Inside The Sample Closet:  On working for Big Pharma

Part 1:  Cheerleader Squad

I didn't want my first post about my experiences with Big Pharma to be about the gender/cheerleader cliché.  Honest, I didn't.  I wasn't even going to talk about it at all, but as I reflect back on over more than a decade now in the industry I realize that this facet of pharma life has been a defining one despite my efforts to not think about it.

If you don't know what a pharma cheerleader is then go to cafepharma.com and do a search for "cheerleader."  You'll have days of reading to wade through, some of it funny and much of it caustic.  For those who don't like to read or who like the Reader's Digest method of information acquisition, cheerleaders, in pharma, are young, female drug reps who presumably got their jobs and any success in those jobs solely for being attractive and despite being stupid and vapid.


Hi Doctor, would you like to see my detail aid?

Like most stereotypes, there is a little truth behind it, but there is also a lot of compensating for one's own lack of success in there.  Blaming yourself for your own lack of progress in your career is hard.  Blaming someone who got ahead of you, who is not as smart or as hard working as you, and who took your place because she's attractive, is very, very easy, whether it's true or not.

Pharma sales attracts young people who want a professional career.  You have to have an outgoing "salesy" personality and be comfortable talking to different people all day.  It's not demanding work, and after the first twelve months you develop a routine that makes the job work on autopilot.  You have to be flexible and do some after hours entertaining, and you have to handle rejection well, but it is not difficult work and anyone who is organized and communicates well can be successful at it.

Does pharma have an unusual number of cheerleaders working in it?  About half the sales reps in pharma are men, and about half women.  Most of the women I have encountered are "average" looking, and by that I mean average for mostly single women in their 20s and early 30s.  If half the reps are men, and the women are no more attractive than average young women, how can the stereotype be true?

Pharma is better integrated than most professional industries, so right off the bat having half of the employees female gives pharma much more gender diversity than other professional occupations.  It would be hard to find a law firm where half the attorneys are female, or a hospital where half the doctors are female, for example.  So even though only half of pharma reps are female, the percentage of female employees is much higher than most professions, and that fuels the stereotype.

Are those female reps given more opportunities than the men, or, are the ones perceived to be "attractive" given even more advantages?  Possibly, but if that's the case, it's not unique to pharma.  Have you ever been in a restaurant where most of the servers were attractive young women?  Some of those women might have been hired partially because they are attractive, but most of them are there simply because that industry attracts young women, and young women are more likely to be attractive.  Those who were hired because of their looks and are otherwise under-qualified won't last long, because even if you were hired because you are attractive, you still have to be able to do the job, and someone who makes a lot of mistakes or has a bad attitude won't make it.

Pharma attracts young, college-educated people because it's a great way to make more money early in your career, and get valuable business and sales experience that you can use to get other jobs, within pharma, device, or another industry entirely, later on in your professional life.


Actual pharma reps who are also cheerleaders.

I'm not convinced that pharma rewards attractive people, anyway.  You can read studies or use your own anecdotal experience to discover that people who are perceived to be attractive are frequently given advantages.   In pharma however, where there is a stereotype that people feel they need to fight against, being perceived as attractive can hurt you as much as it can help you.

First, there is the age-old concept of not being taken seriously as a woman generally.  Any woman who has worked in any industry, especially male-dominated ones, has experienced this, whether she is perceived to be attractive or not.  Whether you are an attorney, doctor, soldier, bartender, or CEO, you have encountered someone, male or female, who treated you differently than the boys.  It's no different in pharma, especially at the higher levels.

Second, if pharma only hires bouncy young attractive women, and if those women have advantages and are impeding the professional progress of better-qualified men, then why are most pharma managers men? Shouldn't the managers be mostly women if they are benefitting from unfair advantages?

Third, and this is the most important argument to anyone who has ever been a drug rep, the attractive, vapid female rep stereotype doesn't work for the simple fact that standing in your way is a gatekeeper, and your boob and smile powers don't work on her:  the Head Nurse (or head secretary).

In order to see a doctor, you have to get by the head nurse.  This is a bossy middle-aged woman who has no time or empathy for anyone who isn't a patient, and even less for an inexperienced young girl who pushes out her chest and bats her eyes at the doctor and get him to sign-off on samples and listen to her prattle on for 30 seconds about the latest indications of a drug.  When I was just starting out, getting by these people was a real challenge, and the scorn I felt coming off of them when I entered the office in my pant suit was palpable.  They know who you are right away, they know why you are there, they know that you don't really know anything about medicine, and that you are inexperienced.  Being young and freshly out of college was a hindrance, not a help, and this didn't change until I earned their respect.


