Corporate Headquarters: 12196 East Sand Hills Road, Scottsdale, AZ 85255 Regional Office: 5 Great Valley Parkway, Suite 180, Malvern, PA 19355 TEL: 877-805-7909 www.gottochange.com

©2015 Delta Point, Inc.

Changing Habits:

A Selling Strategy for

Life Sciences Sales Representatives

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Habits are Pervasive "We are what we repeatedly do. Excellence, therefore, is not an act, but a habit." [Aristotle]

Aristotle had the right idea. Building good habits is one way to improve performance and effectiveness. It’s an essential part of any quest for success.

Habits have been developed over time as a way to help individuals get through their day—they are things that people do without thinking about them. If habits didn’t exist, it would be nearly impossible to accomplish anything because each minor interruption and distraction would require conscious thought and effort.

However, there are times that habits keep folks stuck in a pattern of behavior that’s less than ideal. You might find that you’ve gotten in the habit of asking questions of your customers that just don’t seem to be working the way they used to. When you learn that there’s a better way to ask questions, it makes sense to break that habit of asking questions as you always have and instead develop a new habit of asking questions that are more effective.

Although you may not have thought of your customers in this context before, you’ve likely identified some of your customers’ habits. There are some physicians who like to engage in small talk first. Others have developed the habit of beginning the conversation by getting right down to business. And whether they realize it or not, they probably have gotten in the habit of using a specific product when they routinely encounter a patient with certain symptoms—they automatically prescribe product Z. They do this so often that they may not be consciously aware that it’s a habit—because by definition, habits are done without thinking.

Knowing how to change habits can help you become a better sales professional—not only to develop good habits in terms of your self-development and selling skills but as a tool to help your customers realize that their choice of treatment option may also be due to habit.

How Habits Are Formed Understanding how habits are formed can provide some insight as to the best way to break those habits that are no longer productive and instead, create new ones.

A habit has three distinct components:1

1. The cue (for the automatic behavior to start) 2. The behavior itself (built on repetition so that it becomes routine) 3. The reward (which is how and why the brain remembers this pattern)

Creating a habit is a process. You do something that provides positive feedback and/or gives you pleasure, and then repeat that behavior to obtain that good feeling again. For example, you begin your sales conversation with a certain opening and the physician responds positively, so you try this same opening with another practitioner. Eventually you develop a routine of starting your sales conversations with this type of opening and it becomes a habit.

1 Charles Duhigg, “The Golden Rule of Habit Change,” July 17, 2012, post on blog “PsychCentral,” http://psychcentral.com/blog/archives/2012/07/17/the-golden-rule-of-habit-change/, accessed September 2014.

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The human brain sends messages that encourage repeating those behaviors that bring pleasure. You take a bite of chocolate and because you enjoy it, dopamine is released in your brain. That dopamine creates a memory between that bite of chocolate and its yummy taste (the reward). Dopamine is quite powerful—it controls that area of the brain that is responsible for decision making, motivation and desire. So the next time you are exposed to chocolate (which becomes a cue or trigger), your brain releases some dopamine which sends a signal to you to take a bite. When you do, that memory of pleasure is reinforced. It becomes a never ending cycle—and a habit.2

The process sounds so innocent. You enjoyed doing something. Your brain is wired to steer you to replicate that pleasurable experience which makes you want to do it again and again. So just how do you break the cycle?

You fight the process with process. You keep it simple—which takes advantage of how the brain enables change. Although the steps to break a habit may be easy to understand, the process is much harder, as any smoker who has tried to quit 6 or 7 times can attest to. Changing a habit requires hard work, dedication, time and practice.

Building New Habits Breaking a habit is an inaccurate description of what actually happens. You don’t literally sever that habit connection in your brain. Instead, you make new pathways that overlay the old. And it’s not as easy as it sounds.

