS IN TRINKETS. …” My parents never urged me to “speak loudly” again.

Over the years, I sang solos in school concerts, did readings at Masses, and briefed commanding generals in the army without pause, yet I was still nervous before my first official detail in front of my manager and nine teammates. Bruce gave a little pep talk about it being a “no-pressure environment” and then asked for a volunteer to kick things off. This request was met with lots of paper shuffling, neck scratching, and shoe gazing, but very little hand raising. The humming of the fluorescent ceiling lights seemed deafening. Finally, in what would turn out to be a brilliant move and become a staple in the Reidy arsenal, I said I’d do it. Everyone, Bruce especially, looked stunned.
The drunken guy with the potty mouth wants to go first?