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All things Pharma

How Hygienic is Your Company?

It’s a great job really. So why are so many medical salespeople unhappy and looking to change jobs? Ed Alan tackles this question and examines how Hertzberg’s Hygiene Factors could help companies motivate and retain their field force.

How hygienic is your company? I don’t mean how clean the toilets at head office are, or even whether they pay you a car cleaning allowance. I won’t even contemplate the state of your car boot. I am going to talk about something much, much more important. Something that determines how happy you are in your job (and hence in your life), how long you stay in your current job, and even whether you will eventually leave the industry to do something entirely different.

So what is it that determines all these things? Well, it’s some little things called ‘Hygiene Factors’. Hygiene factors are a crucial part of a management theory written by Frederick Hertzberg. Now, before you switch off, I know most management theories have lots of holes in them, and many do not seem anywhere near as relevant to real life as their authors would like to think, but I believe that this one has a great relevance to every medical representative in the country, and possibly in many other countries too.

I meet a lot of medical sales executives and I am sorry to say that many – should I say most? – do not seem happy in their work. As a consequence of this I find they are often looking for a new job, yet when they get one they don’t stay long. Others just seem to mope on forwards, a bit like Marvin the Paranoid Android from The Hitchhiker’s Guide to the Galaxy, not enjoying life and wondering why things can’t be better – after all, it should be a good job, shouldn’t it? You get a good salary, company car, computer, free phone, lunch allowance, need I go on? So why are the salespeople I meet fed up?

Hertzberg’s theory

Hertzberg published his theory in the 1950s, but I think it’s still spot on for medical salespeople today. He was asked to look at 200 people working for a company in Pittsburgh. They seemed to have good jobs, well paid, good conditions etc, but they were always fed up and leaving to take other jobs. He needed to find out what was wrong. All the factors seemed to be there for motivation. There were good bonuses, appropriate targets to achieve and so on. So why weren’t they happy? He eventually found that there were two sets of forces at work. One set he called motivators – ‘positive motivators’ when they do motivate you to succeed or ‘negative motivators’ when they either fail to encourage you or even discourage you from trying in the first place. The other set he called hygiene factors, and again they can be positive or negative.

Positive motivators are things like achievable targets, good bonuses, league table success, recognition, opportunities for advancement etc. – all the things you expect a successful salesperson to want, and they are generally there in ample quantity. Obviously, occasionally they are not and we all know salespeople who feel their targets have been set too high, feel bonuses are too low, that their efforts are not recognised or that they have been overlooked for promotion. These are common negative motivators – demotivators.

All makes sense so far, doesn’t it? Motivate your salespeople and they perform well, demotivate them and they are unhappy. So why are so many successful sales professionals unhappy in their work, and still often considering leaving? I would argue that this is because of the set of factors that Hertzberg calls ‘hygiene factors’. Hertzberg said that hygiene factors do not provide positive motivation, but their absence causes dissatisfaction. Fulfilling them would prevent dissatisfaction, which then makes employees happier and more likely to remain with their company (and probably be more productive too). This, I believe, is where the pharmaceutical industry can really let itself down.

The motivators

Hertzberg found that there were five main factors that determine the level of job satisfaction. He insisted that these factors related to the job itself rather than other surrounding issues. These factors he called the motivators:
• The Work itself
• Responsibility
• Achievement
• Recognition for achievement
• Advancement.

I would suggest that most pharma sales executives get their greatest job satisfaction and motivation from seeing their customers (the work itself), then seeing the results of this reflected in their sales figures a few months later (achievement) and hitting their targets (responsibility). This escalates to seeing a bonus for the business brought in (recognition), getting league table success (recognition), getting recognition from others in the company (more recognition) and possibly seeing promotion opportunities open up (advancement).

The hygiene factors

The problem with hygiene factors is that they are hard to spot. They are quite insidious. You can be surrounded by hoards of negative hygiene factors, all of which are combining to make you feel as miserable as sin, but still not realise why you are unhappy – which brings me back to those salespeople we all know who are regularly leaving to try to find the company where the grass is greener! They know they are unhappy, but just cannot put their finger on why.

