Health Podcast Highlights

• History of move through Gill McEwen’s work history [06:02-10:22]
• How often would you visit a doctor as a rep? [10:23-12:53]
• Is it typical to see a doctor with 20-30 patients a day? [12:53-13:53]
• What kind of training did you have as a rep? [13:54-19:14]
• How many doctors would a rep see a day? [19:16-19:45]
• What was your training experience at J&J and Pfizer? [21:04-22:37]
• When controversies come up in pharma companies, how does that permeate through the company? [22:38-23:45]
• Gill McEwen’s experience working at Blackmores [23:45-26:31]
• Can vitamins be patented? [26:31-28:17]
• Are big pharma and big vitamin regulated in the same way? [28:18-30:05]
• When new drugs come onto the market, how do you respond? [30:06-31:44]
• Conclusion [32:10-37:42]

Gill McEwen: Blackmores, Johnson & Johnson, Pfizer & More Introduction 

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. This week we are going to gain a little bit of an insight into the industry and in particular two industries. One is the pharmaceutical industry and the other is the vitamin industry, and they have a lot of similarities. And they also have a lot of differences. I mean, in terms of resources, the pharmaceutical industry is so well resourced, lobbies so hard on so many different levels that it is. Perhaps unfair to compare the two. But there are similarities and we are, and I guess the common denominator in all that is that they are part of the health care system.

My guest today is Gill McEwen. Now Gill has been the Global Director of Education at the Blackmores Institute. Now, most people in Australia might be familiar with the word Blackmores, as it is one of the pioneering companies in vitamin supplementation in Australia, and it is now available throughout Southeast Asia and into China. I had the privilege of working with Gill for the BioCeuticals.

In our many conversations during our preparation for that conference, I recognised or realised that Gill actually had a great deal of experience within the pharmaceutical industry. She goes back a long way and works with, has worked with, some of the largest pharmaceutical companies in the world. Sanofi, which is a French company, Johnson and Johnson, Pfizer. The name on everyone’s lips.

So she has insights and shares with us her own experience as she started as a young woman in her early 20s as a sales rep for the pharmaceutical industry, and she gradually got more involved in education and then moved to to the vitamin industry and took some of her skills that she learnt there. To that, she’s also worked with the Institute of Company Directors and the Chartered Accountants Australia and New Zealand. So she has a wealth and depth of knowledge and insights into those industries. And we touched on certain things in sales that I thought were very revealing. I thought possibly one of the most important things, she said was I can’t sell anything unless I believe in it, and I truly believe that many people in this industry, whichever side of the industry you’re on, I truly believe that what they are doing and what they are selling is good for people’s health, and there’s no question that pharmaceuticals do play a very important role in maintaining people’s health. I hope you enjoy this conversation I had with Gill McEwen.

Podcast Transcript

Dr Ron Ehrlich: [00:00:00] For a start, I would like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal People of the Eora Nation and pay my respects to their elders past, present and emerging.

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. This week we are going to gain a little bit of an insight into the industry and in particular two industries. One is the pharmaceutical industry and the other is the vitamin industry, and they have a lot of similarities. And they also have a lot of differences. 

I mean, in terms of resources, the pharmaceutical industry is so well resourced, lobbies so hard on so many different levels that it is. Perhaps unfair to compare the two. But there are similarities and we are, and I guess the common denominator in all that is that they are part of the health care system.

Dr Ron Ehrlich: [00:01:07] Although one might argue that the pharmaceuticals business model is focussed more on the management of chronic disease, engaging with as many patients as possible. In fact, if the population were a patient, which arguably we are, then the management of those patients means big sales, and so the pharmaceutical industry works on that model. 

The vitamin industry works on a slightly different model, and that is based on our chemistry and physiology. Vitamins and minerals are important cofactors in the trillions of processes that biochemical processes that go on in each and every cell in our body from the moment of conception to the moment we die. So the vitamin industry is focussed on supporting those biochemical processes.

Dr Ron Ehrlich: [00:02:07] So philosophically a big difference. One could argue one invested in disease, one invested in maintaining health. But the point is that we are exposed to both industries all the time, whether we like it or not. And so I thought today would be interesting to just gain a little bit of insight into some of the workings at the ground level of how sales are generated and how education is performed in both these industries. Look, it’s a snapshot. 