Your brain contains one hundred billion neurons and each individual one is connected to thousands of others. Conceptually that large number can be hard to grasp but a quick explanation can provide an indication of how complex the brain really is. If it were possible to count all 100 billion neurons at the rate of 1 per second, counting continuously, nonstop, it would take 3,171 years! When you consider changing a behavior that’s become a habit, you’re trying to rewire literally hundreds of thousands of cells in a very complex and interconnected system, according to neuroscientist Bruce Wexler, MD.3

So in reality, you don’t get rid of your old habits, you build new ones. And that’s why it is harder to change existing habits. Those habit pathways are already established and interconnected. When you change a habit, you are changing the wiring in your brain.

The process of building a new habit is accomplished by implementing three steps:

1. Create awareness and desire 2. Gain commitment to try to break the habit 3. Take action with repetition over time

Create Awareness and Desire

At some point, something happens that makes you think that what you are doing (this particular habit) is no longer helping you and you want to do something differently than you

2 Rebecca Skloot, “Why Is It So Damn Hard to Change?” January 2007, post on blog, “Oprah”, http://www.oprah.com/health/How-to-Change-Your-Bad-Habits, accessed September 2014. 3 Ibid.

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have always done. That’s when you develop awareness that you want to change. But knowing that you want to change is not enough. You need to understand why you do what you do before you can change it.

Most people don’t pay attention to what causes their behavior. It’s easy to understand why they’ve stopped noticing. Habits by definition are done without any conscious thought. So even though you may become aware of a habit that is no longer beneficial, there needs to be that desire to change.

You can’t effectively change any behavior unless you involve your emotions. You may be aware that there are better ways to close the sales conversation and ask for a commitment. But logic alone won’t motivate you to change—you need to feel that tug of emotion. In fact, scientists have come to realize that emotions play a dominant role in the decision making process. When deciding to change a habit, identify that feeling that can fuel your desire to do something differently.

To summarize, the first step to replace an old habit with a new one is to become aware of the need to change and identifying the emotional reason(s) to change. It helps to think of the rewards/benefits that this change will bring.

Gain Commitment

To be successful, you need to be committed to want to change. You need to be prepared to work hard. After all, you need to fight against all that wiring in your brain that sends messages to continue doing things as you’ve always done them.

Although concentration and repetition are required, you will be more successful if you figure out how to trick your brain. You begin by convincing yourself that this current behavior is no longer worthwhile. That there is a better alternative. This involves consciously thinking about that behavior you want to change—which is difficult because habits by definition are done without thinking about them. Visualize the process. Think in terms of those small steps you can take now to make this change in the future.

Using effective strategies and keeping the end goal in mind can make a difference. One way to do this is to ask others to help you. When you ask others to support you in your desire to change, it’s another way to hold yourself accountable. Knowing that you need to keep others informed of your progress (or lack thereof) can provide additional motivation to remain committed to change.

Take Action

Taking action is the actual doing—changing that behavior through repetition over time. Your brain rewards you when you do what you’ve always done so don’t expect this process to be easy. Instead of thinking “how can I break this habit?” it’s more effective to think of “what can I replace this habit with?”

Remember that emotions drive actions. How will you feel when this change is made? Keep that reward in mind, especially when setbacks occur. Be prepared to deal with mistakes and failures by identifying ways to reinforce this change you want to make. Use techniques such as self-speak and visualization to provide reinforcement.

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Habits are tied with rewards. When you do this particular action, you get rewarded. Therefore, it makes sense to replace the habit you want to break with some action that will provide a similar reward.

This need to replace a reward with something similar helps explain why those nicotine patches weren’t as successful as originally envisioned. Although nicotine, which is the addictive substance of cigarettes, was still available to the body though those patches, smokers often found that they wanted something to do with their hands. They were accustomed to the feeling of holding that cigarette. To replace their smoking habit, many discovered the need to develop a new habit that kept their hands busy.

Your Customers’ Habits Although the process of changing a habit remains the same whether it is your habit you want to change or your customer’s, it helps to realize why these habits were formed in the first place. On either a conscious or subconscious level, your customer receives benefits from this habit and may be thinking:

This habit streamlines my decision making.

Writing this script for this product makes my life easier. I don’t have to think about the details.

