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!
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”
Consider coming back with an answer (show you care by making a point of following up) vs. answering instantly

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 State your intention to help Restate the barrier
“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?”
Clarify the Barrier

8. Empathize with the Provider2
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.”
Empathize with the Provider

9. Offer an Incremental Solution3
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?”
Offer an Incremental Solution

10. Confirm Understanding4
Confirm Understanding
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)?”
Confirm You Understand

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 solutions with 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 it with the group

14. Detail aids can be used to address many barriers
The detail aid contains information that 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!)