Dr Ron Ehrlich: [00:02:42] My guest today is Gill McEwen. Now Gill has been the Global Director of Education at the Blackmores Institute. Now, most people in Australia might be familiar with the word Blackmores, as it is one of the pioneering companies in vitamin supplementation in Australia, and it is now available throughout Southeast Asia and into China. 

I had the privilege of working with Gill for the BioCeuticals. BioCeuticals is the practitioner brand of Blackmores. It’s a vitamin brand. BioCeuticals holds a national conference every year, and I was asked to emcee that conference. I’ve referenced it before. It was focussed on enhancing mental wellbeing, navigating the modern world.

In our many conversations during our preparation for that conference, I recognised or realised that Gill actually had a great deal of experience within the pharmaceutical industry. She goes back a long way and works with, has worked with, some of the largest pharmaceutical companies in the world. Sanofi, which is a French company, Johnson and Johnson, Pfizer. The name on everyone’s lips.

Dr Ron Ehrlich: [00:04:01] So she has insights and shares with us her own experience as she started as a young woman in her early 20s as a sales rep for the pharmaceutical industry, and she gradually got more involved in education and then moved to to the vitamin industry and took some of her skills that she learnt there. To that, she’s also worked with the Institute of Company Directors and the Chartered Accountants Australia and New Zealand. So she has a wealth and depth of knowledge and insights into those industries. And we touched on certain things in sales that I thought were very revealing. 

I thought possibly one of the most important things, she said was I can’t sell anything unless I believe in it, and I truly believe that many people in this industry, whichever side of the industry you’re on, I truly believe that what they are doing and what they are selling is good for people’s health, and there’s no question that pharmaceuticals do play a very important role in maintaining people’s health. I hope you enjoy this conversation I had with Gill McEwen.

Dr Ron Ehrlich: [00:05:20] Welcome to the show, Gill.

Gill McEwen: [00:05:22] Thank you, Ron. Really, really pleased to be here.

Dr Ron Ehrlich: [00:05:25] And Gill, we work together on that wonderful conference that you organised enhancing mental health and you know, congratulations to you and your team. It was a great programme. A real honour for me to be involved in it. 

And I learnt about your association with so many different parts of this industry, from the pharmaceutical industry to big players there and the corporate world. I wondered if you might just give us a bit of a snapshot of a sort of a potted history of your move from through those institutions? I mean, I know it’s been very education focussed, but tell us about the moment.

History of move through Gill McEwen’s work history 

Gill McEwen: [00:06:03] Look, at the young age of 21, I travelled the world and came back and was looking for what would my career really be? Because up until then, my focus was to leave school, save money and travel. And you know, in all honesty, I’ll say I hadn’t thought about a career, and as an opportunity came, landed in my lap, basically. I’d gone to an agency and the lady said, “Oh, look, I have this role coming up with a pharmaceutical company, and they want you to this role to organise a conference for 350 delegates from around the world.” So it wasn’t so much the local people.

It was bringing everyone in from Europe, the UK, the US and I looked at her and said, “What skills do I have for that, given that all I’ve done is travel the world?” And she said, “You have every skill that you require. You have been able to plan where you’ve travelled, deal with the challenges while you’ve been travelling, and you really have all those frameworks that you need to sit down and project plan what you need to do with the conference.” And look, you’ve got a lot of confidence back at that age. So I just took a leap of faith at that time and thought, “You know what, I can do this.”.

Gill McEwen: [00:07:23] So my first job was with actually Roussel Uclaf, which is now, I think, Sanofi-Aventis. So I spent probably the first six months of my time organising that conference. I learnt a lot, I was able to draw on my French from school, which wasn’t that great at school, but became very proficient at it when I was working with the person who had come across from France to help me. It was a successful conference for us and then I was asked to help organise the global leaders meeting for Roussel Uclaf, you bringing in all of their CEOs from every country in which they played.

And that was for a week, and that was a kind of a different project, but really drew again on all of the skills that you require in organising an event which ultimately led to one of the delegates who came. They were relocating from France into Australia, and he asked me if I would be his EA. And I thought, “Oh, why not?” So I actually spent about a year and a half in that role, learnt a lot. He conversed nearly every day in French. I can remember… remember the telexes? I think it’s the telexes and typing on those that take you back so far, but shows how far we’ve come as well. And then moved into a rep role.

