How hospitalists are changing physician access

The last decade has brought several dramatic changes to the healthcare industry. Rising costs precipitated a transition from fee-for-service to value-based care, which brought with it numerous ripple effects such as the emergence of the accountable care organization and the patient-centered medical home.

In many ways, the patient now occupies the center of a treatment universe in which primary care physicians (PCPs), specialists, and unseen administrators revolve around. However, the cost-savings achieved by these alternative treatment programs are not feasible goals, given the restrictions faced by traditional hospitals.

This is not to say that hospitals have not been affected by recent changes to the industry. To the contrary, a new position has emerged within hospital settings: the hospitalist. MedicineNet.com explained that the role of the hospitalist is essentially to act as a stand-in for patients' primary care physicians, as it was far too costly to bring the PCP into the hospital every time one of their patients fell ill.

Hospitalists share all the qualifications of PCPs and family practice physicians, but they have chosen to focus exclusively on providing care in the hospital settings. On the surface, this might seem like a boon to pharmaceutical marketers in search of more direct physician access. However, as Medical Marketing & Media explained, hospitalists have also made it much harder for pharmaceutical sales representatives to do their jobs.

Rise of the hospitalist
Amid rising costs and unnecessary medical procedures that push the healthcare industry's bill even higher, some would have thought that physicians and sales representatives would have grown closer together in efforts to keep prices down and deliver more volume.

However, various factors point to the fact that the rise of the role of the hospitalist has driven a wedge between this traditionally peaceful relationship. According to MM&M, there are more than 44,000 hospitalists working in the United States. Becker's Hospital Review reported that 33% of these individuals work 26 or more weekends of the year. Perhaps most important from a marketing perspective, hospitalists see an average of 17.2 patients per shift in local hospital groups and 17.9 patients per shift for national hospitalist management companies.

"It is a new breed of professional. They are coming out of the gate eager to take on this new role," Michael Targowski, senior account manager at publisher Wiley, told MM&M.

However, the source also reported that despite all the pharma reps they spoke to, none would offer any advice on how best to tap into this growing network of hospitalists, or into their impressive patient reach. This could be due to a sensitive relationship between the two parties, but according to one unnamed representative, it may be because none exists at all. This is a grim picture for a pharmaceutical industry facing ever-higher research and development costs that continue to cut into revenues. If sales reps cannot find a way to make their advertising strategies work with hospitalists, their jobs might be in jeopardy.

Difference of opinion
One of the most pressing ways that marketing strategies must adapt to break through to hospitalists is interruption-based advertising. Meetings or unannounced visits may have been fine for physicians who have control over their own schedules, but hospitalists work in hospitals, where schedules can be unpredictable and office rooms nonexistent.

The days of old, when physicians and sales reps had ample time to participate in a lengthy discussion or engage in a more interpersonal relationship, are no more. As Dan Dunlop, principal at healthcare research firm Jennings, told MM&M, hospitalists are too busy for traditional sales techniques.

Market with grace
Dunlop is not the only one concerned about the future of in-person meetings between sales representatives and hospitalists. According to a report conducted by marketing consulting firm ZS Associates, 49% of physicians in the United States place severe restriction on how pharmaceutical officials can contact them. Even specialists in departments traditionally favorable to reps, such as dermatology and gastroenterology, showed decreasing numbers in physician engagement.

But if sales reps cannot meet with physicians, how can pharmaceutical companies push their products? Hospitalists and physicians each work different schedules, and marketing materials targeting them should make sense for their workflows. Instead of one-on-one meetings, pharma companies and reps should exploit areas of high visibility in traditional or digital formats to direct or gain attention. They should provide physicians or hospitalists with something that enhances their time with patients, such as a condition-specific educational support piece or a take-home brochure that speaks to the caregiver or patient about living with his or her condition. In most cases, it is about getting the right message to the right person, at the right time. To do that, you need to understand the physician, hospitalist, patient, and caregiver, and empower them through education and support.

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