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MedicinMan August 2012 Issue
 

MedicinMan August 2012 Issue

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Why KAM Fails in Pharma, Job Satisfaction Survey Results. Pharma Rural Marketing. Coaching in Pharma. 9 Simple Steps to Better Team Management. Basics of Pharmacology for Medical Reps and more

Why KAM Fails in Pharma, Job Satisfaction Survey Results. Pharma Rural Marketing. Coaching in Pharma. 9 Simple Steps to Better Team Management. Basics of Pharmacology for Medical Reps and more

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    MedicinMan August 2012 Issue MedicinMan August 2012 Issue Document Transcript

    • A BroadSpektrum Healthcare Business Media’s Corporate Social Responsibility InitiativeMedicinMan ~ FIELD FORCE E XCE L LE N CE ~ TM PHARMA | MEDICAL DE VICES | DIAGNOSTICS | SURGICALSVol. 2 Issue 8 www.medicinman.net August 2012Editorial COACHING FOR CHANGE "If you focus on results, you will never change. If you focus on change, you will get results." - Jack DixonWhy Do We Fail to Get Results?Many pharma companies are adopting coaching to trans-form the way their field force is working. However, whilemost are excited with the concept of coaching, they arefrustrated with the results, because their focus is on thewrong indicators. They imagine that one or two rushed upsessions in a beach resort will transform the behavior oftheir managers from sales bullies to performance coaches!In pharma we focus only on sales; not on changing theknowledge, skills and attitude of the MRs/FLMs/SLMs.As a result, their capabilities and behavior remain thesame, but we expect better/more from them.This is insanity and hence the results are disappointing.As in sports, we must discover the learning needs of fieldforce people and then coach people to change their inef-fective ways of working.Good sportspeople become great sportspeople throughgreat coaching and continuous practice. Doctors and law- Coaching is great. But good stuff doesn‟t come cheap. At FFEyers call their profession as practice because they are con- 2012, Mr. Girdhar Balwani, Managing Director Invida, had thisstantly learning through practice, CME and other profes- to say about their experience as an outsourced field force ser-sional development programs. vice provider – “Pharma companies want good, fast and cheapCompanies like GSK, Pfizer, Eli Lilly once pioneers in service. What they don‟t realize is that they can pick two of thepeople development are today paying billions of scarce options but the third one is not an option but an OUTCOMEdollars in fines to FDA for unethical practices. Surprising- based on the other two options. You can have good and fast ifly when it comes to getting results from doctors, they you‟re willing to spend a lot of money. You can have fast andseem to get the options right and are pleased with the out- cheap, but the quality will be poor. You might even be able tocomes… till they have to pay the heavy penalties to FDA. get good and cheap, if you‟re willing to wait a long time.”If only a fraction of this money was spent on Coaching The MedicinMan Poll on LinkedIn (see Page 14) is anothertheir people to do the right things ! clear indicator to show that employees are aware of what is needed to progress as professionals and businesses. Are the de-When it comes to any developmental activities including cision-makers willing to FOCUS on CHANGE? ▌coaching, pharma does not have or has limited funds.When it comes to CRM for doctors the funds are unlim-ited ! What do you think is the learning field force gets in.linkedin.com/in/anupsoansfrom these ACTIONS ? People pay attention to what youdo and where you put your money and not what you pay @anupsoanslip-service to. facebook.com/anup.soans
    • MedicinMan TM1~ FIELD FORCE E XCE L LE N CE ~ st ANNIVERSARY SPECIAL OFFER Buy FREE And get
    • Every winning team has aligned the aspirations and abilities of its members with the goals of the organization. Great performance coaches combine Business Acumen with Emotional Intelligence to create wins. Get these SuperVision for the SuperWiser Front-line Manager and HardKnocks for the GreenHorn are FFE Enablers to Develop your Field Force Front-line Managers Mini MBA Tailor-made to Transform FLMs into Emotionally Intelligent Performance Coaches. MRP ` 799 Anniversary Offer HardKnocks for the GreenHorn FREE with the purchase of SuperVision for the SuperWiser Front-line Manager* Medical Reps A Starter Kit to Transition Beginners into Achievers. MRP ` 599To Avail this Offer:Send your orders to anupsoans@medicinman.net and make a payment of Rs 800/- to HDFCS.B a/c no. *07141000006761* of “Anup Soans” HDFC Bank, Mosque Road, Frazer TownBranch, Bangalore – 560005. RTGS/NEFT IFSC: HDFC0000714. Offer inclusive of SpeedPost ChargesCall: +91 93422 32949
