When facing objections in thought leader engagement, it is time to ask strategic questions to go beyond the surface-level opinions and guide the conversation to new understanding. Objection handling represents an opportunity to strengthen relationships, establish credibility, and be a resource to help solve problems, provide additional information to further educate on key topics, and deepen understanding.
When the conversation takes a negative tone with dissenting views, it may seem best to avoid an argument and shy away from debate, however, this is the time when medical affairs is called upon to rise to the challenge and lean into the opposing opinions with intellectual curiosity, emotional intelligence, and poise. Conflict in discussion presents the need to understand the “why” behind each position which is integral to gathering useful insights. Letting objections and differing views or opinions go unaddressed is a lost opportunity; exploring divergent views allows us to gather vital information and insights that can make a significant impact when shared with internal stakeholders. Do not walk away from the debate; take the agenda detour together and find the deeper knowledge that can be quite insightful and illuminating.
Benefits of Managing Objections
The benefits of effectively managing objections will pay dividends for the MSL long-term. The ability to listen first, understand the HCP, and try and walk in their shoes will help the MSL to respond without reacting and prevent creating an antagonistic relationship with the HCP. Many times, an HCP will just want an opportunity to vent and be understood. Your ability as an MSL to be an empathic listener, a creative problem-solver when appropriate, and respond with accurate scientific information will help to manage objections and grow the HCP/KOL relationship over time.
Building Strong KOL Relationships: An Engagement Framework
While MSLs are often considered peers of the HCPs/KOLs they interact with, it can sometimes take a while for the KOL to recognize MSLs as such. The framework shown below illustrates relationships with KOLs and the idea that they must be built over time. Your goal as an MSL is to work from the outside in to eventually be seen as a partner with the HCP/KOL.
The rationale for using this model is to help you with planning for, conducting, and following up on scientific exchange discussions with external stakeholders – HCPs/KOLs. MSLs should apply scientific knowledge and business acumen to the various stages, as appropriate. Using the “Engage” component of the model, shown in the figure below, helps to represent an effective approach to an HCP/KOL interaction.
At the recent MSL Society 2023 Annual Meeting, an Objections Handling pre-conference workshop was conducted with over 60 participants, primarily made up of MSLs and Senior MSLs. The facilitators opened the session with a brief survey among participants inquiring if they had received any training or guidance on managing HCP/KOL objections and disagreements. To our surprise, 57% of the participants responded “No”. The 43% that responded yes indicated that they use a variety of tools for objection training at their companies. These included: standard response letters (SRLs), their colleagues and co-workers, frequently asked question documents, their manager, and internal medical experts. The bulk of responses around the current training for objection handling are related to getting scientific information to help answer the question. Very little, if any training and focus, is being given toward the important process of how to listen and respond to these objections in a way that can truly be constructive in the moment over the long term. This audience’s response was a great reminder of the importance of objection-handling training for field medical teams.
Planning for Objections
When you know challenges will arise in discussions, layout polished answers; use a FAQ approach and practice verbalizing answers on the MSL team. Practicing with triads works well in role play where one person is an observer, one is the MSL, and another is the KOL. Rotating roles allow each MSL to view the objection handling from various points of view, allowing each to learn from the other with crisp and accurate verbalized answers.
Consider all Resources:
Go beyond the PI; when questions arise, it may seem easy to reflexively provide a quick answer, yet there is an even greater opportunity to ask why the question is important or further clarify what is being asked such that additional resources come to mind providing a well-rounded, polished and thoughtful answer that goes beyond a quick comment. Some resources to consider when planning for challenging questions or objections include:
- Product PI: know all aspects of the PI thoroughly
- Sales aids: maintain current knowledge of what commercial is using to present data, their messages, and resources
- Speaker deck: know-how speakers position the data and patient needs
- MSL core medical decks: ensure consistent presentation of medical data; listen to other medical colleagues present the same data
- Payer / HEOR decks: stay current with data used to present to payers
- Standard Response Letters (SRLs): know which formal letters may supplement information; ensure up-to-date knowledge of all SRLs
- Company publications: what additional or new data has been published?
- Company posters: with each conference, there are often new pieces of data shared that enhance conversations when needed
- Clinical Study Reports (CSRs): read the pivotal and important trial reports; be prepared to search for data when needed to help address questions
- Marketing data: ensure awareness of data captured such as sentiment analyses, disease state and competitor landscape information, surveys, etc.
- Additional resources: look beyond company data; publications, posters, presentations, intelligence, thought leader commentary, CME programs, and more
While all these sources will require significant time and effort to read and digest, it may be possible to divide this effort among the MSL team to keep abreast of any new information and resources to share with them. Taking time to become a true scientific expert for a given product and condition will allow for enriched thought leader discussions and deeper, more strategic intersections that help shape medical strategy and enable impactful dialogue with internal stakeholders.