Pharma reps getting ready for work in the pharma locker room.

Successful pharma reps aren't the ones who impress doctors with youth or boobs.  They are the ones who impress doctors with their knowledge and professionalism, and who impress nurses with humility and respect for their time and efforts.  If you have an attitude that you are a professional and are above them in some way, nurses and secretaries will hinder you and make sure you do not succeed.  If you are not knowledgable about your product and do not have respect for a doctor's time, doctors will not rely on you for information or prescribe your drugs.  If there is anyone I ever tried to bribe with anything, it was nurses and secretaries, and I used flowers, candy, and conversation, not makeup or tits.  When you know the name of a woman's daughter and what grade she is in, or recognize a new haircut or color, you will get in the door much easier than by acting like the shot girl at a strip club.

The people who make a lasting impression are the ones who are noticed.  People might make you notice them by doing something smart, by doing something dumb, by having an unusual nose, or by wearing unusual clothes.  A man might do nothing to distinguish himself other than have an unusual accent.  A woman might be remembered only because she was unusually tall.  So the few shallow, unqualified women who become pharma reps because being a realtor wasn't glamorous enough might have made some mistakes that people remember because it's exciting.  People get arrested for DWI every day but you don't hear about it unless they are politicians or athletes.  Pharma reps, male and female, make mistakes all the time, but when a "cheerleader" does something dumb, everyone says, "see, another cheerleader in over her head!"

Rather than thinking of pharma reps as belonging to either the "cheerleader" or "deserving" groups, I like to think of them as either belonging to the "sample dropper" or "resource" groups.  Many reps think of their jobs as collecting as many signatures as they can.  Getting out and visiting clinics and hospitals, dropping off samples, and getting doctor signatures for the samples, which also shows how many doctors you got in front of (an important metric for pharma reps).  During this sixty second visit, you have the chance to very quickly recite the latest indications of a drug.  "A study was published in JAMA last month that showed that using Biaxin to treat acute maxillary sinusitis due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae is 15% more effective than competing drugs!"  The doctor says "mmm-hmm," as he signs your sheet and wordlessly hands it back and turns away.  You do that half a dozen times per day and hand out some Vikings tickets while you're at it, and chalk your day up as a success.


Yay! I got another signature!

Or was it?  The other category of pharma rep is the rep who isn't just a sample dropper, but who is a resource for the doctors he or she visits.  After seeing a doctor a few times, if you are doing your job properly, your doctors should see you as someone they can call when they are considering what drugs to prescribe.  You are a person who can shorten the amount of time it takes for them to make an informed decision.  Instead of getting online and looking at journal articles or looking in drug reference books, they can call you and ask you if you think your drug is the right choice.  This only works if the doctor trusts that you will give him or her your honest opinion, and if the doctor believes you really know what you're talking about.  The only way this can happen is if you break that mold that a lot of reps are in and establish yourself as a person who can be relied upon.  Sample droppers don't do this because they either don't understand their real value to physicians, or they just don't care enough.  It's not for lack of training or smarts.  You don't have to be smart to do it, and they get training on being a resource for their doctors, so I believe it's just apathy or a fundamental lack of understanding of what their role is, and what they have to do to be successful.

One of the ways pharma is overcoming this issue is actually what I spend 50% of my time on.  Digital marketing is incidentally taking care of the problem by supplanting the field rep in some ways.  We provide web applications for computers, phones, and tablets that allow doctors to quickly look up drugs, indications, etc., all in a searchable database.  The goal is to make it even easier than picking up the phone and calling the rep.  I feel a little weird about doing something that cuts the rep out of the picture even just a little, but reps are just people, and a lot of people aren't all that committed to their jobs.  The reps who work hard to make themselves valuable to their doctors will continue to be utilized by them and be successful, and the company and doctors will get the benefit of an electronic rep to supplement those reps who just drop samples.

I'm not a sales rep anymore, and I have been out of that job for several years now.  I'm still in pharma, in business development instead of sales.  Despite my managerial role, I am frequently asked to conduct training for sales staffs in the U.S. and Europe, so I still hear what's going on and hear about the successes and complaints that sales reps are experiencing.  The industry has changed, but in a lot of ways, it's still the same.  The stereotypes are still there, and it's the same people holding onto them.  The people accusing women of being cheerleaders are the ones who are sample droppers, and if they took a look at why a woman actually got ahead of them, they might realize it wasn't what the "cheerleader" did, it's what the "sample dropper" didn't do.


Thanks doc! See you next month!