    • MedicinMan August 2012 IS THERE BUSINESS IN RURAL MARKETS?By Dr. Surinder Kumar Sharma,Head - Strategy & BusinessDevelopment, TTK Healthcare Ltd.“India lives in its villages.” - Mahatma Gandhi covered).And after so many years, we still wonder – is there a busi- One thousand more PG seats are sanctioned for privateness in rural markets? medical colleges, and 4000 more seats are created in exist-According to census 2011, out of 1.2 billion Indians, ing government colleges. Land required to open a medical68.84% live in Rural India. college is being reduced from 25 to 20 acres. To meet the shortage of teachers in medical colleges, age-bar for facultyRural India is undergoing a tremendous change – machines position is being increased from 65 to 70 yrs. To encourageare replacing man and tools and as a result farmers and their rural healthcare, 50% PG seats are allocated to doctorsfamilies have a lot of time for non-farming activities. working in rural areas.According to census 2011, 91.21 million households in ru- There is narrowing of rural urban divide due to:ral India have access to phone, compared to 64.67 million 1. Better income from farming60000 2. Increasing income from non-farming avenues and im-50000 10678 migrants 872540000 7435 10517 RURAL 3. Industry projects in rural areas 9513 CLASS II TO VI30000 6766 8392 16998 METROS 4. Infrastructure development 7084 14728 CLASS I TOWNS20000 9937 12351 5. Increase in literacy and awareness10000 11686 13622 15291 17314 6. Affordability of technology & white goods 0 2009 2010 2011 2012 Income from non-farming sector is increasing. Now around 50% income in rural India is being generated from trade, food processing, industry, and money brought back by emi-households in Urban India. Computer is not a magic-box or grants. Better procurement prices for crops, a run of gooda genie for a rural folk anymore. There are 8.64 million monsoons, cash crops, etc. have increased disposable in-households with a computer in rural India. Internet usage in come. Rural folks are buying cars, flat screen TVs, micro-rural India has overtaken usage in urban India - more Inter- waves and high-end mobile phones. Rural income is 43%net users in rural India than in urban. TV and dish antennas of national income. In terms of absolute numbers disposa-are common sight in rural India. 56 millions households ble income and middle class is more in rural India. Litera-have a TV, compared to 60 million urban households. cy is improving in rural India - there are 493 million lit-Government is aggressively spending for rural develop- erates in rural India, 285.4 million in urban.ment. Active steps are being taken to improve healthcare. In spite of its huge potential, as indicated by various param-Rashtriya Swasthya Bima Yojna (RSBY) was launched in eters mentioned earlier, rural markets‟ contribution to phar-2008. Its purpose is to cover all BPL families with a health ma remains abysmal; even its growth, over the past fewinsurance of Rs. 30,000/ (government or private hospital years, has been suboptimal. What are the factors that aretreatment, no age limit and pre-existing ailments are also preventing the rural pharma market to achieve its potential? 4
    • MedicinMan August 2012 Road Blocks Creating awareness Inadequate Infrastructure 1. Educating rural masses about safe and reliable remedies There are gaping holes both in government as well as for common ailments private sector‟s initiatives to create a good healthcare 2. Partnering with rural institutions and NGOs infrastructure. There are gross inadequacies - be it the 3. Making use of annuals fairs, weekly haats and mandis number of hospitals, dispensaries, staff, or doctors to spread awareness (only 1 doctor per 3000 people in rural area, compared Some aspiring initiatives, which have done good to both to 2/3000 in urban). Quacks rule the roost. 60% of rural company as well as masses are: diseases do not get treated at all. 1. Novo Nordisk Education Foundation is undertaking Lack of awareness massive diabetes control program that involves screen- Lack of awareness towards diseases, even the highly ing, spreading awareness and training doctors. prevalent ones, continues. Superstition and belief in 2. SPARSH, a multilingual helpline for diabetics to sup- witchcraft is still rampant. Most of folks still believe port Januvia and Janumet. that diseases are due to God‟s curse, and have fatalistic 3. NPL had run „Teach more, reach more‟ campaign to attitude towards health and disease. educate masses about epilepsy. Lack of affordability 4. J&J‟s Mobile health for mothers helped many. Many drugs remain expensive. Rural masses have Providing affordability stronger value for money. A few days‟, or a little, suf- 1. Making medicine more affordable is very important. fering is preferred to spending money on medicines. Companies can think of differential pricing strategy for Poor accessibility rural areas, e.g. Microsoft has low prices for its products Highly disbursed markets make distribution expensive for students. and a logistic nightmare. Maintaining cold-chain or 2. Rural healthcare insurance can help decreasing the bur- special storage conditions is a challenge due to erratic den of payment on the individuals electricity supply. To establish a dependable distribu- 3. Training medical staff for cost effective disease man- tion system in interiors one needs strategic approach, agement may help in establishing trust in allopathic rather than tactical, as ROI period is long. medicines. What is the way forward? Arogya Parivar (Healthy Family), a low-profit social initia- To develop rural markets, one needs a multipronged tive developed by Novartis, is a good example. This pro- approach, and need to: gram is proved to be a commercially sustainable program. 