Gill McEwen: [00:08:45] So something, I guess back then at the age of 22, not having done a science degree, not having a background at all in that area as I was very unique and really was given the opportunity because of the skills and the knowledge and I guess the work ethic that I had displayed during my time with Roussel Uclaf. 

And I said, “Look, if you get through the six, six-week induction, you’ve got the job.” And I guess really, you could say the rest is history. So I stayed in the rep role for six months and then at the time I was married and my husband got a transfer with his role up to Port Macquarie. So I had to go in and say, “I’m sorry, I need to leave. I’m moving.”.

Gill McEwen: [00:09:32] And they actually gave me the first what you will call country role. So I lived in Port Macquarie, but still ripped across, calling on all the different specialists, pharmacists and was able to promote the products that we had from, I think it was Newcastle to Tweed Heads out to Moree. 

So that gave me a flavour of what it was like to talk about and discuss and go through the clinical trials that we had for not just our day to day products, but also some products that we used in surgery that were quite cutting edge at that time and taking them from what was typically in the core hospitals in Sydney, but expanding out the market into the country hospitals.

How often would you visit a doctor as a rep?

Dr Ron Ehrlich: [00:10:23] And when you were a rep, how often would you say a drop in on a doctor, a particular doctor? I mean, it takes six months or 18 months to get traction in practise. What typically would be your visits?

Gill McEwen: [00:10:39] From a country perspective, what I learnt was you could actually call on them nearly every month, but I will flag for those who are listening now who are in the industry, it is very different now to what it was then. Back then, you could have in an even in one company, I can remember at Pfizer, we had six reps calling on one territory. 

They might have had different products, but the priorities of the products would differ, were separate for each team. Whereas I’m talking many, many years ago and there weren’t as many reps. And while they had calendars and they’d say, “Oh, you can call on us three times a year and everyone have madly run around in July every year to get their bookings for the next year.

Gill McEwen: [00:11:28] As you built up your portfolio and profile with the doctor, it actually became a lot easier to call in and you had to make yourself relevant. And I think the biggest thing I can remember back then was a lot of reps just thought, “Ah, this is a sample drop. I’ll call in and see if I can grab the doctor over the counter and give them samples.” Don’t get me wrong, samples are really, really important. But on the other hand, you have to be relevant. 

Why are you visiting them? What information have you got for them that they may not have already read in their journals? Or is it that they want the clinical papers that they need you to highlight the evidence and take them through the evidence of the drug? Or have you talked to them about the different patient profiles of the patients they’re seeing and linking your drug into the benefits for those different patient profiles and helping them make their life easier?

I can remember seeing doctors and they were having 30 patients lined up in the waiting room. They’d already seen 60 patients by about two o’clock in the afternoon. They have really, some of them have exceptionally busy practises. And so to be able to get that door to open and get them to give you some time, they needed to feel that you were giving them what they wanted.

Is it typical to see a doctor with 20-30 patients a day? 

Dr Ron Ehrlich: [00:12:54] Mm-Hmm. I mean, that picture of the general practitioner or specialist, whatever doctor seeing 30, 40, 50, 60 patients in a day, is that a very typical, you know, you’ve gone around to a lot of practise over time.

Gill McEwen: [00:13:10] You could see, they were the hard ones to get into and you’d have probably 30% of your territory might have been really busy practises. But then there was also a lot of practises that you could just walk into quite easily. 

And yes, it was nice, just great to see them and great to be able to give them an update on their clinical evidence that was supporting the drugs that you were actually there to promote. But at the end of the day, you also want to be working with the people that have got a sizeable practise that can see a greater variety of patients that have got the opportunity to trial out the drugs.

What kind of training did you have as a rep?

Dr Ron Ehrlich: [00:13:54] And you mentioned, you know, that you wouldn’t sell anything you didn’t believe in yourself. So presumably training was an important part of because you didn’t have that science or medicine background. And here you were, you know, as a rep, what kind of training… Can you just kind of give us a bit of a snapshot behind the scenes of what kind of training you would go through as a rep before they’d send you out on the road and how often that would occur?