The 4-Step Method to Manage Objections
Many times, objections and conflict arise in engagements with HCPs/KOLs when the HCP feels that their interests are being opposed or negatively impacted by circumstances out of their control. The MSL Society workshop and this paper introduces a simple but effective method to manage objections with an HCP and work towards a mutually beneficial outcome for both the HCP and you, the MSL.
Take the detour and then continue the discussion
- Validate their concerns
- Show interest in what they are sharing
- Gather insights about WHY they are concerned and what impact it has on their treatment decisions.
Being an active listener, validating their concerns, and showing empathy will help to de-escalate the situation and help the HCP/KOL understand that you as the MSL are there to help them.
Time to ask clarifying and probing questions:
- Would you like me to discuss some of the factors that may have contributed to this data?
- What specific concerns do you have?
- Would you be interested in reviewing additional data related to this?
- When you decide on a treatment plan for your patients, which clinical trial data are most important to you? What are you looking for in a treatment?
Share appropriate data and supporting information:
- Provide clinical data, supporting information as appropriate after clarifying questions and probing for a deeper understanding of interests.
It is not until Step 3, and well into the discussion, that you should bring data and supporting information to the discussion. Not jumping so quickly to the “fix it” mode will help you to listen first and then respond with an informative answer after fully hearing out the HCP/KOL concerns.
Expand on the resources that apply to this concern
- Ensure a thorough review of related materials and items that can be helpful in providing context and useful responses to this inquiry.
- Close the objection by re-affirming key data/points
- Check to establish thought leader acceptance of this response and identify any outstanding aspects of the objection to address
- Depending on the thought leader’s response to the information provided, you may need to proceed to discuss related topics or end the detour and move back to the planned agenda
Once you have confirmed that the objection/concern has been fully addressed, the MSL may then return to the original agenda for your meeting. Even though detours and HCP objections will often come your way as an MSL, using this 4-Step method will help you be more professional and under control to adequately listen, validate, respond, and then return to your agenda.
Workshop Small Group Exercises
After a review of the FAQ template for aligning consistent answers to questions and the 4-Step method to manage objections, workshop attendees worked in table groups of 3 to practice the 4–Step Method in a scenario-based exercise. The groups of 3 were designated as the HCP, MSL, and Observer. The HCP scenarios focused on one of four categories: 1) a safety concern, 2) HCP does not have enough time, 3) HCP says I cannot find a patient, and 4) HCP has a negative perspective.
Table Group Discussion and Comments
The feedback from the attendees regarding the scenario sessions was very positive. The attendees enjoyed the simplicity of the 4-step process and voiced that it was helpful to have an observer provide additional feedback about the use of the 4-Step method to work through the objections.
Workshop Survey Data
During the recap and closing of the workshop, attendees were asked to share a best practice they learned today. 82% of attendees responded with a plan to implement a better way to engage HCPs when faced with objections. Most respondents said they would ask more questions, be empathetic, listen, and clarify to understand the concerns being shared by an HCP/KOL. All these methods are reflected in the 4-Step Method.
This workshop emphasized the importance of continued training in objection handling with HCPs. Most attendees had not had any formal training in this area. Using the FAQ tool to standardize medical responses and the 4-Step method to process through objections are two important and effective mechanisms to help MSLs not get derailed when HCP dissent occurs.
Asking more questions, being empathetic to the HCP/KOL concerns, and not trying to fix it first are key components to overcoming these detours.
Learning to lean into HCP/KOL objections and not feeling like you must avoid, react, or escape from the topic are key elements to successfully overcoming objections. Additionally, using the simple scenario-based practice sessions to role play the 4-Step Method is another way to provide a continuous improvement opportunity for your team.
About the author:
Larry Dollar, PharmD, MS, MSL-BC
Larry Dollar has been a Senior Director and Field Medical Head at Takeda Oncology since 2014. Larry has also served in various MSL and MSL Director roles with Sanofi/Aventis, TAP, and Millennium Pharmaceuticals since 2000. He received his BS in Pharmacy from the University of Kansas, his MS in Pharmaceutical Sciences from the University of Missouri-Kanas City, and his PharmD from Idaho State University. His pharmaceutical career also includes experience in clinical research, medical research, and regulatory affairs. Larry currently lives in Prairie Village, Kansas, and enjoys spending time with his wife and four children.
Cherie Hyder, PharmD, MSL-BC
Cherie Hyder is a Syndicated National MSL Director at Syneos Health. In her previous job at Biohaven Pharmaceuticals, she supported a virtual launch of Nurtec ODT for acute migraine. She has been involved in drug development for more than 30 years, working at the FDA in CDER and pharmaceutical companies including Pfizer, Lilly, Novartis, Solvay, and Avanir, among others. At the University of Missouri, she received a Doctor of Pharmacy degree with the intention to devote her career to pharmaceutical research. She has multiple adjunct faculty appointments and enjoys teaching opportunities.