1. Improve Healthcare System Ensuring Accessibility 2. Create Awareness Highly disbursed market and thinly populated area make setting an effective distribution system a nightmare. Main- 3. Provide Affordability taining cold chain etc becomes very difficult due to frequent 4. Ensure Accessibility power failures. Various options could be: Improving healthcare system 1. Company delivery vans It shall be viewed as a community responsibility and 2. Pooling of resources by collaborations between compa- corporations shall take active responsibility. Various nies to set up viable distribution channels steps that can be taken to develop and robust healthcare 3. Developing products suitable for rough storing condi- system in rural India are: tions 1. Partnering with government, NGOs and other key 4. Mobile clinics and mobile pharmacies stake holders 5. Post offices duplicating as pharmacies 2. Training rural doctors and supporting staff Ranbaxy and Pfizer have formalized an alliance with ITC to 3. Providing microfinance to doctors, retails, etc. to penetrate the rural markets for their over-the-counter (OTC) create healthcare infrastructure products. Some of the initiatives taken in this area are: Traditionally Indian companies, especially mid- & small- 1. MSD India launched Project Transcend, a program size, have a better penetration in rural and class II-VI mar- to train GPs on evidence based management of dia- kets. Now multinationals (Indian & foreign) are becoming betes. more aggressive in these markets. Every other day, there is news of some or other company hiring to enter into rural 2. Sanofi Aventis‟ PRAYAS - a program to meet rural markets. In view of these developments, mid- & small-size India‟s healthcare needs and to bridge the gap by companies need to be proactive to make the most of the new training rural doctors - plan to train 150,000 doctors markets created by these companies and, more importantly,5 across India. to protect their current business in these markets.▌
    • BREAKFAST FOR THE BRAIN Where Pharma Business Leaders Brainstorm To maintain the tempo generated by Brand Drift and FFE 2012, MedicinMan will be hosting the 1st BREAKFAST FOR THE BRAIN on Friday 7th September 2012 in Mumbai from 0830 AM to 1000 AM. CONTACT Arvind @ 9870201422 or email - arvindnair@medicinman.net or Chhaya @ 98674421131 or email - chhaya@medicinman.net at Mumbai or Anup @ 09342232949 or email - anupsoans@medicinman.net at Bangalore MedicinMan TM
    • MedicinMan August 2012 Why Does Key Account Management Often Fail in Pharma? Hakeem Adebiyi, Managing Director, Hands Associates Ltd I am regularly asked this question by my pharma clients ing your value proposition). As one respondent put it “I think it and my usual response is what Einstein said: "if you cant would be useful to define KAM in various levels. Basic, Inter- explain it simply then you dont understand it well mediate and Advanced. This way people will have a roadmap to enough," i.e. the fundamental reason that KAM fails is the adopt KAM.” Defining what needs to be achieved determines over complication of the process. I have worked on KAM the skills, capabilities and structures companies need. If you are implementations for 8 years across various healthcare not clear at the outset, then its successful implementation is un- companies and use this experience to model what makes likely. KAM successful. I have condensed the factors into “the 3 Lack of clarity around what type of KAM you are striving will golden rules.” inevitably lead to the second factor. 1. Align to business strategy II. Lack of organisational support. 2. Right people/right skills 1.Senior managers who structure the DNA of the company do 3. Align business process not buy in to KAM If any of these rules are neglected then KAM falters. 2.No buy in from relevant stakeholders who may be required to However, in a quest to refine the rules and identify com- interface with customers mon reasons which may fall outside these, an invitation was extended to members of an interested group (Pharma 3.No supporting HR structures KAM) on LinkedIn to participate in a discussion about: 4. Appraisals and reviews don‟t drive KAM behaviours such as “What is the main reason that KAM fails in Pharma.” KAM teams or long term planning This group is focused upon account management in Phar- 5.No supporting business process e.g. CRM still focuses on ac- ma and has active discussions on a range of topics associ- tivity and individual customers rather than profitability and de- ated with the management of key accounts. cision making units The group highlighted several areas as potential reasons In reality an effective KAM approach needs to originate from for failure of KAM. I summarized them below and linked the top of the organisation to create the right KAM mindset them to the relevant golden rule where appropriate. company wide The comments above shows that there are several factors III. Lack