Gill McEwen: [00:14:19] Frequently. So if you think back to the first role I had, it was a six-week training programme. And despite the fact that a lot of the reps I was with had actually gone through as an example, a science background, they still took you through the anatomy and physiology and the mechanisms of action of how the drugs worked, etcetera, and you had to pass all of those exams through the training programme. 

But then there was the whole piece around the evidence and how the drugs actually work themselves, and it’s combining that knowledge with the evidence that you’re being presented with and being able to have the right dialogue. So not only did it include recalling the information, but it was how can you actually describe it, how can you actually ask the right questions, are you listening, and I really, if I had one thing I reflect back on, a lot of people will say to you, “Are you asking the right questions?”, that’s really important, but to me, it was also about what were you hearing and what weren’t you hearing and being able to tap into that too would be able to further the conversation with the doctor that you were seeing.

Gill McEwen: [00:15:33] So your training really involved a lot of the skills practise around having the conversations being put in very sticky situations and out of the field so that you were ready when you got into the field. And the other thing is, one of the companies I worked with, we didn’t, a lot of companies that are the bigger ones give you trade or presenters that you’ve got a nice selling story and you can walk to the doctor or the specialist or the pharmacist through your selling story. At one of the companies I work with, we didn’t have any at all. And if you can pick…

Dr Ron Ehrlich: [00:16:09] What does that mean that you’re, what you said…

Gill McEwen: [00:16:12] It’s like a four-page sales ad.

Dr Ron Ehrlich: [00:16:16] Right.

Gill McEwen: [00:16:16] So it’s had this story that you could ask the questions of who you were calling on, but then be able to quickly take them to the right information that answered the question that they may have had about that particular drug. And one of the companies I worked with didn’t have that. And I actually thought, on reflection in my time in this industry, that was probably the best training I ever had. 

And the reason being is you had to read the clinical data from front to back. And so if you think of a, remember those old pilot bags that the pilots actually still have them, I had a bag full of clinical papers for the hospital cephalosporin that I had, and I would make sure that I read, re-read, read again the content in those so that before I went in to see one of my customers, I already had in my head from the last time I called on them. 

Where do we get to then? What have we agreed on? And where are we going, you know, where would I like to take them next on this journey? So that I already had those clinical papers at my fingertips, and if I needed to, I could pull them out and take them straight to the data that they required to help convince them that this was the right solution for their patients.

Dr Ron Ehrlich: [00:17:40] But with you, when you arrived that six-week sort of induction programme, familiarised you with anatomy and physiology and biochemistry and all those kind of sciences, and then a specific drug comes onto the market, and so would that involve a whole day programme for you to brief on?

Gill McEwen: [00:17:59] So the ongoing part is that you see, you generally work in cycles. So it might be a three-month cycle, a six-month cycle, so a company may have two or three drugs that you promote. And maybe for the first cycle drug, number one on promotion, so you spend a lot more time focussing on that particular drug. If a new one comes in, there’s a whole launch around that, and they might, depending on the size of the drug, the potential market and the marketing placing, you might be brought into your head office for a week and you go back to step one, you revisit all of the core information that you need to know, you delve really deeply into those clinical papers, and go back through that same training.

If you think about, you know, top tennis players around, they’re continually doing the same basic core skills and fitness training. It’s no different as a rep, you’d be brought in again and again and again, you go into the office back in those days every Friday. Sometimes that would be admin, sometimes that would be two or three hours of skills training.

How many doctors would a rep see a day?

Dr Ron Ehrlich: [00:19:16] Hmm, mm-hmm. And typically, as a rep, how many doctors would you be visiting on this, on a day? What would be a busy day?

Gill McEwen: [00:19:23] A busy, successful, successful day would be six to eight doctors. Now quite often you saw you brought in lunch, and that was the only time they had is a break. So in that instance, sometimes you’d say up to six to eight doctors at that lunchtime. So it does vary, but the average call rate was around six to eight.

Dr Ron Ehrlich: [00:19:45] Right. And how does one measure success as a rep? I mean, is it the number of sales? How does that, I mean, is it visits? The number of times you’ve got into the door? Or obviously, it’s got to be related to sales?

