Also, this section is focused at the territory level and the types of hospitals that are generally found there. Many companies have a specialized hospital or institutional representative who may be assigned to larger operations, including universities, Veterans Administration hospitals, and major medical centers. The purpose of this discussion is to merely raise the comfort level of working in the type of medium sized hospital typically assigned to an average territory.
First and foremost, these accounts should be viewed in the same light as individual office practices, specifically what is the business potential and resulting return on investment. As many institutions are subject to formulary restrictions, active product promotion may be limited by whether or not it is approved. At a minimum, great effort and expense may have to be expended merely to achieve this status.
The most important question then, is what will be the ultimate result of having a product on formulary? If it is an office type agent and there is no large outpatient clinic associated with the hospital, per haps this effort could be better focused elsewhere. Certainly, it may be important to have formulary status for a product merely for the prestige and ex ample, but this should then be limited to larger and more influential locations.
Similarly, many territories are burdened with a fair number of hospitals, managed care organizations, long term care facilities, and other large institutions, and it is virtually impossible to affect them all equally. Choose carefully which of them will best reward your efforts. Coordinate closely with company counterparts and specialists to ensure maxi mum coverage and influence. Most importantly, pick your fights carefully!
When visiting facilities, moving comfortably around these sometimes huge edifices and their seemingly endless corridors is a necessary prerequisite. Spend some time acquiring maps or speaking with security personnel to ensure that you know where you are going. Successful hospital sales de pend in part on being able to find the place that will generate the scripts; furthermore, you will en counter less resistance on your calls if the image you portray is positive and confident.
Some specifics on critical areas in a hospital include:
Buyer's Office Many institutions require that you stop here to sign in and pick up an ID badge. Though, hopefully, as time goes on, this may no longer be necessary, in the beginning it provides good orientation and information as to the current status of products and hospital policies.
- CME offices A critical stop in any hospital call. This office can coordinate grand round speakers, displays, symposiums, and possibly even after hours programs. Continuing Medical Education (CME) programs offer an excellent opportunity to provide third party endorsements.
- Pharmacy No doubt an absolutely key location. Certainly to gain or maintain formulary acceptance, close work with the Chief of Pharmacy or Drug Information Coordinator is essential. Furthermore, key information can be obtained as to product usage, competitor activities, in house studies, or pending formulary changes. It is no secret that pharmacy and therapeutics (P & T) decisions are weighing more and more heavily on drug therapy utilization, and involvement and influence here is critical.
- Department heads Though many department heads may not actually prescribe, their influence cannot be overlooked. Not only does the weight of their position carry significant authority, but they also may have an informal network of friends and influence gained over many years of association with the institution. Department heads may also be involved in teaching, P&T committees and selection of CME programs.
- Outpatient clinics This is where most in office products will be prescribed, although these centers may not be located directly in the hospital itself but rather off the hospital grounds nearby. Not only does this site provide an excellent opportunity to increase product specification, but also the many nurses, physician assistants, and physicians are the end users and may affect drug therapy decisions.
- Public relations office An overlooked re source that can pay big returns in advertisement and relationship building. Here is where sponsorship of major campaigns, fund drives, or other such programs can be planned. Not necessarily a regular stop, but one that can prove valuable in the long run.
- Physician's lounge A key location if access can be gained, but beware, this area is often verboten and usually can be entered by specific invitation only! Once inside, it is an excellent opportunity to visit with an important prescriber who may be taking a short break and looking for some diversion. However, make this stop short and pertinent, it may be the only place that many physicians may be able to really relax for a moment.
Care must be taken, however, not to upset the flow and operations of the hospital. Many a representative has met an ill fate by not abiding by this rule being shut out, having your products removed from the formulary, and letters of complaint sent to headquarters are only some of the consequences. Move quietly and unobtrusively, respect busy physicians and employees, and lastly, if you feel your welcome cooling, leave and come back another day.