of skills and capabilities. Once again, if you are not which can lead to the failure of KAM in the pharma indus- clear what needs to be achieved then you can‟t be clear what try. I grouped them into 3 general categories for simplici- competencies are required. It is critical to get the appropriate ty. person for the appropriate role, as one respondent put it: role I. No clear understanding of what KAM actually clarity is of utmost importance; the only reason for failure is means in the pharma market, this is demonstrated in the not understanding the role properly. “understanding KAM”. KAM isn‟t just a sales person‟s Whilst the 3 golden rules still stand, this feedback shows that state of mind. It is a business methodology, which needs they are best understood when supplemented specifically with to be in the company‟s DNA. The challenge for Pharma is the common mistakes that need to be avoided. whether full KAM is needed (KAM teams working with customer teams to deliver integrated partnerships sharing common objectives) or just good account management hakeem@handsassociates.com (sales people identifying who the key decision makers are www.hands-associates.com7 and interacting with them more effectively when deliver-
    • MedicinMan August 2012 GoldenGeneral Categories Comments RuleOrganizational support –  KAM often doesn’t have backing of senior management 1leadership  Asking questions like: Why, Who, How KAM is the beginning of developing effective KAM approaches originating at the top of the organization and works on creating the right mindset towards KAM; companywide.  The strategy isn’t clear across the organization  We don’t spend enough time shaping the DNA of the company  Because they don’t have the backing of the organization in its entirety to do- ing business in an account centric and KAM led manner  Functions will still be organized in their traditional way and KAMs will still be treated as sales force i.e. a route to market amongst many othersOrganizational support –  Functions still arranged in their traditional way 3processes and structures  KAM’s still just seen as a sales forceSkill Gap  Identifying the customers need and aligning their needs with yours 2  Do they have the commercial acumen-if not coach them, do they understand business per se and business planning-if not give them the knowledge, do they ask the right questions-if not train/coach themUnderstanding of KAM  KAM is a state of mind 1  KAM requires commercially aware sales people 2  A commercially astute KAM will, given the correct personal internal motiva- tion (i.e. "state of mind"), understand intuitively the importance of focusing on the new decision makers, rather than the traditional target list - the latter often being based on historical factors that may not still be valid.  Only reason for failure is not understanding the role properly KAM on the Web1. In the post blockbuster and share-of-the-voice era, Pharma will have to deliver a lot more value:http://www.pharmaphorum.com/2012/07/27/kam-future-pharma-sales-model/2. KAM in the Harvard Business Review:http://blogs.hbr.org/cs/2012/07/how_to_succeed_at_key_account.html#comment-589214138 Contributed by Hanno Wolfram, MD at Innov8 GmbH, Germany 8
    • MedicinMan August 2012 9 Steps to LEAD your sales team to WIN K.HARIRAM, Former MD - Galderma Success is a personal matter: team members can work toward it at their own speed, provided there is constant progress. Given below are practical and easily implementa- ble strategies. You may ask the team members to build on one at a time and gradually add more. 1. SET GOALS. If you dont know where youre going, you will never get there. It is as simple as that. 2. WRITE IT DOWN. With many things happening every day, it may be hard to focus on real important mat- ters. Writing out goals and consistently reviewing them keeps them fresh in your mind. 3, DRAW OUT A SCHEDULE. Use anything such as a gadget, pen and paper, Daily to-do list or a planner to build your goals into your schedule. 4. PLAN. Knowing where you are going is one thing. Equally important is to decide, how you will get there. 5. KEEP AN IDEA PAD. Note down the ideas as they occur to you. The mind gets free to focus on other things. This will help to preserve and review on ideas and to work on it later. 6. LEARN EVERY DAY. Read a few pages of a book, any interesting articles from a newspaper, or e-zines, try and pick up a new skill- or the one that you dont often use. 7. EXECUTE. Goad yourself to action and measure your progress. 8. NOTE YOUR SUCCESSES. Observe any small or incremental progress. Do not discount the small victories. Remember, each small win motivates you to greater ones. 9. GIVE YOURSELF TIME TO THINK. Taking time to stop, sit and think is very important. Allowing time to review your day or a meeting gives you tremen- dous insight that inspires change. " Your ability to connect with your team members directly impacts their level of engagement. The more engaged your team is, the better the results ".9