Gill McEwen: [00:19:58] The doctor can tell you that they’ve they can say, “Hey, I’ve recommended it.” And you go, “Hmm.” So you’ve got to ask them a few more questions so that they’re telling you this story about the patient, what they recommended the drug for, and what that success is for. That, to me, was the number one measure of success because they could really drill down into the patient time and the example, you could go next door to the pharmacy where the doctor resides and you might have been selling the drugs into the pharmacy as well. 

And they quite often would say, “Oh yes, I’ll have two dozen of that because Dr Such-And-Such has been recommending that.” And you’d think, “Okay, that’s great.” That’s another measure of success in terms of what I’ve achieved. So it’s more like validation in that instance. But if you think about that now, back then, you didn’t have the chemist warehouses in the big discount pharmacy, so it was quite easy to track how you were performing. I would suspect these days in that area, that would be a little bit tougher.

What was your training experience at J&J and Pfizer? 

Dr Ron Ehrlich: [00:21:04] Hmm, hmm. And then I mean, Pfizer and then Johnson and Johnson, a similar role at Johnson and Johnson in terms of education?

Gill McEwen: [00:21:12] Yes, definitely. I think I was there for about five years after Johnson and Johnson bought out the division of Pfizer that I was in. So again, I stayed in the same company. I just kept moving. I didn’t really…

Dr Ron Ehrlich: [00:21:24] Wow, I mean, that’s such a feature of the pharmaceutical industry. I mean, in your time where you’ve been from Sanofi to when you left the pharmaceutical industry, I mean, it must have gone from many companies to really consolidated? Is that what’s happened?

Gill McEwen: [00:21:44] Yes, you could say it consolidated, but at the same time, Ron, when I first started, there were no companies that sold generics. So we’re, there were, let’s say, and I don’t know how many companies they were, but let’s say they were 60, yes, it shrunk a little bit, but then it grew because you have all of these organisations and creating generics of all of the drugs that you’ve spent years promoting and the companies you’ve worked for have put poured millions and billions of dollars into research. 

Not only researching and getting those products onto the market, but the research that brings us to where we are today and will take us to where we are tomorrow, and making sure that we’ve got drugs again, you see, and treat patients with the conditions they’ve got in the future. Solve the problems that we have today.

When controversies come up in pharma companies, how does that permeate through the company?

Dr Ron Ehrlich: [00:22:38] And when controversies come up within pharmaceutical companies as they have done, you know, I mean, I think Sanofi is interesting. I didn’t realise Sanofi because I know they had a drug called Depakine, or Depakine, it that was an epilepsy drug that caused all sorts of problems. And they get, you know, there are fines issued and claims made against the company. How does that permeate through the company? How do people within the company become aware of that? Or how do they even become aware of it?

Gill McEwen: [00:23:10] Look, there’s normally a first response, a framework that people follow. And there’s a division within the organisation that’s there to deal with just that. And but then there are really good frameworks put in place that ensures that the right communication goes to each and every person that touches this customer-facing, I’ll call it. So that we know exactly what we’re to say, how the way to respond might be we don’t respond. It just depends on what that scenario is and the direction that the company gives you.

Gill McEwen’s experience working at Blackmores 

Dr Ron Ehrlich: [00:23:45] Then you moved into the big vitamin and you can’t get much bigger vitamin in Australia than Blackmores. What are the differences? What are the similarities between these two industries because you’ve been right there at the cutting edge of getting these products into practitioners’ hands? What are the difference and similarities?

Gill McEwen: [00:24:08] Look, when I was in the first part of my career, I think it’d be fair to say a lot of people were quite sceptical about the vitamin industry. Didn’t really have a role to play, is it just… No, are they, do they actually work? That’s what I should say. And I think what attracted me to Blackmores, in the beginning, was it’s still had Marcus at the helm.

Dr Ron Ehrlich: [00:24:36] This is Marcus Blackmore.

Gill McEwen: [00:24:37] Blackmore Yeah. And he’s been involved or his father started it over 90 years ago, and there’s a lot of history and heritage. And they’ve really driven the industry in Australia for a number of years, and they have expanded out to Asia and China. And I learnt very quickly because I went there as a consultant for a learning management system project, not necessarily for an education project, but as part of that project, I had to become immersed in understanding more about the vitamin industry, and I started to read a lot more about each of the products and really, they followed the same principle.

