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IJCRR - 7(8), April, 2015

Pages: 75-82

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A SURVEY ON DOCTOR'S EXPECTATION FROM MEDICAL REPRESENTATIVE IN KARNATAKA STATE

Author: Ankush C., Virendra S. L., Kiranshanker K., Sreedhar D., Manthan J., Muragundi P. M., Udupa N.

Category: Healthcare

Abstract:The aim of present study was to know to the effectiveness of personal selling in perception of doctors and to find out exactly what doctors expect from medical representative.A self-administered questionnaire was distributed to 200 doctors. Both open end and close end questions were included in the questionnaire. Results obtained from the study were informative. Doctors find the services rendered by medical representative useful. Today, providing information on price and discounts and availability of drugs are most important services rendered by medical representatives. So it was concluded from the study that
many doctors are price sensitive today and want drugs at less price for their patients

Keywords: Personal selling, Perception, Medical representative

Full Text:

INTRODUCTION

Marketing and selling are important functions of any business.The American Marketing Association define marketing as: “Marketing is an organizational function and a set of process for creating, communicating, and delivering value to customers and for managing customer relationships in ways that benefit the organization and its stake holders”.1 It is hard for many to believe, but when compared to economics, production and operations, accounting and other business areas, marketing is a relatively young discipline having emerged in the early 1900s2.Good marketing is a result of careful planning and execution. Marketing practices are continuously being refined and reformed in virtually all industries, including the pharmaceutical industry, to increase the chances of success. But marketing excellence is still rare and difficult to achieve.As we go back to the history of pharmaceutical marketing, it reveals that the first pharmaceutical sales representative appear on the scene in 1850s in the United States.3 Unfortunately there is no solid evidence to show when and how the pharmaceutical sales representatives appeared in the Indian pharmaceutical market. Sales representative in pharmaceutical marketing are called as Medical representative. They promote the company product to the customer that is physicians. Promotion is a method utilized to tell the customers about product, place and price. Promotion has two basic elements 1) to provide information about product 2) to persuade potential customers4 .Selling may be defined as the process of analyzing potential customers’ needs and wants, and assisting them in discovering how such needs and wants can best be satisfied by the purchase of a particular product, services or idea5 . The focus of selling thus is on the needs and wants of customers rather than on the features of a product. A pharmaceutical sales representative has to perform four crucial tasks6 . Even a slight improvement of in effectiveness of anyone of these will lead to a significant increase in results. These four crucial tasks are:-

1. Detailing

2. Monitoring

3. Sampling

4. Retailing (retail booking)

Detailing is singularly the most important task that a representative has to perform. Ethically speaking, effective  detailing with the help of a proper visual aid is the only way to increase prescription generation7 . It is said that the pharmaceutical companies often use effective methods of influence in combination with misleading “logic”. Promotion can influence prescribers more than we thought possible. Frequent exposure to promotion correlates with more expensive, less appropriate prescribing.8 As we know, personal selling is a crucial determinant factor of success in pharmaceutical marketing. Till date nothing has replaced the profession of personal selling in pharmaceutical industry and in other industries too. The pharmaceutical sales representatives play a critical role in the development and sustainability of the business through the selling of products and services. Pharmaceutical representatives are trained in traditional ways and because of this they are doing detailing in traditional ways. But expectations of doctors have been changed over a period of time. Pharmaceutical companies spend huge amount and time for such promotional activities; hence it is essential to know what doctors are currently expecting from medical representative so that money of company and efforts of medical representatives will not go waste. The present was carried out to analyze the perception of doctors towards medical representative in Karnataka, India. The following objectives were framed to study.

OBJECTIVES OF THE STUDY

1. To find out the effectiveness of personal selling in perception of doctors.

2. To find out exactly what doctors expect from medical representative.

METHODOLOGY

Survey Design

A mail questionnaire was prepared to collect data from doctors. Mail questionnaire were sent to 10 doctors for testing the response rate of doctors. After waiting for 20 days another reminder mail was sent to each and every previous doctor. After waiting few more days it was decided personal interview will be more appropriate.