    • MedicinMan August 2012 What Benefits do Doctors Derive from Meeting Medical Reps? tion products as well as meet an MR marketing anxiolytics and anti-depressants. But his priority will always be to meet MRs from oncology product companies like Bayer, not only for product and disease related information but also to know the latest happenings in his field and what his peers are do- ing. A good MR is one who blends science with the social to keep the busy doctor in the loop of happenings that matter to him. A good MR might even begin the conversation with general or specific information about what is happening in other oncology treatment centers. Once the doctor is aware of the value that MRs brings to the interaction, he will al- ways make time to meet them. As medical practice becomes more and more corporate oriented, the role of MRs will change as the decision-making shifts from doctors to hospi- tal managers. But the need for information still remains andIndia is slowly catching up with the fatigue levels of its so the role of MRs might evolve but it will remain as long aswestern counterparts when it comes to Doctor – Medical modern medicine is practiced.Rep relationship. But the Indian healthcare landscape and This is true of every medical specialty. For most doctors,situation are entirely different and hence the reasons for meeting with MRs is a part of their daily work. What theyfatigue are also different, although there are many similari- would want is adherence to basic norms of interaction. Sev-ties in the challenges faced in terms of access to doctors. eral doctors have remarked that the social skills of MRs haveThe problem of plenty and popular perceptions often obfus- been going down steadily - MRs are unable to connect withcate real issues. This is more so in India, where nearly doctors. This continuous reinforcement of poor social expe-3,00,000 Medical Reps (MRs) jostle for time with 5,00,000 rience because of the lack of basic training is one of the maindoctors (The figures are only indicative). Majority of these reasons for general lack of receptivity by doctors.MRs are merely an appendix whose main task is to The Indian education system follows a 10 years of schooling„remind‟ the doctors of their branded generics in a market followed by 2 years of pre-university education. In the earli-overcrowded with 60,000 branded generic drugs. er days till the 80s most MRs studied science together withIn general, how receptive are doctors to meeting MRs? future doctors and engineers in the 2 years of pre-university education. Thus a natural bonding occurred. It was not unu-How critical is the product or service offered by the compa- sual for an MR to meet his pre-university classmate, whony to the doctor‟s practice determines the quality of rela- became a doctor. This initial comfort level in interactingtionship between the doctor and the MR. with doctors went a long way in creating confidence and rap-Doctors are receptive to different MRs differently - an on- port. All this changed rapidly with the rise of IT and BPOcologist will be keen to meet an MR from a pharma compa- sectors especially in the urban areas. Students who did notny, which has a patented anti cancer monopoly products. get into medical or engineering colleges had many other op-Most of the information regarding the drug and the latest tions other than pharma field sales. And for students whoclinical trials reports will be provided through the MR. The study B.Pharm, field sales is the last and often temporarysame oncologist will also meet MRs from other companies career option. The steady decline of quality of people enter-marketing anti cancer drugs to keep himself abreast of de- ing pharma field sales is one of the main reasons in additionvelopments relating to launch of products at different price to other reasons that make Doctor – MR interaction uninter-points. For example, the oncologist who has been seeing the esting.MR from Bayer (Nexavar) regularly will also be keen to While most doctors still maintain a high degree of decorummeet the MRs from Cipla and Natco who have now intro- in their attire and sophisticated demeanor in their approach –duced generic Sorafenib at a fraction of the price of the same cannot be said of the majority of MRs. Their attireNexavar. But this equation will change when ten more is sloppy, their demeanor unprofessional and their approachpharma companies jump into the bandwagon and market diffident. This creates a natural barrier for receptivity. MRsSorafenib – then it is the marketing strategy of the company who are high on social skills and good in their technicaland the skill of the MR that will determine the receptivity. skills still receive very good reception from doctors.The same oncologist will also like to keep in touch withMRs from various pharma companies who market products MRs must offer tangible value to increase the doctor‟s recep-needed by a cancer patient. This could be as mundane as a tivity. Either their products have to be unique or their socialcough syrup with a new combination of more effective anti- skills endearing and their technical skills valuable. When alltussives or a marketer of high-end pain relievers. The on- three are present, the receptivity is high; when they are poor,cologist will also like to meet and receive samples of nutri- the receptivity also decreases.