Gill McEwen: [00:25:20] They want this science-based evidence that is put forward that helps them bring the products to market and then helps them put those products in the hands of, let’s say, a pharmacist. And then the same concept, you’ve got reps that are going around and educating pharmacists and showing them the scientific evidence that supports the value of those products.

Dr Ron Ehrlich: [00:25:44] Hmm.

Gill McEwen: [00:25:44] So they are actually quite similar. Even my people would say them is different. You’d probably say the vitamin industry is not seen as being as big and aggressive, but it’s not to say that there’s no value there. 

And, you know, over time, again, when you start to talk to in this instance, I don’t go out and see the customers, but I have and I’ve talked to the people who do go out and see them and through the education programmes that we provided. And it’s still so many stories there where pharmacists have taken that leap of faith with those different vitamin products, recommended them to their patients and have seen brilliant results. 

Can vitamins be patented?

Dr Ron Ehrlich: [00:26:31] Hmm. Hmm. So I mean, I guess one of the biggest differences must be the patents because patents must play a huge role. I mean, in the pharmaceutical industry, something comes online and is patented. This is obviously a more attractive thing. And once it comes off patent well, it’s not really, it’s a generic drug now, so it’s not really the same relevance. Is that how it works? I mean, can you patent Vitamin C? I don’t even think you can patent vitamins, can you? Or?

Gill McEwen: [00:27:02] I don’t think we do, but I think what it is is more around you don’t necessarily have one active ingredient in a vitamin. It might be what your patient type. What do they need in that vitamin? And how might we have done the research to bring two or three different active ingredients together to provide this solution for that particular patient type?

Gill McEwen: [00:27:28] So if you went into a pharmacy today, is every magnesium powder exactly the same?

Dr Ron Ehrlich: [00:27:34] Mm-Hmm. Mm-Hmm.

Gill McEwen: [00:27:35] Some yes. Some no. And some with the glucosamine products might be the graded ingredient that’s used sometimes, and that could happen in the pharma industry as well. And the different grades of ingredients. You could have high quality, medium quality, low quality. 

And I can recall a time wherein a particular drug class, some people were using the low quality. Some people were using the high quality. And when I mean low quality, the product that comes out of the blister pack and falls apart. But people would buy the cheap one because it was cheap, but it had a lower quality grade of the active ingredient in it.

Are big pharma and big vitamin regulated in the same way?

Dr Ron Ehrlich: [00:28:18] And in terms of regulation, are both industries regulated in a similar way?

Gill McEwen: [00:28:24] I think there are differences in the way they’re regulated, but they play differently. It’s really cutthroat in pharma, so you have to be, if you’re promoting something about your drug, you need to have every T crossed and I dotted, because if you go slightly off claim, one of the other pharma companies will be all over you and they have to withdraw you. 

Your promotion for that cycle is an example. And that happens all the time. Whereas it certainly doesn’t happen as anywhere near as much. In fact, I can’t even say I’ve seen it happen maybe once since I’ve been at Blackmores. So they’re two very different industries.

Dr Ron Ehrlich: [00:29:12] I mean, I imagine the resources of the industry are very different as well. I mean, in the pharmaceutical, we’re talking multibillion-dollar industry. I think in vitamins, we’re talking multimillion-dollar industry. I mean…

Gill McEwen: [00:29:26] It’s getting now. I think you’d be very, very surprised. Like even think about it, Ron, you walk into a pharmacy these days, how much of the front of shop space is dedicated to vitamins? 

Dr Ron Ehrlich: [00:29:39] Mm hmm. Oh yeah, it’s huge.

Gill McEwen: [00:29:40] And I think back to when I first worked at Pfizer, we had products like Kodjoe, Benadryl, Sudafed, and they would be taking up the shelf space of what the vitamins are taking up now. Now that cold and flu space is close to the back counter, but nowhere near the size of the vitamin space, they’ve almost swapped shelf space.

When new drugs come onto the market, how do you respond?

Dr Ron Ehrlich: [00:30:06] So, Gill, knowing your whole journey through this and all sorts of different levels when new drugs come onto the market, are you filled with excitement or caution or how do you personally look at it knowing all that goes on in both industries?