QUESTIONNAIRE DESIGN

Questionnaires were typed in Microsoft word and then converted to PDF format for ease of printing. Size of paper used was A4 and 200 copies of questionnaire for doctors were printed. Each copy consisted of two pages (front and back). Total 10 questions were included in questionnaire.

TYPES OF QUESTIONS

Both open end and close end questions were included in the questionnaire. In case of close ended questions respondents were asked to tick ( Ö ) most appropriate answer and in few questions respondents were asked to give number in order of preference.

DOCTOR LIST

Karnataka medical council registration data base was used to identify MBBS doctors in Bangalore; approximately 20 thousand doctors were identified. Then by using random number generator from www.random. org 1400 MBBS doctors were selected. 800 BDS doctors, 600 ophthalmologists, 400 orthopedics, 400 MD and 400 Surgeons were identified using www.yellowpages.com and www.doctorduniya.com and like this doctor list was prepared. That sum up as 4000 doctors total.

SAMPLE SIZE

200 doctors from above doctor list of 4000 were selected. In those 4000 doctors, 1400 were MBBS that means 35% so to maintain same percentage 70 MBBS doctors were randomly selected from list of 1400 doctors by using random number generator from www.random.org , likewise 40 BDS, 30 ophthalmologists, 20 orthopedic doctors, 20 MD and 20 MS were selected after randomization.

SAMPLING TECHNIQUE

Doctor

Stratified randomized sampling technique was used for sampling of doctors. They were stratified according to their qualification as mentioned above and then randomization was done in each stratum and 200 doctors were selected

DATA COLLECTION

Data was collected from respondents in Bangalore (Capital of Karnataka)

DURATION OF STUDY

The duration of the study was 6 months

DATA PRESENTATION

Tables, Pie charts, Bar diagrams etc.

DATA ANALYSIS AND INTERPRETATION

Analysis and interpretation of the data has been carried out to deduce the conclusions with the aid of appropriate statistical tools.

RESULTS AND DISCUSSION

SURVEY OF DOCTORS

Out of 200 doctors who participated in the survey 35% were MBBS, 20% were BDS, 15% were Ophthalmologists,10% were Orthopedics, 10% were MD and 10% were MS.

Doctors were met personally, interviewed and their responses were noted in questionnaire. Except questions in questionnaire some other questions were also asked by the author to doctors and many interesting facts came out, they are discussed with some of the questions below.

SURVEY RESULTS

Question 1: Do you feel medical representatives are useful to the medical profession?

Survey indicated almost all (99.00%) of the respondents feel that representatives perform a useful service to them (table). Only one MD and one MS mentioned that representatives perform no useful service to them.

Question 1 (a): If yes then why?

71.71% respondents respond to all option. Among rest 28.28% price information and discounts got most response (10.10%), followed by information about drug use (8.58%), information about availability of drugs (6.06%) and at last distribution of samples (4.04%). Two respondents did not respond to any option. If we see point wise price information that means one point for every response, price information and discounts got most points and became first ranker followed by information about availability of drugs on second rank, information about drug use on third rank and providing samples got least points and attained fourth rank. When asked why doctors need price information and discounts as priority majority of doctors told they wants drug at less price for their patients because if patients will get medicines at lower price than they are more likely to come to the same doctor. So it was concluded from the study that many doctors are price sensitive today and want drugs at less price for their patients.

Question 1 (b): If no please write what are the alternatives to MR, in your opinion?

Two respondents told the same answer. The answer was emailing of literature and information. But when asked do they check mail every day, the answers were negative.

Question 2: Generally how many representatives you see in one day?

Most of the respondents (86.86%) said that they see 6 to 10 medical representatives daily. A small number (4.54%) said they see more than 10 medical representatives while 8.58% respondents said they see less than 5 medical representatives a day. One MD and one MS told they are not entertaining medical representatives. It can be concluded with this survey that MD and MS have less time so many of them (actually well experienced doctors) have a tendency to see less than 5 medical representatives. Interview revealed that young doctors and students are more likely to entertain medical representatives than experienced doctors.

