The Money-Empathy Gap

Motivating a sales team with money talk can prime teams to be self-focused and less collaborative, driving the wrong behaviors.



Management guru Peter Drucker once said, “Culture eats strategy for breakfast” - and one senior pharma executive we spoke to would definitely agree. With a background of running the most successful sales teams in almost every pharma organization he’s worked for, he appears to understand exactly what will intrinsically motivate and drive a winning team – and has multiple awards to prove this.

In today’s business world, few companies would admit that they aren’t focused on their consumer, and pharma companies are no exception. eyeforpharma 's Whitepaper “Patient Centered Culture by Design,” discusses how achieving a patient-centered organization requires more than lip service or drawing up new company slogans. Change will come only from commitment from top management, from an understanding of what the new culture looks like, and from a clear idea of what changes need to be made to embrace these new ideals.

It all starts with culture

When the pharma executive, who contributed to the whitepaper but wishes to remain anonymous, speaks of building successful teams, he points out that it comes down to being sincerely purpose-driven. With a qualification in management psychology, he is particularly interested in behavioral priming. For example, he discusses the experiment in which groups of people were exposed to various stereotypes of the elderly and were then asked to walk down the hallway to their next test. In fact, the real test was timing the speed at which they walked down the passage, and the pace of the experimental group was much slower than the control group. The ‘age primed’ subjects took almost 50% more time to walk the corridor. With this powerful notion in mind, the executive has studied recent work in the area of money priming. Research indicates that priming teams about money can create internal competitiveness, in addition to promoting disruptive behavior.

“When corporations constantly emphasize share prices and sales targets, they can prime their teams to be more self-focused and less collaborative,” he says. “If the message of not forgetting the patient is tagged on at the end, teams can find the concepts at odds with each other, and psychologically they can’t do both. Companies then wonder why their culture isn’t changing, without realizing that they’re continuing to steer their employees in the direction of the old culture.”

Given that the healthcare industry’s fundamental purpose should be to save lives, he feels that more companies need to use this to motivate their people. He has worked with a wide range of pharma companies and has often found that sales meetings focus entirely on selling more drugs. The consequences of failure can be subtly threatening while big money is offered to those who succeed. He feels that the reasons why people joined pharma in the first place, what they like about the industry and what non-monetary motivations truly touch them need to be discussed because these go way beyond threats and rewards.

Building a sense of purpose

A few years back, this sales-leader was engaged by a large pharma company to build an independent contract sales team. He was able to start from scratch to bring the right people into his team. All companies will tell you that getting the right talent on board is crucial, but this exec takes it to another level, as he believes this is where embedding culture begins. He says, “I’m obsessive about hiring. I believe the key piece is getting the right people on the bus and I look for specific qualities rather than just experience.”

A trained MBTI practitioner, he uses Behavioral Based Interviewing (BBI) to ensure that he uncovers what motivates the individual and that he can gauge the individual’s ability to build relationships. He spends time interacting with prospective candidates and can think of many times when a well-qualified and experienced individual just didn’t seem to engage with purpose and didn’t display the empathy he required. In this type of situation, culture fit always trumped previous years of experience. Once this contract sales team was in place, he worked on coaching them and instilling a sense of purpose. He explains that about 10% of patients who should have been on the product they were selling (in this particular therapeutic area) weren’t on the regime. In certain instances, about a quarter of these people could have died as a consequence. The team understood that if they could get patients to engage with the product early, they would literally save lives. “Once you have a strong purpose and engage teams you can do anything,” he says. From this point, his sales team started to excel.

When corporations constantly emphasize share prices and sales targets, they can prime their teams to be more self-focused and less collaborative. If the message of not forgetting the patient is tagged on at the end, teams can find the concepts at odds with each other, and psychologically they can’t do both.

The contract sales team went on to win multiple prestigious awards for several years in a row, outperforming teams from 35 other pharma companies. From the time of the first award, he was shadowed for many months by high profile companies that included their reps with his team, requested mentoring, and arranged to attend sales conferences together. Many companies, the exec shares, reached the conclusion that they couldn’t compete with his contract team because the culture of their companies was too deeply entrenched.

Once you have a strong purpose and engage teams you can do anything.

At another stage of his career, he headed up a project to bring sales in-house for a manufacturer that had been using a contract company to market its drug. He was again required to build a specialist team quickly, so many successful people were poached from other companies. ‘Day One’ saw blue-sky planning on a flipchart and the team documented good and bad aspects of a sales culture. They knew they could make the culture look however they wanted it to, but that they would have to commit to the behaviors and principles they chose. What followed was a tripling of growth over the next six months based on the previous six achieved by the top tier marketing company. As he notes, “It was because we’d got the culture right from the start. Unfortunately, in big pharma you don’t often get the opportunity to start from the ground up.”