Gill McEwen: [00:30:24] I think for main, like anything that’s new, especially if you can solve a big issue in terms of health care today, that’s exciting. But as I’m sure many people would do, the first thing you want to know is what’s the evidence support that supports that, knowing that it’s got to market in the majority of instances because it has been able to demonstrate that it is effective in the claims that it is making and everything is an example at Blackmores that we produce. We’ve got claims that we’ve had approved and then we promote those products, according to those claims.

So, you know, here, in your heart that the product has made it to market for the right reasons, and really, it’s up to you to it goes out to the market and the market will tell you, do we want it? Don’t we want it? You know, people will take it. Word of mouth is huge in the vitamin market. “Hey, I’ve tried this.” And they tell their family, their friends, their cousins, their relatives, and we’ve got some products even in our stable of Blackmores, which have got to where they are today because people have tried them, find them effective and they will tell everybody. 

Dr Ron Ehrlich: [00:31:44] Ah well, Gill, you know, I really want to thank you. This has just been a little bit of a behind the scenes view of what goes on in these companies that we all have contact with nowadays one way or another. So thank you so much for today and thank you so much for sharing that experience with us.

Gill McEwen: [00:32:04] That’s a pleasure, Ron. Thank you for having me.

Conclusion

Dr Ron Ehrlich: [00:32:10] So look, there it was, it was a snapshot. It was an insight into the workings at the ground level of sales in the pharmaceutical industry and some of the challenges and some of the promotional educational materials and events that go on. It’s a big subject and for busy time-poor professionals. 

It’s very clear that sales reps, whatever their level of expertise or background is, play an important role in educating doctors at the coalface. And for doctors that are time poor and run practises which might see 30 or 40 or 60 or 100 patients, I can’t even imagine that, seeing that many patients in a day, you are certainly time-poor, and that’s why the prescription pad formed such an important part of health care.

If you’re running a practise where you’re seeing that, well you do the maths if you started, even if you started at seven or eight o’clock in the morning and finished at seven or eight o’clock at night, fitting 100 patients in, gives you probably around five or 10 minutes with a patient. And when you consider that every patient has a complex health history, complex health story.

And as a listener of this podcast, you will know how interconnected various aspects are that you realise why the prescription pad plays such an important role in many doctors practises. And I’ve often said in health care, there are various models that you can use. One is a symptom-based model where a person comes in, say, with depression, and you’ve going to deal with that depression by prescribing an antidepressant that may make it difficult for them to get to sleep so you might prescribe something that allows them to get some sleep. 

All of those medications may interfere with their digestion. They might get heartburn, reflux, indigestion. So you would also then prescribe them with an antacid or a protein pump inhibitor like Nexium that may then effect… And so the list goes on and on and on.

And if you are running a symptom-based practise, then the prescription pad is your greatest friend. And if you have been advised about how to deal with each of those products, by reps that have come into your practise and offered you simple solutions and even better giving you samples of that, then that is one way of running a practise. And I would suggest that there are many, in fact, maybe even the majority of medical practises in the Western world run their practises like that.

Another way of running the practise is to be finance centred. And you know, there’s been a recent story in Australia on cosmetic surgery, which has been, which is poorly regulated in Australia and is very profit-driven. So there is another example, or if you have a skill, then you want to pursue that skill with the patient. And so perhaps upselling treatments that may not be in the patient’s best interest is a financial centred practise.

Another type of practis- I think we’ve all experienced is a practitioner centred practise where you are just so honoured, you as a patient, should be so honoured to be in this practitioner’s presence and so honoured to have this practitioner look after you. The practise model that we’ve used, that I’ve used in my practise for over 40 years now, is what I refer to as a patient-centred practise. 

And that is, we need to make the patient the centre of that experience, and we need to find out what is best for that patient. And I think if you use as simple as a practitioner, or simple mental trick if you like, and that is if I was sitting in the chairs, my wife, my daughter, my mother or any relative or friend was sitting in the chair knowing everything that I know, what would I want done? And that’s a good model by which I think to practise.

Actually, this is why the prescription pad has become such an important part of health care, and the management of the chronic disease is arguably the way our health system works. And we may actually be seeing that play out. We are actually seeing that play out in our current pandemic. 

So I thought it was just an opportunity to share an insight, an insider’s insight into that without being too controversial. I know we could have gone down many rabbit holes there, but I just really wanted to hear firsthand what went on. I hope you found that useful, informative. I hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well. 

 

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.