Unless I hear a really good reason to change, I will continue to do as I have always done and write this product.

Awareness

The first step is the same—your customer needs to develop awareness of the habit. Customers may or may not recognize the role that habits play when deciding which product to choose for a patient.

For the customer who does not recognize that habit plays a role in choosing which product to use, you may want to say something like…

“I’ve learned from talking with other physicians that many of them would prescribe our product a little more if they weren’t already in the habit prescribing X. Is it fair to say that that’s one of the things that keeps you from thinking about our product a little more often?”

There could also be those practitioners who come to realize on their own that habit is one reason they are not writing your product. Regardless of whether or not the customer introduced the concept of habit, once your customer agrees that habit does play a role when deciding which treatment option to select, you’ve accomplished the first step of changing a habit—developing awareness.

Commitment

The next step is for the customer to become committed to change. Some sales people have found it effective to acknowledge how difficult it is to change a habit:

“Habits are really necessary—they enable us to be more efficient as a human race. But I also know that habits are incredibly difficult to break. And we don’t break them unless we want to. So when you share with me that habit could be one of the reasons you don’t

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think about our product a little more often, I interpret that to mean that I haven’t given you enough reasons to really want to break that habit. And I want to change that today.”

Therefore, you need to give at least one really compelling reason to break a habit. Come prepared to build a powerful case that will motivate that individual practitioner to want to break that habit and replace it with a new one. Remember to include both rational and emotional reasons because the customer needs to have the desire to change.

Take Action—the Reward

To help the customer take action you need to assume ownership of providing those compelling reasons to change and start using (more of) your product. By asking questions and through meaningful discussions, you and your customer can identify the specific emotions and reward(s) that this new habit can offer:

How will the patient feel when they take this different medication?

Will the physician find the side effect profile reduces the number of call backs that they receive?

Will this new treatment option make it easier for the patient to remember to take their medication?

Will the doctor spend less time during the office visit explaining the treatment option?

You could even suggest that the healthcare professional could work with their patients to help them identify how to get in the habit of taking their medication as prescribed.

One way to ensure success is to identify reminders of the behavior the practitioner wants to change. One place to begin may be to change the environment. These don’t have to be physical reminders but they do need to be specific enough to interrupt a person’s normal thought processes.4

Remember, change will happen only when the individual feels the need to change. The prerequisite is for you to provide those compelling reasons to change.

Your Selling Habits When calling on customers over a period of time, you may come to realize that you need to break the routine and conduct your sales call differently. To help you break this habit, you might want to communicate this need for change to your customer. Here’s an example of what you could say:

“Can I tell you something that blew my mind the other day? I was driving down the road, thinking about this seminar that I just attended, and I suddenly realized that in the last 2 years of calling on you, I’ve taken the wrong approach. This webinar forced me to step back and rethink how I was doing my job and interacting with you. I’d like a chance to start over and instead of selling you today I’d like to take this opportunity to ask you questions, to pick your brain so to speak. Would that be alright with you?”

4 Chip Heath and Dan Heath, Switch: How to Change Things when Change is Hard (New York: Broadway Books, 2010) p. 211.

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Then be prepared to ask questions that will help you gain insight into the thought processes of that individual practitioner:

“You have multiple treatment options when it comes to treating this disease. How do you decide which one to select for an individual patient type?”

“How did you come to that conclusion?”

“What differences do you see among the products in this class that are real versus the ones that don’t matter much at all?”

Your objective is to learn your customer’s beliefs. Because beliefs drive behaviors, you can’t change a behavior (such as choosing product Z to treat this patient) unless and until you understand the belief behind this behavior.

Changing your approach in this manner shouldn’t be restricted only to the physicians. Practice on everyone you meet. Treat everyone as if they are important because they are. Utilize the opportunity to engage other key stakeholders as a chance to practice and build rapport. (Remember repetition is required for new habits to be built).

Ideas and Strategies for Change When you are trying to change something, especially something that seems so difficult to do from the onset, it makes sense to learn what others have done to be successful. Thanks to the plethora of research and studies about habits and how to change, there are some successful strategies that will help you fight the battle as you struggle to change your habit.