Question 2(a): What should be the interval between visits in your opinion?

Majority of respondents (61.11%) said for them ideal interval is 21 to 30 days, a significant percentage of respondents (22.22%) said, less than 20 days is the ideal interval. Few respondents (15.65%) said that ideal interval should be more than 30 days. It was noted that majority of this 15.65% were experienced doctors having experience more than 10 years. It is also interesting to note that young less experienced doctors and students wants to meet more medical representatives to enhance their knowledge.

Question 3: To what extent these medical representatives influence your choice of drugs in prescribing?

More than half the number of respondents (52.52%) said that they are influenced very little by Medical representatives in their choice of drugs in prescribing. 18.68% indicated ‘Quite a bit’, a smaller percentage (15.65%) mentioned ‘Very much’ and 13.13 percentage of respondents were of the opinion that they are not at all influenced by the medical representatives. It was observed from the survey that majority of well experienced doctors responded to ‘very little’ and ‘not at all’. Young and new doctors are likely to be more influenced by medical representatives than old and experienced ones

Question 4: In your opinion what should be the minimum qualification of MR?

The most frequent answer was bachelor in pharmacy (65.15%). Next answer was diploma in pharmacy (27.77%), next comes science graduates (6.06%) and a insignificant percentage of respondents (1.01%) told that matriculation should be the minimum qualification. Author asked question to all of the respondents who responded to ‘Bachelor in pharmacy’ that why they want B. Pharm as minimum qualification for medical representative, few doctors told that it is a waste of time for them to meet medical representative who do not have product knowledge, meeting them is just a formality but whenever they meets a medical representative having B.Pharm degree it is easy for them to ask questions and get answers. When asked the medical representative having diploma in pharmacy also can perform the same, majority were unconvinced by their knowledge levels and told that B.Pharm is extensive degree than D. pharm. While majority of respondents told that MR with B. Pharm degree is far superior in knowledge than other degrees mentioned in questionnaire. So the study reveals that majority of doctors wants a medical representative who is good at product knowledge and can provide scientific information. That is why they think that MRs should have B.Pharm as their Minimum qualification.

Question 5: In your opinion what should be the qualities of a good MR?

The survey indicated that regularity has been considered as the most essential quality of a medical representative followed by sincere in claims, brief detailing, good education, product knowledge, courtesy, personality and salesmanship in that order of preference. When asked that why majority of doctors considered regularity as most essential quality that medical representative must possess, majority of doctors told regularity reflects the efforts of a MR. They told regular MR develop a relation with doctors which is not possible in case of irregular MR , regular MR can brings answers to the questions raised by doctors quickly than irregular MR. Few doctors also told that regular MR from many companies bring useful literature and samples for them regularly. So it was concluded from the above question that a MR should be regular with sincerity in claims, should be quick with detailing and have good product knowledge.

Question 6: Do you find medical literature distributed by representatives of any use to you? The most frequent answer (34.34%) was somewhat. The second most frequent answer was very little (32.32%), next comes very much (21.71%) and the last was none (11.11%). It was noted that MBBS are more likely to use medical literature than MD and MS. Majority of MD (47.36%) and MS (57.89%) have opinion that medical literature is of very little use to them and a significant percentage of both (21.06%) think that medical literature is of no use to them. It is derived from the study that majority of MD and MS owing to higher education are less receptive to information provided by medical literature. Experienced doctors also pay less attention to medical literature provided by MR, actually when asked why few of them told they cannot depend on information provided by medical literature because the information in literature may be biased.

Question 6(a): If little and not at all what are the short comings?

Total 87 respondents told that literature provided by medical representatives are little and not at all useful to them. Majority of them (80.45%) told that medical literature is too detailed and time consuming. 13.79% told that it is misleading, 3.44% of respondents think it is not informative only 2.29% of respondents think it is not interesting.

Question 7: Are the drug samples distributed by MRs are useful to you?