    • MedicinMan August 2012Is there a particular time of day or week when doctors sides let‟s remember that well trained MRs with B.Pharmare more receptive to meeting with MRs? are an excellent source of information about drugs. Over time, Doctors will learn to distinguish between the goodThis would entirely vary from doctor to doctor. Some and the not-so-good and can make an informed decisiongeneralizations can be made. For example most General about meeting MRs.Practitioners (GPs) would have the same schedulethroughout the week and hence everyday would be more Even experienced and busy practitioners can benefit im-or less the same, unless he practices in different localities. mensely by meeting MRs who are well trained. By ask- ing for information that they need, they can create a tailorWith specialists, it will depend on their schedules. The -made information source that is easy and simple to ac-MR has to find out the various affiliations that a special- cess. Most well trained MRs will be only too happy toist has in hospitals and academia to discover the best time serve the information needs of doctors. The new genera-and place to meet him. tions of graduates passing out of college are digital na-What are the most common topics of discussion be- tives and can be a great source of knowledge for the doc-tween doctors and MRs? tor to learn about technology, social media and newerThis depends again on the company and its offerings. trends in technology. The talents of MRs, the tools thatWhen it comes to oncology product companies like they use and the training that they receive go a long wayBayer, the oncologist would certainly be eager to know in making the Doctor – MR relationship beneficial tomore about Nexavar and will ask questions about the both.most appropriate ways to use the product safely and ef- MRs are an integral part of the cycle beginning with drugfectively; how other oncologists are using it and what is research and leading to marketing; usage by patients andtheir experience. But the same cannot be said for an MR feedback on the results – both efficacy and ADRs. Thiswho is promoting the 160th brand of Amlodipine or some loop needs to be maintained, as the feedback from doc-other irrational combination of vitamins, minerals and tors to MRs is as important as the information providedtrace elements - all rolled into one – only the brand name to doctors by MRs for the progress of modern medicine.matters and the benefits that the doctor will derive by Both doctors and MRs need to find new ways and newprescribing the product. tools that will make this relationship mutually rewarding.For physicians who arent experienced in meeting Indian Pharma business leaders need to apply their mindswith MRs, whats the most valuable advice you feel to address this issue by engaging doctors at all levels toyou can give them about making these meetings as know their expectations and reinvent their discourse withproductive as possible? doctors through MRs. In the future MRs will be more of Information Editors and Technology Partners who under-Physicians entering the profession should make the most stand the business and economics of modern medicineof the opportunity of meeting MRs - they will benefit the and help medical practitioners to increase their efficiencymost. Provided the MRs are well trained, which other and effectiveness in delivering total patient care and satis-source will offer so much information in such short peri- faction.▌od of time in the convenience of one‟s own clinic? Be- MedicinMan Editorial Team Post FFE 2012 MedicinMan Klout at an All Time High! Post FFE, MedicinMan’s social media influence as measured by the social media analytics website Klout has hit an all-time high of 71. MedicinMan wishes to thank all its read- ers, followers and well- wishers for following and sharing MedicinMan con- tent.