Herzberg came up with the answer, as he was the first to show that satisfaction and dissatisfaction at work nearly always arise from different factors, and are not simply opposing reactions to the same factors, as had always previously been believed. Though a set of positive hygiene factors will prevent you being dissatisfi ed, they will not motivate you. To be really effective a company needs to have both positive hygiene factors and positive motivators.

It is my belief that it is the quantity of negative hygiene factors that cause many pharmaceutical salespeople to feel the way I have described above, and to be regularly searching for that elusive ‘perfect’ job.

Hertzberg listed the five main hygiene factors as:
• Company policy and administration
• Supervision
• Salary
• Interpersonal relations
• Working conditions.

Company policy and admin

Ask any medical sales professional about the admin they do and what will the answer be? Almost invariably they will describe a situation where they feel rightly or wrongly that they spend too much time on admin, and that they are given a computer program that is poorly programmed and very user-unfriendly to record their calls. So straight away we have a negative on Hertzberg’s number one factor (Company policy and administration). Add in that company policy will often insist that these programs are used in particular ways that salespeople find increasingly frustrating, and we can start to see the root of the problem. Targeting is another area that I feel causes problems. Many salespeople feel that they are being asked to visit the wrong customers, with the wrong frequency, for the wrong reasons. Targeting involves both company policy and supervision, so now we have a negative against more of Hertzberg’s key points.


Interestingly, salary is considered a hygiene factor rather than a motivator, and often it is a perceived inequality in reimbursement that is the final straw that makes someone feel they will look for a new job. Often salary is the one measurable, definable factor that makes someone think their employer values someone else more than them. We can also add job grading in here, as many companies now have a series of grades for their field force. Again, this often gives rise to perceptions of inequality when colleagues are promoted for reasons they believe are not justified or without any transparent reasons at all.

Interpersonal relationships

Although field-based staff do not work in an office environment, they do spend a very closely supervised day with their manager every couple of weeks. During this day they interact far more closely with their manager than anyone in an office ever does. They sit in the car together, wait in surgeries together passing small talk, see the customer together and eat together, all followed by a serious debriefing and ranking session at the end of the day. In other professions this type of close inspection with the manager is either non-existent or only done every few years. No wonder we have problems. However, the problems I see are again either those of perceived inequalities – “Why does he seem to rate her better than me?”, or perceived lack of positive feedback – “He never gives me a pat on the back for all the things I do really well.”

The other bugbear is that, much of the time, salespeople feel that they are being told what to do, where to go and who to see by people who do not know how things work on today’s industry front line. They often believe that the people they only see once or twice a year at conference, who may have spent very little time making field visits recently, do not really understand what is needed or possible. I think this can be classed as a negative hygiene factor for both interpersonal relationships and supervision.

Working conditions

You would initially think that there is not much a pharma company can do about working conditions except offer nicer cars, and many already do offer very nice cars, but I believe this is a simplistic view. I believe that under working conditions, we have to encompass many of the points discussed above, but in the context of a typical working day.

From the minute they leave the house in the morning, pharma salespeople have to worry about hitting target doctors, getting the right call rate, getting past the various medical receptionists, battling for parking spaces, fighting traffic jams, getting a speeding or parking ticket, beating the competitor representatives to the call and how they will get to the next appointment in time. Then, when they do get home, it’s to hunch over that dreaded computer whilst trying to read the numerous emails they will have been sent – many of which they will feel are pointless – plan tomorrow, and enter today’s calls before the deadline – and all with the hustle and bustle of a modern household and kids going on around them!

So, to summarise: if a company wants to have well-motivated salespeople, it needs plenty of positive motivators; but if it wants to retain them and get the most out of them, it also needs to minimise negative hygiene factors as much as possible. If you can persuade your company to improve its hygiene factor rating, you will find you enjoy your work more, are more productive and more successful, and your company will benefit from increased productivity and reduced staff turnover. The savings in recruitment and training costs could be substantial, but when we add the benefits of having a well-established, well-motivated, stable workforce turning in increased sales figures, we can see how much could be gained by employing Hertzberg’s theories.

Ed Alan has been in the pharma industry for nearly 30 years in a variety of posts. He is professionally qualified in Marketing and runs Firefly Pharmaceutical Marketing Services – see www.fireflypharma.co.uk.

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