Ali Morris, Business Director for the Healthcare Sector at sales & negotiation performance experts Huthwaite International, spoke to GHP about the way our industry sells and negotiates, and some key skills everybody needs.
How would you characterise the particular challenges for salespeople in the healthcare industry, compared with other sectors?
Few other sectors must adhere to such a wide range of laws, regulations and industry standards. Ethical promotion of products and services is, quite rightly, of paramount importance. However, rather than necessarily seen as challenging, this is an accepted way of working for Pharma and Healthcare Sales and Marketing professionals
Much more challenging is the near constant price pressure experienced in the majority of interactions with Healthcare customers. Increasing patient life-expectancy coupled with the rapid pace of innovation in detection and treatment of medical conditions, means that cost-containment or cost-saving is a fundamental requirement of most customers. And it is the front-line sales person that is subject to that pressure, on a daily basis.
This, coupled with the huge changes in buying responsibility and power over the last few years, for example the rise in professional procurement practices in the Healthcare market, mean the world of medical sales is now an extremely complex and challenging environment in which to work.
Is there much difference between, say, devices and med-tech on one hand, and pharma on the other, when it comes to the necessary sales skills?
From a selling skills perspective, no not really.
The specialist and technical product knowledge required to converse confidently and competently with the clinical customer at any level is still crucial in both med-tech and pharma, and indeed in any of the other sub-sectors of the healthcare market. But salespeople now require a much wider portfolio of skill to meet the needs of the diverse customer group. Where previously patient outcomes were the main and sometimes only interest of the customer, it was product efficacy and reliability that were the main subjects discussed in sales visits. These still feature heavily in a typical customer interaction, but increasingly both pharma and med-tech sales need the skills to really understand and meet the business needs of the department, practice or hospital.
Drawing on your experience in the industry, how have the expectations and requirements for firms such as yours changed?
It’s interesting – there have been some really major changes in the expectations and requirements of our customers, but throughout my time at Huthwaite there have also been some remarkably similar projects and implementations, many years apart. The need for consultative sales skills is ever-present, but one of the biggest changes we’ve seen in the requirements of our Healthcare customers, particularly across Europe, has been the request for Negotiation Skills training. Salespeople need to be able to effectively negotiate with the influential economic or non-clinical customer, in a climate where price is always key. For example, at first sight, because of regulation, tariffs, reimbursement, etc, it can appear that there aren’t as many negotiable parameters as you’d find in other industries. But with imagination, the skilled Healthcare salesperson can often uncover more. We help people to think through what these might be, and what value they might carry in the bargaining phase of any negotiation, such as the length and terms of service contracts; the value (financial or otherwise) that could be placed against education and training, and other valuable resources which have in the past been given away.
How has the skill level of salespeople in the industry changed in line with these industry developments?
The breadth and depth of skill required has changed immensely. We’ve already discussed the need for effective negotiation skills, but it’s much wider than that. Greater financial understanding and acumen, coupled with business planning skills are essential. But what’s really noticeable is the need for actual selling skills. By that I mean the face-to-face behaviours used with customers, together with the account navigation and account strategy skills. Until relatively recently, in many areas of Healthcare, particularly Pharma, selling was not seen as an active, practised skill. It was more of a feature-led conversation, or worse a monologue, with an uncertain outcome.
Now salespeople really have to understand the full set of customer needs in the wider decision-making unit, and what the implications of those needs are, before they even think about demonstrating the capability of their products or services. If they move into that area too quickly, they won’t be persuasive because the product features they’ll describe won’t be so obviously targeted at solving the customers’ toughest problems. Medical reps have long been familiar with the need for an ‘evidence-based’ approach but now the evidence they have to bring is about much more than clinical efficacy. So we are still seeing many requests for consultative selling skills, but now tailored to very different customer types than in previous years.
You say that Huthwaite International specialises in helping people sell and negotiate. Can you explain where one stops and the other starts, and the skills required for each?
That’s an interesting question, and one on which Huthwaite has a very particular view. From our observation, research and experience, we’d say that they are distinct phases, and that you shouldn’t actively begin the process of negotiation (with all the preparation, planning, power management and actual trading that entails) until you have built the value for your product or services in the selling phase, and have established that you are probably going to do business together. Start negotiating too early and you could be conceding on issues that you later learn you had no need to, and you can undermine the value of what you are selling even as you are trying to build it. However, there’s no doubt that the negotiation phase is heavily influenced by what happens (particularly in terms of information exchange) during the selling phase. What you (or the other party) learn early on about competitor activity, critical deadlines, budgets, fallback positions, contracting complexity etc will all be put to good use once you sit down to start going through the terms and conditions for the deal. And that’s all the more reason not to bring them into the discussion and give things away unnecessarily, before they can have their maximum impact.
The other important point is that there is (and the research shows this) a specific set of verbal behaviours that are most used by successful salespeople in the main sales phase ‘ mostly to do with asking questions in a particular way and presenting solutions in a particular way. And then there is a completely different set of verbal behaviours that make up the successful negotiator profile. Some of those behaviours still surprise some people ‘ like the pointlessness of making counter-proposals, the high impact of a well-timed description of your feelings, or the importance of avoiding some all-too-common ‘irritators’ as we call them.