Most frequent answer was to some extent (50%). The next most frequent (23.23%) answer was very little. A small percentage (16.66%) told very much and 10.10% respondents told none. Study shows that drug samples distributed by medical representatives are useful to majority of doctors. Samples are more useful to doctors in village area to treat the patients.

Question 8: In your opinion, how do drug samples distributed by MR serve you?

Most of the respondents (63.13%) told that they use samples for poor people, 17.17% respondents told samples serves them to remind of brand. 16.66% respondents told that they use samples to try and ensure potency of drug. Very few respondents (3.03%) told that they use samples to try and ensure potency of brands.

Question 9: Do you prefer MR who distributes samples to you?

54.54% of respondents told they prefer medical representatives who distribute samples. 45.45% of respondents told they do not prefer medical representatives who distribute samples to them. Few doctors told that they will prefer MR if the start to provides samples for poor people for full course of therapy not only for few initial days. They told MRs are giving the samples in very less quantity so that if doctor wants to give the free medicines to poor people they have to give samples for few initial days and after giving samples of one company they cannot switch to another brand. Then poor patients have to purchase the drugs by their own.

Question 10: Would you like to give suggestions as to how the services of representatives can be made more useful to you?

Not many respondents respond to this question because of time constraint. Some good answers were – Medical representatives must at all times maintain a high standard of ethical conduct in profession. They must ensure that the frequency, timing and duration of calls on health professionals. Further representatives must observe the wishes of an individual health professional like representatives must be sensitive to a doctor’s workload and tailor visits accordingly; also they should ensurethat an appropriate interval is maintained between visits and promptly follow up on all requests and queries of health professionals.

CONCLUSION

To conclude, doctors find the services rendered by medical representative useful. Today, providing information on price and discounts and availability of drugs are most important services rendered by medical representatives. So it was concluded from the study that many doctors are price sensitive today and want drugs at less price for their patients.Study revealed that young doctors and students are more likely to entertain medical representatives than experienced doctors. Further regularity is considered as most important quality of medical representatives. So it was concluded from the study that a MR should be regular with sincerity in claims, should be quick with detailing and have good product knowledge. Also doctors want medical representatives having sound product knowledge that’s why most of them considered bachelor in pharmacy as minimum qualification. Majority of medical representatives working in the field do not meet quality criteria by doctors. Overall this study may help to increase the effectiveness of personal selling by pointing medical representatives towards right direction.

ACKNOWLEDGEMENT

Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

References:

1. Kotler P, Keller K. L., Marketing Management, Twelfth Edition, Pearson Education, Page- 6

2. What is marketing [internet].2011 [Cited 2011 Dec 2]. Available from http://www.knowthis.com/tutorials/principles-of-marketing/what-is-marketing.htm,

3. Peterson, Arthur F., The Professional Service Pharmacist, Journal of the American Pharmaceutical Association, April 1949, Page-212

4. Impact of drug promotion on doctors -They become biased and do what drug-makers tell them to do [internet]. 2011 [cited 2004 Aug 22]. Available from http://apps.who.int/ medicinedocs/en/d/Js8109e/9.html

5. Subba Rao S. V. R., Handbook of Pharmaceutical Marketing in India, Panther Publishers, Page- 7 – 1

6. Association of the British Pharmaceutical Industry (ABPI). Medical sales representative.[internet]. 2011 [Cited 2011 Dec 2]Available from www.abpi.org.uk

7. Janodia M. D. Detailing “Theme”- A better alternative to conventional detailing “Story” [internet]. 2011[cited 2006 jun 25]. Available from http://www.pharmainfo. net/reviews/detailing-%E2%80%9Ctheme%E2%80%9Dbetter-alternative-conventional-detailing- %E2%80%9Cstory%E2%80%9D

8. How does pharmaceutical company promotion affect prescribing?; International Conferences on Improving Use of Medicines (ICIUM), World Health Organization,[internet], 2011[cited 1997 dec 11] Available from http://archives. who.int/icium/icium1997/posters/4P7_fintext.html,

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Awards, Research and Publication incentive Schemes by IJCRR

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


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A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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