As you begin to take action, keep topmost in mind your ultimate goal in adopting this new habit. Ambiguity can hinder building new habits. It is easier if there are clearly defined rules to follow. To be successful in building new habits, you need to identify the critical moves.5

Keep It Simple

Breaking the habit into simpler components is one way to increase your success rate. This will help you gain confidence as you begin to see and experience how much of a difference simple uncomplicated changes can make. For example, if you want to build the habit of asking more effective questions, you may want to break down the question to its basic components: intent, content, and condition.

Intent reflects your mindset as you pose the question. Why are you asking this particular question?

Content is the meat of the question. What exactly do you want to learn?

Condition refers to how this question makes your customer feel. Does this question make your customer feel defensive? Or does this question create a safe environment that fosters an honest dialogue?

Focus on developing awareness of and changing just one aspect at a time. As you gain confidence, you can incorporate the other components, building in complexity. You soon will

5 Chip Heath and Dan Heath, Switch: How to Change Things when Change is Hard, p. 209.

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experience a difference in your customers’ responses as you start asking more well-designed and thought-provoking questions.

Savor the Small

When your customers have become accustomed to prescribing product Z for this particular patient type, odds are they’ve experienced success in this approach and are unlikely to believe that what they are currently doing is not the best choice. You’re not likely to sell someone on the idea that your product is dramatically better than what the customer is already using when the customer has that mindset.

That’s why a better approach might be to find just one aspect about your product where it makes sense for the customer to use it—and not completely displace what they are currently using. Think in terms of your product’s unassailable position.

If you ask for a lot, you wind up getting very little. Asking to replace their workhorse product with something else (your product) has a very low probability of success. Conversely, if you ask for a little, you get a lot. If you can uncover one particular aspect where it would make perfect sense for your customer to try your product, that’s how you’ll get more business. You will have “broken” that habit of always writing product Z. After using your product and reaping its benefits, the customer will likely want to expand its usage.

Set Realistic Timeframes

Habits are developed over time by repetitive action. Therefore, it’s unrealistic to expect that you can build a new habit quickly. It will take time. Many people start the process of changing a habit with the mindset that it will take 21 days. This timeframe has been the accepted rule of thumb as to how long it takes to break a habit. Yet recent research has confirmed that this timeframe is inaccurate.

The time required to change, to stop doing something one way and/or to start doing something new so often that it becomes a habit, is variable. It is a function of many factors and there is no accurate timeframe. You can blame it on your anatomy. The human body has finite resources and there will be other demands for your time and attention that will interfere with your attempt to build a new habit. This means that you should not become discouraged if you find it takes you longer than you originally planned to change a habit.

This also applies to your customers and their ability to change their habits. Try to think of ways you can provide reminders and reinforcement of the habit they want to build and enlist the help of staff members, if possible. Communicating realistic timeframes can help prevent customers from feeling discouraged when change doesn’t happen as quickly as they’d like.

Understand the Role of Stress

Stress plays a role in how you interact with your environment. According to research psychologist Michael Schlund, when you encounter stress, your body releases hormones that inhibit the frontal lobe—which causes the brain to revert to the learned behaviors of habits.6

6 Rebecca Skloot, “Why Is It So Damn Hard to Change?”, accessed September 2014.

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You can view this as another way your body is sending a message not to change that habit. This explains why despite your best intentions, when something stressful happens as you start your sales conversation, you find yourself opening the sales call as you always have, even when you’ve been working hard to implement a new opening. Something triggered a stressful situation and your brain directed you to go with the safe tried and true approach.

Change the Environment

Undoubtedly, the current environment contains cues that will trigger the old habit to occur. That explains why some people will wait until they are away on vacation before they try to change their habit. They don’t want to be surrounded by reminders that prompt them to do what they now want to change.