Companies that have successfully changed culture

The difficulty with a culture change is that it takes time, energy, and constant commitment. The bigger the company, the longer it usually takes for this shift in focus to take place - it’s the proverbial slow turning of a huge ship. Also, the larger the company, the more difficult it is to start again, as the culture shift must take place through existing employees, which can be a laborious process. Changing entrenched behaviors is a formidable task, as any leader knows.

The Japanese pharma company Takeda is one that this pharma executive cites as having had great success in changing its culture, but this is true only because it did radical things, and probably because it wasn’t a giant player in the industry. After changing its business modus operandi to a key account model, it decided to rehire the sales force, and almost all of the existing sales force were let go. Not everyone lost their jobs; some shifted to the new ethos quickly and were retained. The company then rebuilt itself with this new way of doing business uppermost in mind, and had phenomenal success.

Without starting afresh, how can companies embed a patient-centered culture?

The exec has observed that the pharma industry tends to hire people with a talent for business despite never having interacted with patients before. Many of his teams have been required to spend time alongside a physician and he believes this experience had a profound effect. While many pharma companies are concentrating on getting patients up on stage to give their stories, he’s not sure that this changes the culture significantly. “Something that works better is when you’ve got a colleague who talks about his or her experiences. If someone has the illness, and is part of the tribe, we listen more when that person talks about his/her journey.” He has also found that if a sales rep has a specific illness or if that illness is in the family, that person almost always does better in selling the related product.

Another effective tool is experiential learning. One sales team got a makeup artist to create a psoriasis effect on their arms or faces and then they were required to walk around and be seen by the public. Observing the impact first-hand was a powerful experience for them. The crux is that the patient experience has to resonate. The exec likens it to convincing a 20-year-old to contribute to a pension fund. It most likely will not work because a young person cannot emotionally appreciate the need for it. He reveals that bringing in an 80-year-old person in a wheelchair on oxygen might not be an effective training method for a healthy young sales team because the experience of the condition is not first-hand.

The qualities a leader needs to build a patient-centered culture

For the pharma exec, narcissistic tendencies are the death-knell for a patient-centered culture. He believes that empathy is key for both salespeople and leaders. Again, he stresses the disconnect between what some companies say they want and how they behave. For example, some pharma companies claim to be looking for leaders who are ‘givers’ and empathetic, but they reward technical capabilities in the promotional process. The exec warns that a technical-based meritocracy could easily lead to leadership that’s influenced by the ego. He feels that there is also a bias towards extroversion and that those who project the most confidence might not be the most competent. Pharma, like the rest of the business world, is still quite attracted to alpha males and females, and according to the exec, this sometimes leads to disastrous consequences.

We actually have effective leaders in our companies but they’re not being promoted because we have a bias toward aggressive, highly vocal people, and it’s those people that the organization is picking to promote.

A Gallup poll survey across a huge base found that only about 13% of employees are engaged in their jobs, and that twice as many are actively disengaged. Being engaged in your job is mostly attributable to the relationship with a direct line manager, and this executive feels the disengagement is because business is still learning to identify what a good leader looks like. “We actually have effective leaders in our companies but they’re not being promoted because we have a bias toward aggressive, highly vocal people, and it’s those people that the organization is picking to promote.” He believes that good leaders should be measured according to whether they’re able to retain their key people: if they’re not, something is wrong. Job engagement and employee retention are key to consistent performance. He shares that the multi-awarded contract teams, despite receiving less pay and fewer benefits than the industry average, have less than 10% staff turnover.

In order to embed and measure culture change, he is in favor of regular surveys. He feels that conducting a job survey every couple of years is of no use. When organizations embark on culture change, regular feedback is necessary to determine which areas of the plan are working and which aren’t. Therefore, he believes that statistical data should be reviewed every six months to gauge the organizational culture index. Otherwise, the exec likens it to learning archery while blindfolded, where you need to be told where your arrows are landing so you can adjust your aim.

He is also a big fan of 360-degree evaluations and thinks they should be used three to four times a year, but he admits this might be a silly idea for many people at first. Ultimately, though, it’s clear that culture remains king: leaders need to be aligned with the patient-centric approach and salespeople need to have a clear sense of purpose in order to embed that culture. “There are lots of ways you can measure positive culture,” concludes the pharma exec, “but first the crucial building blocks need to be in place.”
 


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