Playing a Prevent Defense

Wouldn’t it be nice if, after you’ve shared the results of a clinical study, the physicians always responded with a hearty, “Makes sense to me!” Unfortunately, as Medical Science Liaison Institute president Jane Chin points out in a recent article in Pharmaceutical Representative Magazine, a physician is much more likely to react to your presentation with something else entirely: an objection.

In truth, reps should welcome objections, Chin says, because at the very least they indicate a level of interest from the physician. Too often, however, representatives will respond improperly to objections, and undermine their chances for moving the conversation forward toward a common, mutually beneficial understanding. Chin says one of the most common mistakes she sees pharmaceutical reps make is to become overly defensive in response to such objections.

While it’s natural to want to defend your study against the physician’s objection, it’s not particularly productive, since you’re essentially telling the doctor that he or she is wrong. Say, for example, a physician you’re detailing objects to your use of a study by arguing that the low p value renders the data insignificant. The quick-to-defend rep might reply with, “But as you see here, the data has a favorable trend.”

This would be a terrific response if you were hoping to engage the physician in a discussion of study design and statistical manipulation. But you’re not. And this route will quickly lead you to a dead end, sales-wise.

Chin says a marginally better response might be to agree and follow up with a question, such as, “You’re right, it’s not statistically significant. What do you think about the claim of a favorable trend?”

At least this rep isn’t taking a defensive stance from the outset. Nevertheless, this approach can still lead you down the path to talking about study design and statistical manipulation. For this reason Chin suggests a third approach, one that offers agreement and then shifts the discussion in a more positive direction: “You’re right, it’s not statistically significant. Based on this data, what would you conclude about the utility of this drug?”

Again, you’re not disputing the physician’s assessment nor are you redirecting his or her attention. Instead, you are asking the doctor to share an opinion about how the data should be interpreted, which will help you understand the factors that he or she considers when making prescribing decisions.

Want to steel yourself against the tendency to jump to defend a study in the face of a physician’s objection? Then know what to watch out for. Chin says that the most common objections that put reps in a defensive posture are questions about study design, patient population or sample size, statistical significance and statistical versus clinical significance.