Put Yourself in Their Shoes

Understanding the challenges physicians face on a daily basis will help you develop a better marketing plan for your nutraceutical products.

ByErik Goldman

Imagine that gradually, over the course of a few years, everything you thought you knew about your business was challenged. Loyal customers who once seemed happy with what your company offered were suddenly shopping elsewhere. Or they were coming to you demanding things you never even knew existed. You’re a savvy professional who works hard to keep abreast of developments in your field, but suddenly your customers are coming to you with information gleaned from sources you’ve never seen, about stuff you’ve never even heard of. They’re dissatisfied and they voice a quiet consternation at your seeming backwardness.

You spend a lot of time and money ensuring your products are safe, clean and have some scientific basis. Suddenly, there are all these other companies popping up from who-knows-where, claiming to offer better stuff, nicer service and lower prices.

You used to shrug it off, thinking it was just another passing fad, the whims of a few simpleminded folks. But it’s been happening a little too often to ignore. To compound the trouble, your own trusted sources of information and materials are suddenly wracked by financial scandals. They’re accused of unseemly or even dangerous business practices. Economic pressure has intensified, and you’re now forced to deal with more customers with heavier demands in less time. But don’t think that gives you an excuse should something go wrong. Make a mistake, and aggressive attorneys will be on you like condors on carrion.

You know in your heart that the products and services you offer have their limits, and don’t always live up to their claims. The business world definitely doesn’t live up to the ideals you had when you first entered the game. Sometimes you wish you could just start over, return to core values. But you can’t just change everything. What will your peers say? Change is risky, after all. You might lose key customers and referrals. Your staff is growing, and your kids are going to start college soon. Can you really afford to redesign your entire business? On the other hand, can you really risk sticking with status quo?

Harsh Realities of Modern Medicine

This scenario is very close to what many physicians face every day. Ask any doctor within earshot, and you’ll hear tales of woe: insurers and federal payors spool out ever more red tape, while cutting reimbursement and forcing doctors to see more patients in less time. Malpractice lawyers lie in wait, clicking their talons against their briefcases, watching for a misstep. Pharmaceutical science gets more voluminous and less clear by the minute. On top of it all, proactive patients are demanding alternatives. They’re experimenting with all sorts of natural products and therapies for which most mainstream docs have no formal training.

If you are interested in marketing nutraceuticals to healthcare practitioners—and well you should be, since they represent a fast-growing segment of the natural products industry with tremendous potential to reshape healthcare—you need to understand who they are. To understand a potential customer, it helps to put yourself in his or her shoes.

It is safe to say that today’s physicians, be they conventional MDs, naturopaths or chiropractors, face challenges their predecessors could never have envisioned. Your success in marketing to them depends on your ability to show them how your products and services will help them meet these challenges.

MDs in Transition

It’s easy to slag off on mainstream doctors. Their historical arrogance and scientific rigidity, not to mention their political clout (relative to “alternative” practitioners) make them easy targets for derision. But natural products executives would do well to pay close attention to them. For one, there’s over 700,000 MDs and DOs (doctors of osteopathic medicine) in the U.S., making them one of the largest, best organized professions out there. They also represent a huge growth market. Leading supplement categories like omega 3 fatty acids, glucosamine and probiotics have experienced major growth over the last few years in large part because mainstream physicians and clinical researchers have begun to recognize their value.

Second, doctors still have a lot of influence over their patients’ healthcare choices. The average primary care physician has an active population of between 2000 and 5000 patients. Multiply that by the number of doctors in the country and you’re looking at a serious field of influence over consumer behavior.

Third, it’s better to have them as friends than enemies. Healthcare is on the national political agenda once again. Whether we like it or not (whether we even understand it or not), healthcare policy is likely to undergo major changes in the coming years. This could include big changes in how supplements are regulated. Given the political power still wielded by mainstream medicine, it would be far better to have doctors on our side rather than against us.

Fourth, and perhaps most importantly, having well-informed physicians who are as comfortable with nutraceuticals and herbal medicines as they are with pharmaceuticals would be a very good thing for the nation’s overall health in general.

The Physician Personality

Most people who become doctors go into the field for the right reasons: to help people, to heed a call to serve. But somewhere along the way, many lose touch with that impulse. Medical education, to say nothing of the healthcare reimbursement system, does a good job of beating down their spirits.

In developing a series of workshops to help doctors overcome their emotional, intellectual and spiritual blocks, Dr. Lee Lipsenthal, a cardiologist in San Rafael, CA, has thoroughly studied physician personality traits. He sees the typical doctor as a combination of intelligence, compassion, sensitivity and inqusitiveness, mixed with fierce competitiveness, driving “type-A” behavior, perfectionism, and a tendency toward safety-seeking. Unfortunately, medical training amplifies the latter tendencies, while squashing the former.

“Conventional medical training is highly dysfunctional,” says Dr. Lipsenthal. “It exaggerates traits like competitiveness, perfectionism and emotional distance, at the expense of compassion, sensitivity and social connection.”

Mainstream physicians’ historical defensiveness toward natural products and holistic medicine is partly rooted in their lack of education about it. Conventional training, with its total focus on drug therapies, teaches next to nothing about nutrition, let alone therapeutic use of nutritional products. But there’s an element of pride at work, too. After all, the people who become doctors pride themselves on their smarts. They hate looking stupid, and the constant challenge from “alternative” medicine makes them feel insecure.