Are these negotiation behaviours transferable to other environments, such as health procurement?
Yes, absolutely. It applies in both the public and private sectors. A few years ago we did some research which uncovered that the natural fear and trepidation that many salespeople find in confronting procurement professionals was often misplaced ‘ and probably has a mirror image on the other side. It was interesting to hear from procurement category managers just how lonely and relatively lowly their position often is, as they are seen internally as the barrier to clinical users/healthcare professionals getting the particular equipment or drugs they feel are best for the job. The skilled salesperson can use a variety of behaviours to help those procurement people be seen to add value, rather than trying to destroy it, and the skilled negotiator can bring that back to the table later on to emphasise the risk of letting that value slip if the right terms can’t be concluded. Furthermore, on the buyer’s side, skills that can help a procurement professional understand a fuller range of negotiable issues and options, and how to discuss them creatively, can bring about far better outcomes for healthcare providers and payers.
Inside companies in our industry, do you think enough emphasis is placed on developing verbal behavioural skill, to sit alongside the technical skills that we take as read?
I’ve said a little about a small handful of the many verbal behaviours we train people to use in commercial negotiations, but of course there are many other opportunities in this industry to persuade and influence one another, and they don’t always directly involve the customer or supplier. Internal persuasion between, say, account managers and technical experts in getting a bid together is a good example. Communicating within your own organisation to put together the best proposition can mean needing to influence the very different cultures and processes found in Production, Operations, Commercial Excellence, and R&D departments for example. But agreement between all these people might be the key to providing the best solution for customer. Developing excellent communication skills within such teams can maximise the chances of winning a big contract against tough competition.
In my experience, one of the vital areas for behavioural alignment is between Sales & Marketing in Healthcare companies.
We have often seen, particularly in highly technical fields, a marketing launch of a product to the salesforce that is heavily focussed on features, rather than on customer or patient needs. This inadvertently impacts on the verbal behaviours of the salespeople, encouraging them to reduce the number of questions they ask their customers in order to uncover the customers’ needs, and instead leads them to ‘push’ the features of the their product. Unsurprisingly this is not usually as successful as the rep, or their Sales & Marketing department would wish, often creating objections from the customer and making the rep’s job more difficult.
Secondly, effective verbal behaviour is essential to ensure that communication is clear and specific between the two departments, so that their actions support one another, and every sales or bid opportunity is seized upon to the maximum with the teams working side by side from the outset to the final decision. That requires a level of verbal behavioural skill between busy professionals, working under stress, each with their own priorities and KPIs. Finally, verbal and written content from both marketing and sales needs alignment to ensure that items like product materials or social media messages are congruent with the market level value propositions that the salespeople are using in front of customers, and that a statement that comes out of a salesperson’s mouth is a clear echo of a marketing message that appears in the company’s advertising or media coverage. You’d be amazed at how often they are at odds, but it’s a relatively easy problem to fix, with the right skills.
How does selling and negotiating in healthcare vary globally?
Not as much as you might think. Most of the challenges, pressures and needs exist to some extent across the different Healthcare markets. Most of our implementations are with global companies selling all across the world, and the core behavioural traits really are remarkably transferable. That’s particularly helpful if an organisation wants to develop a common approach to sales or negotiations, that can be modified locally if necessary to reflect cultural or market needs.
How does technology affect your work internationally?
We’ve put a lot of effort and investment into this lately. In essence, training is no longer just a classroom interaction at a single point in time. It’s a continuing journey of preparation, self-paced knowledge acquisition, immersive interaction between a trainer and delegates, digital reinforcement, integration with working life, measurement, refreshment, and analysing the payoffs. We like to think that anyone we work with gets each of these things, and that they get them delivered where and when they want them in the languages they need them. So, for example, a great deal of the knowledge-based digital pre-work, and the Insights and Refreshers we provide to people who train with us, are available in their languages via a common portal. We were also pretty much the first people in our field to offer a fully virtual sales training experience, so that people in all corners of the world can experience a fully featured simultaneous live SPIN’ Selling programme, with a live trainer. That means that organisations with globally dispersed sales teams can get real life behavioural sales training, as a group, without having to get on a plane.
Being able to support embedding and reinforcement of skills, through ‘ for example ‘ mobile devices and our new App, means that wherever in the world people are travelling, as long as they’ve got a smartphone or a tablet and an internet connection, they’ve got Huthwaite.
Will people in our industry still need face-to-face behavioural skills ten or 20 years from now?
Looking at the last 20 years, and the huge changes we’ve seen in global healthcare, the only thing we can be sure of is that there is much more change to come over the next 20 years. Will there still be a need for medical sales? In some form or another, yes. People will still be buying from other people, and looking for added value in the relationship. In fact, the more reliant people are on digital sources of information to sift the early candidates in a supply opportunity, the more important the behavioural skills become for the rarer moments when you get the one make-or-break chance to influence the customer’s thinking through your persuasive, consultative behaviour. Anyone who enters that phase without the necessary skills will continue to be at a big disadvantage.
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