Overcoming Barriers to Change

1. Overcoming Barriers to Change Session 7

2. Overcoming Barriers to Change Session 7: Objectives • Identify common barriers to change presented by providers • Develop appropriate solutions to overcome barriers to change • Deliver solutions using 4 step process • Practice overcoming barriers with solutions

3. Barriers often emerge during conversations that medical detailers have with providers Why? • Providers hold pre-conceived ideas about services, products, and behaviors • Argument(s) can be made against the value proposition you are giving them • Change is uncomfortable • Doing things differently introduces risk for the provider (What if something happens that they don’t expect? What if it doesn’t work?)

4. Barriers-the med rep’s worst nightmare! Consider coming back with an answer (show you care by making a point of following up) vs. answering instantly • Not true! • Barriers are really golden opportunities to clarify your client’s motives and beliefs • Ask questions to understand and clarify how they feel & what they believe (be sure, don’t assume) • Use open-ended questions • Say you’d like to better understand • Don’t ask them “why”

5. What kinds of approaches work best for medical detailers to overcome a barrier? • Solutions used by medical detailers today include all of the following -- depending on the circumstances and local environment • Key opinion leader • Other expert opinion (other influencer) • Clinical data / evidence • Education • Nurse or staff endorsement • Client preference • Economic / cost information • Government policy information

6. Four steps to overcoming a barrier… 1 2 3 4 Clarify the Barrier Empathize with the Provider Offer an Incremental Solution Confirm Understanding

7. Clarify the Barrier 1 Clarify the Barrier State your intention to help “OK, I want to make sure that I understand you properly.” Restate the barrier “Do you mean that you’re not sure why using IUCDs is beneficial to your client?” Clarify the scope and any other issues “Do you mean for all of your clients, or just certain ones? Which ones?” Ask for confirmation “Is this the main reason that you haven’t started to use IUCDs?”

8. Empathize with the Provider 2 Empathize with the Provider Let them know others have felt the same way “I’ve spoken with others who used to feel the same way.” Ensure they know you understand “I can understand how you might think this way.” Let them know it’s OK to feel hesitant about change “I can understand that you might feel it’s risky to change since you’ve done it this way for so long.”

9. Offer an Incremental Solution 3 Offer an Incremental Solution Provide the solution that you think is best “Based on what you’ve told me and my experience many providers in the same situation have tried....” “Clinical data shows that…” What do they think about the solution “Does this seem like a solution that might work in your practice.” “Does this address your concern?”

10. Confirm Understanding 4 Confirm You Understand Ensure future benefits are understood “Do you think that taking this course of action is certain to make you better off in the future?” Obtain agreement on the plan of action “So it’s agreed that I will do the following for you (or help you in the following ways)?”

11. What are the common barriers providers have with… • IUDs • MA or Medabon

12. Exercise 1: Overcoming Barriers • For your assigned barriers – develop solutions • Write the barrier on one side of the paper • On the other side, write how to overcome the barrier • Share solutionswith the group • Then it is time to practice!

13. Exercise 2: Provider Strategy Planner • Refer to the Provider Strategy Planner • Complete the Barriers section of the Provider Strategy Planner, • Identify the barriers that this provider is likely to present • Brainstorm some solutions that might help address the barriers, using the Barrier Handling cards for ideas • Do not go further right now! • Are there any barriers that did not make it onto our original list? • Add it. • Share itwith the group

14. Detail aids can be used to address many barriers • The detail aid contains informationthat you can share to: • Explain offerings • Demonstrate impact • Offer proof • Describe costs • Using a detail aid to address a barrier is similar to using it to deliver a value proposition – but should be more focused

15. Exercise 3: Practicing Overcoming Barriers • Form groups of 3-4 people • Distribute Barriers to each group • In each group: • Shuffle the Barrier sheets • One participant is provider, one med rep and others observers • Provider selects a barrier, reads it aloud to med rep • Med rep uses 4 step process to overcome barrier and propose a solution • Then switch so that everyone plays provider and med rep at least twice • Focus on one barrier at a time • Return to larger group and share experiences

16. Overcoming Barriers to Change Recap • Overcoming barriers takes preparation • It’s important to not just react to a counter argument or concern from a provider • Always take the time to fully understand and empathize with the provider before you offer any solutions • Confirm that the solution you propose is accepted and acknowledged and then promise to follow-up (and do it!)