What time is it for the physicians?

Over the past years the market dynamics associated with both the medical and pharmaceutical industries have shifted dramatically. In many cases, these shifts have not been positive ones as it relates to access opportunities for pharmaceutical representatives. Shifts such as diminishing reimbursements by managed care, more burdensome paperwork, more complex patient management and productivity contracts have placed incredible pressures on already busy physicians. As a matter of fact, physicians are losing economic ground (see graph 1) under the current environment. Physicians are spending more time with complex patients and as a result incomes are falling. Again, this contradicts their productivity requirements agreed upon with most group practices.

Graph 1

Today's physicians must balance their time in the day with the primary demands of patient care and productivity expectations. This balancing act has created an environment where the physicians can rarely afford to take time for ancillary responsibilities such as CME courses and pharmaceutical representative's information exchange. These shifts have relegated the once common appointment between physicians and pharmaceutical representatives to a foreign concept that is fondly remembered.

What time is it for the pharmaceutical industry?

The response to diminishing time and access with a physician has been met with a twofold strategy. First, is the dramatic increase in marketing expenditures over recent years. Rosetta Marketing Strategies reports that the pharmaceutical industry has gone from just over 5 billion dollars in sales and marketing expenditures in 1995, to nearly 25 billion dollars spent in the year 2000. That is an extraordinary percentage increase over the past five years. More extraordinary is the fact that in the same study Rosetta Marketing Strategies contrasted the revenue generated per $1 of sales and marketing expenditures (ROI) and the results were alarming. In 1995 the ROI was 18 billion, by the year 2000 even with an incredible amount of dollars spent the return was reduced to just over 12 billion (see Graph 2).

Graph 2

This diminishing return on investments in sales and marketing is a national phenomenon, which has prompted the pharmaceutical industry to rethink their strategies on expenditures. Pharmaceutical companies are consistently reminding their representatives that they should strive to develop innovative programs that better serve the physicians and their patients. The representatives are also encouraged to think "outside of the box" in order to accomplish this is an ethical, efficient and effective manner. There are various ROI studies that support this order of thinking.

Secondly, the pharmaceutical industry has responded to access challenges by ramping up sales forces at an unprecedented rate (see Graph 3 - Scott-Levin Auditing). In the September 2001 Pharmaceutical Representative Magazine, article entitled, "Detailing ROI Is Falling", Datamonitor reported, "Between 1999 and 2001, 64% of the 40 sales forces profiled increased their size, with an average growth of 21%…In particular, five pharmaceutical companies profiled in the United States increased their sales force by an average of 42%…the result is even greater competition for time of increasingly pressured physicians."

In a related story IMS HEALTH data reports, …"a huge increase in the number of pharmaceutical sales reps since 1997. Yet in spite of this estimated jump of 70% in the number of reps, the data also shows that the actual number of rep calls on physicians has risen just 16% during the same period. Increasingly, sales reps have but a few minutes to discuss a newly launched product, an added indication, a change in formulary status, or other issues with a physician.

In addition, IMS HEALTH's Health Strategies Group found in its November 1999 study, "Access To High Prescribers", "Two-thirds of physicians actively limit the access they grant to reps."

Graph 3

Busy physicians have felt this "share of voice" race across the nation and their response is commonly a passive practice of simply avoiding representatives.

The result of not being able to have a meaningful information exchange with a very busy physician is detailed in the journal Health Industry Report. Health Industry Report reported;

• You don't know my business," complains 67% of the physicians."
  
• You waste my time," claim 50% of the physicians."
  
• Too many of you call on me," say 45% of the physicians."
  
• You don't tell me both sides of the story," 69% physicians point out."

These percentages are simply a result of an already pressured physician not able to make time for a representative who would otherwise dispel these misconceptions. It is a vicious cycle of a burdened physician trying to manage the time in a day to treat patients efficiently and effectively and too many representatives trying to spend too much money in order to accomplish access and impact.

This vicious cycle tells us it is time for a better process. A better process is needed which serves the real customer, the patient. After all, as time is increasingly diminished so goes the meaningful exchange of information that could and would benefit the patient.

The exchange of information between the physician and the pharmaceutical representative has been invaluable, but over time the dynamics of the market have mandated that something give. That something has increasingly been that important exchange between the well-intentioned representatives and the burdened time sensitive physician.

"What is Time-Concepts.com?"