    • MedicinMan August 2012 drug thereby decreasing their plasma concentration. Con- The Basics of versely, some drugs (e.g. ketoconazole) inhibit an enzyme and thus increase the plasma concentration of co- Pharmacology administered drugs leading to their toxicity. So, both the enzyme inducers and inhibitors can lead to clinically signif- icant drug-drug interactions. Pharmacokinetics The final step is the elimination of the drug and its metabo- lites from the body in urine, bile or feces. Renal excretion is the most common mechanism of drug elimination. This ex-In this section on pharmacology, we would like to let plains the rationale of dose adjustment requirement in pa-you know about the important terminologies related to tients with impaired renal function. The drugs having anpharmacokinetics. Pharmacokinetics is a commonly alternative route of elimination (fecal route) are safer inused term while comparing two drugs. It refers to what patients with severe renal impairment.the body does to a drug. Four pharmacokinetic proper-ties (absorption, distribution, metabolism and elimina- In the next issue, we would be discussing the terminologiestion) determine the speed of onset of drug action, the related to clinical applications of phar-intensity of drug‟s effect and duration of drug action macokinetics.▌(Figure 1) once the drug is administered to the patient.Absorption is the transfer of a drug from its site of ad-ministration to the blood stream. The rate and efficiencyof absorption depend on the route of administration of Dr. Amit Dangthe drug (enteral or parenteral). For drugs given by the Director at Geronimo Healthcareintravenous route, absorption is complete, i.e. the total Solutions Private Limiteddose of the drug given reaches the blood circulation.Drug absorption by other routes like the oral route is notcomplete. This may be due to the presence of food or Schematic representation explaining Phar- macokineticsdrugs in the gastrointestinal tract. Drug absorption isalso determined by various factors like the ionic state ofdrug; the uncharged drug is better absorbed than thecharged state.The second step is the distribution of the drug whichrefers to movement of drug into the interstitial tissue andintracellular fluids in the human body. The distributionof drug depends on blood flow to different organs (e.g.brain, liver and kidney have greater blood flow as com-pared to skeletal muscles leading to quicker distributionto these organs), extent of plasma protein binding, lipidsolubility of the drug etc. Plasma protein binding, anoth-er commonly used term of pharmacokinetics refers tothe binding of drugs to the plasma proteins (usually al-bumin). Bound drugs are pharmacologically inactive.Metabolism or biotransformation refers to chemicalalteration of drug in the body. The liver is the major sitefor drug metabolism. The reactions are often called asPhase I and Phase II reactions. Cytochrome P-450(CYP450) enzymes located in the liver are responsiblefor Phase I reactions. Some of the drugs (e.g. rifampicin)can induce the synthesis of some particular enzymes(CYP2C9), thus the co-administration of drugs with ri-fampicin can lead to excessive metabolism of the second 12
    • Mumbai Monsoon Magic – Healthcare meets Technology at Health 2.0 Mumbai Chapter Meet–Up! Dinesh Chindarkar, Health 2.0 Mumbai Chapter Leader Addresses the AudienceTrue to the Health 2.0 global culture, the first meet-up of Dr. Amit Bhargava, VP (Medical) - Alkem, presented hisHealth 2.0 Mumbai chapter captured in its essence newer thoughts about what pharma expects from technology andhealth ideas, technology, medias and health innovations. The how the two can be united. He also mentioned about the Biggathering had a variety of people from diverse backgrounds Data specific to India that can be generated with pharmaof technology, pharma, hospitals, digital agencies, start-ups partnership for medicines and patients.etc. But they gathered here with one objective – to connect Pankaj Dikholkar Chief Manager, Strategic Marketing Ser-the varied dots of healthcare and create a complete picture. vices – Abbott, gave parallel examples from other industryThe setting was completely informal and unconventional. of the effectiveness of newer medias. He also emphasised onAs it rained outside, the MIG club in Mumbai rained with the opportunity that existed since increasing number of con-health ideas. Dinesh Chindarkar, Health 2.0 Mumbai Chap- sumers & patients in India are searching online for healthter leader, presented the concept and introduced Health 2.0 solutions.philosophy to the audience. This was followed by a video Aditya Patkar emphasised on how websites & electronicfrom the co-founder of Health 2.0 – also an Indian – Indu medical records are emerging trends amongst Doctors andSubaiya – who specially crafted a message for the Mum- slowly becoming mandatory. Dr. Neelesh Bhandari shedbaikars from Los Angeles. light on how social media is changing the way Doctors areThis was followed by a presentation by Dr. Shalini Ratan, connecting with patients and also how it is benefitting themwho shared her observation about how technology is affect- to access information. This is where a dire need for Socialing Doctor & Patient behaviours & changing outcomes. She Media training is needed for physicians.also shared a project of telemedicine for rural markets that Ashwin Bonde Sr. Manager, MCM – MSD, shared hisshe was involved with. thoughts on leveraging newer channels for marketing inThe pharma industry was represented by quite a few people. pharma and how going the unconventional way is the need of the hour. Shreekant Pawar, co-founder of Farasbee – a start-up and sponsor of the event, demonstrated his product – Diabeto that helps connect Glucometers to smartphones in a unique way. He enthralled the audience with the friendliness of the device for physically & visually handicapped people too and urged pharma to create products that were patient – centric and offered value. Dinesh Chindarkar thanked the audience and promised to have more diverse speakers and more frequent meet-ups to Dr. Shalini Ratan, member - MedicinMan Edit Team, interacts with cultivate brighter, innovative patient – centric health ideas & participants. Chhaya Sankath, CEO of MedicinMan is seen chatting with Dr. Neelesh Bhandari in the background. technology solutions. This was followed by discussions & networking over coffee.▌
