Problems motivate physicians. Products don't," says Henry Slotnick, PhD, PhD, professor of neuroscience, University of North Dakota. "If you say to a doctor, 'Let me tell you about our wonderful product,' the doctor says, 'Today I am supposed to get root canal work done; I hope you'll excuse me.' On the other hand, if you say, 'Tell me about a problem you're facing,' the doctor is happy to do it."

As doctors become busier and busier, grabbing their attention gets more difficult. But by employing adult-learning principles, reps can engage physicians' interest, and succeed in increasing prescription sales, Slotnick says. He has worked with several pharmaceutical companies, designing detail aids (the materials reps bring physicians) based on techniques for motivating physician behavior change. Then he trained the sales reps in how to use the aids and approach physicians in a new way. The result: Physicians spent more time with reps, and doctors reported they enjoyed the conversations because the problems presented were challenging and fun. As far as the bottom line, Slotnick says that the training resulted in double-digit prescription increases, as well as increases in market share.

Selling Solutions Most detailing materials stress why the doctor should use the company's new product. Instead, when developing his aids, Slotnick employed adult-learning principle number one: Adults are practical learners and they want to learn solutions to problems they already have.

Slotnick identified patient problems he anticipated physicians might encounter that could be solved with the client company's product. "Not only that, but the product was better than all the competitors' products at dealing with this specific problem," he says.

The materials also employed adult-learning principle number two: participation. The detail aids presented a patient care problem: Mrs. Jones is a 55- year-old white woman who works in housekeeping at the hospital. She complains of sore, inflamed knees, and her knees are red and tender. The aids included the patient's vital signs and other information and then a list of treatment goals, which the physician was encouraged to modify. Then, the materials presented several therapeutic options for the various treatment goals. For instance, if the goal was to reduce Mrs. Jones' swelling and pain, aspirin would be useful for both, but acetaminophen would be useful only for pain, not swelling.

"The doctor would bounce back and forth across all the options, doing a comparison, product to product, relative to the needs of the patient," says Slotnick.

The therapeutic options offered were not identified according to the company that produced them, says Slotnick. "The doctor was working blind. The materials gave the doctor sufficient information to decide what to do, and come to the conclusion on his or her own that the use of the company's product was the proper solution."

But of course physicians do know what companies produce what products. In one scenario that Slotnick developed, the company's product was not the best choice. After reading through the case, Slotnick recalls, doctors would say to reps, "I know what product your company sells, but it's not the best one to use with this patient." The reps were trained to answer, "That's right. We included this problem, because we want you to know the limits of the utility of this pharmaceutical." The result, says Slotnick, was that the company increased its credibility with physicians.

The process will not work, Slotnick stresses, "unless there is a unique indication for the drug. We did not try to convince people to do something that wasn't the very best for the patient. The philosophy we used was: We wanted the doctor to write a script on every occasion when the product was the best one for the patient, and on no occasion when something else would be better."

Role-Modeling with Reps When training the reps, Slotnick employed the same adult-learning principles he wanted the reps to use when talking to physicians. The reps, like physicians, had problems they wanted to solve. For instance, they wanted to increase the time physicians spent with them. So, Slotnick says, instead of telling reps "'this stuff is great for docs,' we said, 'this stuff is great for you. Doctors will want to spend more time talking to you and the numbers of prescriptions will go up.'"

Slotnick also used participatory techniques, such as role-plays, to educate the reps in how to use the materials. "We role-modeled the way we wanted them to behave with the doctors," Slotnick explains. "Working with us, they experienced what the doctors would experience working with them."

Initially skeptical, reps soon found the techniques really did work. One rep told Slotnick that he arrived on a call just as the doctor was walking out the door. "You have from here to the elevator to tell me whatever you want to tell me," the physician said. "I don't want to tell you anything. I'm curious about how you would manage this patient," responded the rep, handing the doctor a case history. The doctor scanned the information,then sat down in the hall and kept reading. "Thank you for an interesting 20 minutes," he told the rep.

In a recent Wall Street Journal article, Scott-Levin, a drug company consulting firm in Newtown, Pa., reported that almost 30 percent of pharmaceutical reps' sales calls are now made to staffers other than physicians, such as nurse-practitioners or physician assistants. Though his detail aids were developed for physicians, Slotnick says, the adult-learning principles he used would work with other health care professionals as well.

"When you train sales reps, you play to a tough crowd," says Gloria Harrell, director of client services at The Resources Group, a training firm based in Raleigh, N.C. "A little comedy, a boat-load of business knowledge, and toys can go a long way in motivating these special folks to learn."

Pharmaceutical companies including Wyeth-Ayerst, Bayer, and Smith-Kline Beecham bring in TRG to train their reps in new sales-related software. Though computer training can be dry, it is anything but when Harrell's in charge. In addition to role-plays, she uses interactive quiz game shows to get reps involved in the learning process.

"They love competition--they're sales- people," she says. She divides groups into teams, with the trainer acting as game show host, asking questions related to the curriculum. "We let [the reps] yell the answers. The trainer determines who is the quickest," she says. Prizes are awarded the winners, usually a T-shirt from the company or a gift associated with the software theme.

Usually, classes are small, about 12 people. But when a company is doing a product roll-out, Harrell and her team are often charged with training hundreds of reps at once, and because of hotel meeting space limitations, Harrell sometimes combines reps from different districts in one classroom. That's when the competition really gets going, she says. "They get raucous and wild," she laughs. Then you just feed on that, and they get involved in the learning and have a great time."

Training in Trenchcoats Companies can inspire excitement and generate participation from the reps even before the training, Harrell says. For instance, one company ran a contest for the new software's name. The winning name, Customer Interface Automation--CIA--sparked the idea for the training theme. From the moment they arrived at the airport for the week-long training, the reps assumed new identities--as operatives. Everyone from the airport shuttle drivers to the facilitators was dressed as a spy. TRG's training center in Raleigh looked more like the set of an I Spy movie, says Harrell, complete with cardboard people lurking around corners. All classes incorporated the spy theme.

"If the trainees aren't motivated they're bored," says Harrell. "and if they're bored, they won't learn."