Datamonitor also reported, "…between 1995 and 2000, the amount of time spent with sales reps by the average U.S. physician decreased from 12 minutes to seven minutes per day." If a busy targeted office sees an average of 20 representatives a day (and they do) that is approximately 35 seconds per representative per call. Healthcare Center for Exhibition Industry Research, valued a sales call in 1999 at approximately $302 per call. This diminished access is costly to everyone, especially the patient, and there is no end in sight.

Access to the busy physician's offices is denied everyday because of practice pressures and real face time for the representatives is diminishing yearly. What is going to be the response to this inevitability of no access just about everywhere?

Well, our response was to look for a better concept and a better process for facilitating a meaningful exchange of information between a physician and a pharmaceutical representative. We wanted a concept that addressed the real world challenges of that busy physician who doesn't have time for the representatives and the evening programs. A concept that would, at the end of the day, make representatives a better resource for that physician's practice and most importantly that physician's patients. Lastly, we wanted a concept that was fair, reasonable and ethical.

That concept and that process are embodied in Time-Concepts.com. Time-Concepts.com is an independent web based consults company that is committed to improving the exchange of information between physicians and pharmaceutical representatives in order to ultimately benefit the patients. Time-Concepts.com accomplishes this process by facilitating consults via our suite of proprietary software programs known as, "Curbside Consults" located at www.time-concept.com. Again, Time-Concepts.com is a web-based system that coordinates consults between the physician and the representative.

Time-Concepts.com expressed mission is to provide the representatives with professional feedback from their physicians about their marketing material's relevance, their presentation skills and whether or not that information has impact. Finally, and most importantly, to determine whether or not these two variables were a benefit to that physician's practice and patient.

The process is simple. Time-Concepts.com is currently enrolling large groups of physicians into the Time-Concepts.com network, via consulting agreements. These physicians are very excited to participate in the program as consultants in order to improve information exchange, representative access and patient resources. The physicians have a clear and expected role as consultants.

They receive a modest remuneration for their consult. This fee is predicated on their completion of an impact analysis of that consult via the website located at www.Time-Concepts.com.com. (see Graph 4).

Graph 4

The representatives will benefit by gaining insight on how to be a better resource to that particular physician, that practice and those patients. Based on current market dynamics, the representatives are not receiving this on a consistent basis. This opportunity provides the newer representatives with feedback from which they most sincerely will benefit from. Simply stated, they benefit professionally.

From a marketing and performance improvement perspective Time-Consults software "Curbside Consults" provides invaluable opportunities. Time-Concepts.com growing network of physicians will be able to provide real time feedback on marketing material and whether or not the material is relevant. This will help avoid costly marketing errors and focus messages pertinent to issues around the management of a particular disease state. In the near future the network will have available other consultant type utilities as well. Finally, as a performance improvement tool, Time-Consults can provide real time data that is important to the development of a representative or group of representatives.

This concept is not unique: consulting agreements are viewed as a favorable way of doing business in the pharmaceutical industry. In fact, Dr. Frank Reddick, Chair of The Council on Ethical and Judicial Affairs for the AMA, in an August issue of American Medical Association News suggested that a similar concept, "…may be the wave of the future." He felt this type of concept would "strip away the pretense" and perhaps avoid other types of questionable events. Dr. Donald Swikert, Director, Saint Elizabeth Family Practice Residency, suggests this type of concept "kilters" the relationship between the physicians and the pharmaceutical representatives back to the right direction. The concept provides a direction that will benefit the patient and create a better exchange of information in an ethical and reasonable manner. Currently, there are several other companies developing this program nationwide.

Time-Concepts.com has merely taken the educational meetings at the expensive venues and program events and moved them back to the office where the busy inaccessible physician is available. The patient truly benefits from a meaningful exchange of medical information between their physician and the pharmaceutical representative. It is simply an alternative that is effective, convenient and measurable.

Time-Concepts.com consists of individuals who have brought unique experiences and industry specific skills to the organization. These individuals include a senior pharmaceutical industry expert, a primary care physician, an Internet service provider/web application developer, and an individual with a marketing and product development company. This diversity of expertise has nurtured an exquisite combination of perspectives that in turn has produced a tremendous concept. This innovative approach has led to the rapid introduction of our process to the industry.

In addition, we have our own sales force, office staff and outside consultants who provide support. Time-Concepts.com is a product of innovative problem solving and again everyone benefits; the physicians, the pharmaceutical industry, and most importantly the patients.

We look forward to working with you to create a better process and a better impact for the patients. If you are in need of additional information, please contact via our website at www.Time-Concepts.com. If you would like to speak with us directly, please call 1-888-437-0945, or you can email us at sales@Time-Concepts.com.

Thank you for indulging us and for your incredible support for this program.

The Time-Concepts.com Team