    • >>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 2012 Job Satisfaction While companies are experiencing high levels of attrition and lack of employee productivity, Q MedicinMan Poll clearly shows job satisfaction factors that can lead to reversal of the current lose – lose situation. Link to MedicinMan Poll results and comments - http://linkd.in/MDfst Organizations can conduct their own surveys regularly to discover unique job satisfiers that bring about Employee Engagement instead of Salary Being Equal, waiting to conduct „exit interview‟ which does not benefit anybody. What Will You Choose MedicinMan Poll insights also show the importance of need for Front-line Managers to gain insights into people motivation and as Important to Job engagement factors to function as people leaders and business managers as written in the book – “SuperVision for the SuperWiser Front-line Satisfaction? Manager.” In the above poll conducted by MedicinMan, 441 respondents were asked to choose one of the 5 options as most important job satisfiers, salary being equal. The majority of the respond- ents were from the 18 – 29 age group, followed by the 30 – 36 and 45+ age groups. Salary Being Equal, What Will You Choose as Important to Job Satisfaction?>>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 2012
    • >>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 20121. Learning and Development OpportunitiesLearning and Development emerged as the No.1 job satisfier, especially among the 18 – 29 agegroup respondents. This is an important feedback for employers – Young people are aware of theimportance and need to acquire skills at the workplace to further their career aspirations.How many Pharma Companies are offering Learning and Development as one of their main of-fering to attract, develop and retain talent? 1. Work-Life BalanceWork – Life Balance emerged as the second most important job satisfier reflecting the need for amore balanced work-life. This was a common factor across age groups and is one of the mainreasons for attrition as employees leave to get a temporary respite from work-life imbalance inthe new job. This feedback is important for line managers and HR managers that people want notonly to work, but have a balanced life as well. The need is a bit more pronounced in 30 – 36 agegroup, as this is the stage in life when they have to cope with important personal life issues such asmarriage and arrival of children. The 45+ age group also expressed this as an important job satisfi-er. Companies that take note of these employee aspirations will be able to move ahead in thearea on people management. >>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 2012
    • >>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 2012 3. Inspiring Work Environment This was followed by Inspiring Work Environment – mostly by the 37 – 44 and 45 + age group, who have by now moved to comfortable office jobs or have lesser field work as part of their work. It is significant that the 18 – 29 and 30 -36 age groups did not consider Inspiring Work Environment high on their list of job satisfiers. Probably they are aware and have accepted the rigors of field working as essential part of their work. 4. Good Immediate Manager & Seniors For the 18 – 29 age group, Good Immediate Manager and seniors were important and this is a significant pointer that has emerged in all polls and discussions – the need to develop Front-line Managers as good people managers. When an individual performer gets promoted on the basis of his sales record, his focus will be on his areas of strength and not the areas needed to be an effective Front-line Manager. The sales pres- sures also make it difficult for Front-line Manager to be „GOOD‟ to people and it multiplies the work pressure leading to high attrition. 5. Growth and Promotions Surprisingly growth and promotions came last on the list. Again this was the top need of the 30 – 36 age group, signifying the social importance of growth in career prospects. The 18 -29 age was next in line with growth as a job satisfier decreasing significantly among the 37 – 44 and 45+ age groupsPeople management is not some esoteric art. Companies that take note of employee aspirations will be able toattract, motivate and retain people but also deliver higher productivity as Engaged Employees are 50% – 80%more productive and the key to Employee Engagement is Job Satisfaction. >>> A MedicinMan Poll to Ascertain Employee Perspectives | MedicinMan August 2012
    • What do you expectyour FLMs and SLMs to be good at? What are you doing to ensure that they gain proficiency in the desired skills?The Half-Time Coach A Psychometric Assessment-based Feedback and Feed-forward Program for FLMs and SLMs 1. Management Games  Relearning by Reflection,  Feedback by Observation 2. Case Studies 3. Movie ClippingsThe Half-Time Coach is delivered by Anup Soans, Editor MedicinMan &Author of SuperVision for the SuperWiser Front-line Manager, HardKnocks for theGreenHorn and RepeatRx Contact: anupsoans@medicinman.net Ph. +91 93422 32949