To many doctors, the public’s shift toward natural medicine also represents a broader breach of what many doctors view as an implicit social contract. According to Dr. Lipsenthal, physicians are often attached to an unwritten societal contract stating that when one becomes a doctor, one spends a life in service. We accept these terms for four reasons: 1) It is socially esteemed as a “right” thing to do; 2) We are driven to be physicians so strongly that we’ll sign on for almost anything; 3) We want job security; and 4) We are averse to change.

Dr. Lipsenthal says the contract is clearly tearing. “The financial security…is dwindling. Our patients change doctors frequently. We get sued more often.” This, coupled with the rise of managed care and the demands for alternative therapies, “violates our innate sense of justice. We acted in good faith, yet society broke its ‘contract’ with us.”

How bad is it out there in clinic-land these days? Bad enough that the American College of Physicians (ACP), the nation’s leading organization for internists, just issued a White Paper stating that without a major overhaul, the nation’s primary care system faces imminent collapse. The paper cited a recent survey by the American Medical Association (AMA) showing that fewer recent medical school grads are entering primary care, and mid-career primary care physicians are frantically searching for the exit sign.

Willing Spirits, Thorny Logistics

Despite their reservations, many mainstream doctors are now looking to natural medicine as a way of re-connecting with the original healer’s intention. Some also see it as a potentially more financially viable way to practice. The growing number of conferences, seminars and tradeshows aimed at informing doctors about holistic medicine, and the rising membership in organizations like the American Holistic Medical Association, the Institute of Functional Medicine, and the American College for the Advancement of Medicine speak to a clear trend.

For many conventional doctors, the spirit is truly willing. But the flesh can run into significant roadblocks on the road to holistic practice. For one, insurance reimbursement—the financial basis of their practices—covers very little in the way of alternative services. Then, there are malpractice issues. The medicolegal precedents governing the practice of natural medicine have yet to be defined.

Relative to naturopaths or chiropractors, conventional doctors seem to have more political and social authority, but only if they stay within the narrow confines of the allopathic model. “I am always on the line as far as the medical boards go. I practice many things outside conventional standards, so I am always at risk,” said Kenny Bock, MD, current president of the American College for the Advancement of Medicine. “The reality is, we can lose our licenses.”

In marketing your products to physicians, you are asking them for a high level of trust—far higher than you may realize. To win their hearts and minds, you must prove to them that your products really are as safe, effective, and reliable as you’d like them to believe. After all, if they recommend or sell your products to their patients and something goes wrong, they’re going to take the heat.

The Other Side of the Fence

Naturopathic doctors (NDs) and chiropractors (DCs), long the mainstay market segment in the healthcare practitioner channel, face different challenges. NDs are only licensable in 14 states. Although they are actively pushing for licensure laws in key states like Florida and New York, many NDs are either practicing underground (i.e., illegally) or they work in “integrative care” settings, under the aegis of MDs and without full practice autonomy.

NDs are well-trained in nutritional and botanical medicine; chiropractors who expand beyond manual adjustments may not be. While some DCs seek out formal training in nutrition, herbal medicine, Chinese medicine or other holistic modalities, the reality is, many DCs are practicing well beyond their established scope, putting them at legal risk.

It is true that NDs and DCs generally need less overall convincing than mainstream MDs. They’re already “on the bus” of alternative healthcare. But from a marketing viewpoint, it’s a pretty glutted segment. Since just about every professional-level nutraceutical company is marketing to them, getting your product onto their formulary shelf means knocking someone else’s off. And the reality is that while in-office supplement dispensing is a solid revenue stream for many NDs and DCs, for many, it is a management headache. You try running a small retail shop out of the corner of your office.

In the long-term, mainstream MDs represent a vast, largely untapped market potential. For one, the average MD sees a lot more patients in a week than the average ND or DC. Secondly, MDs who buy into nutritional medicine tend to move more product than their ND or DC counterparts. Field reps for a number of different pro-channel supplement companies have observed this trend.

Promising Signs

As mainstream physicians, often driven by their patients’ demands, become familiar with natural medicine, they will inevitably become more open to the therapeutic and preventive potential of science-based nutraceuticals. The current healthcare crisis represents a massive opportunity for the industry to step up and show its worth.

In it’s recent White Paper, the American College of Physicians called for a radical and immediate shift toward preventive healthcare. ACP argues that our current healthcare system is based on a “just in time” mentality. For example, insurers are willing to pay tens of thousands of dollars for the amputation of a necrotic limb in a diabetic patient. But they pay next to nothing to primary care physicians trying to prevent the onset of diabetes and its horrific complications. The “just in time” approach is economically untenable. We need “stitch in time” thinking. This sort of statement is unprecedented, coming, as it does, from an historically conservative, mainstream medical organization like the ACP.

The current chaos and contention in healthcare could lead to a bright and promising future for natural medicine and the nutraceuticals industry, provided representatives of this indus-
try keep their eyes on the big pict-
ure, stay aligned with the highest ethical standards, undertake the hard but necessary scientific and education-
al work, and truly deliver the safety and efficacy that physicians and their patients need.NW