Fortunately, even small changes to your environment can be a reminder to do something differently than you’ve always done—and provide that reinforcement to build that new habit. It could be as simple as changing your phone to your other pocket so when you go to look at the time and/or make a phone call, you get a physical reminder to do something different.

Look for ways to change a part of your customer’s physical environment. Is it possible to move the trash can to a different location in the exam rooms? That could serve as a trigger to do something differently.

Use Action Triggers

Because habits are done without any conscious thought, it makes sense to look for something that can serve as a reminder of the need for change. It’s not always possible or sensible to have a physical reminder to change—and that’s when mental reminders can be very effective. In fact, some might argue that the mental reminders are more impactful.

This approach requires identifying something, such as a particular situation, which can serve as a trigger to do something differently. When situation Y occurs, you will do Z. When you use your imagination to envision a time and place that you’ll implement this new behavior, you are engaging a powerful motivator to change. These are called action triggers.7

Psychologists Peter Gollwitzer and Veronika Brandstatter created a study to demonstrate how effective this technique can be. College students were told they could earn extra credit by writing a paper about how they spent Christmas Eve—and the paper was due on December 26. Although many students indicated that they would complete the assignment, only about one-third actually did. A different group of students was given the same assignment but different directions. They were directed to identify exactly when and where they would write the report (action triggers). That act of creating a visual image of writing the paper made quite a difference—75% of those students in this group wrote that paper and submitted it on time.8

Help your customers visualize what they want to change and how they will feel once they’ve accomplished this. Perhaps you can enlist the help of the nurse or medical assistant who reviews the chart before the physician sees the patient. When a patient fits the profile, the

7 Chip Heath and Dan Heath, Switch: How to Change Things when Change is Hard, p. 209. 8 Ibid.

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nurse or medical assistant could provide a verbal reminder (or even a code word) to the physician before they step into the exam room and meet with that patient.

Summary How to build a new habit is a straightforward process to understand—it requires 3 steps:

1. Create awareness and desire 2. Gain commitment to try to break the habit 3. Take action with repetition over time

In theory, this process seems relatively simple. In application, it’s a lot harder. Dale Carnegie, author of the bestselling book How to Win Friends and Influence People, wrote a book dedicated to change. Yet he admitted that these ideas would be difficult to put into action: “You will probably find it difficult to apply these suggestions all the time. I know because I wrote the book, and yet frequently I found it difficult to apply everything I advocated.”9

The way habits are formed with their interconnected neurons in the brain makes changing any habit a rather difficult undertaking. Therefore, it’s helpful to begin any effort to change a habit with the expectation that there will be failures and setbacks. Blame the hard wiring of your brain and not your lack of effort.

Plan for these setbacks and be prepared with reminders of how to get back on track. Be patient and recognize that building new habits will require persistent and consistent actions over time. Focus on what is possible, what you’ll feel like when this new habit is formed and the benefits you’ll derive.

It also helps to explain this process of building habits to your customer. When encouraging them to develop the habit of using your product for those appropriate patients, keep things simple. Identify a small subset of those patient types who would likely benefit from your product. Starting small can reap great benefits as customers begin to change their prescribing habits.

Perhaps the best way to summarize how important habits are is to share the wisdom of Mahatma Gandhi:

“Your beliefs become your thoughts, Your thoughts become your words, Your words become your actions, Your actions become your habits, Your habits become your values, Your values become your destiny.”

9 Dale Carnegie, How to Win Friends and Influence People (New York: Pocket Books, 1981), p.xxv.

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Appendix: Suggested Reading • Psycho-Cybernetics by Maxwell Maltz

• Switch: How to Change Things when Change is Hard by Chip Heath and Dan Heath

• The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg

• The Power of Focus: How to Hit Your Business, Personal and Financial Targets with Absolute Certainty by Jack Canfield, Mark Victor Hansen and Les Hewitt

Corporate Headquarters: 12196 East Sand Hills Road, Scottsdale, AZ 85255 Regional Office: 5 Great Valley Parkway, Suite 180, Malvern, PA 19355 TEL: 877-805-7909 www.gottochange.com

©2015 Delta Point, Inc.