The expected evolution of pharma interactions: Live from physicians

[00:01] Get to know your providers get to know what their needs are get to know if they have. [00:07] A specific area of sub-specialized I’ve yet to see a farmer company come back and make a metric on how much information have you gotten back from that physician about themselves and how are you using that information to tailor the next response to that physician? [00:19] And how are you using data or AI at scale to do that? [00:26] hello and [00:28] welcome I’m Marc Iskowitz editor at large for MM+M [00:30] and I’m pleased to be joined by two amazing guests Dr. Osama Hashmi [00:34] who is co-founder of the company Impiricus and a practicing physician [00:37] and he’s joined by Dr. Tamara Green [00:40] a general neurologist practicing in Alpharetta Georgia [00:43] and they’re here to discuss the expected evolution of pharma interactions from the valuable voice of the physician. [00:53] Drs. Hashmi and Green welcome to the MM+M podcast [00:56] thank you. Thanks for having us. [00:58] Absolutely, it’s my great pleasure. [01:00] Just taking a step back for a moment. You know Impiricus is a company that leverages text and data. [01:06] to augment hcp engagement [01:08] and three years ago Dr Hashmi you and I did a podcast with another colleague. [01:12] And we discussed the fact that Physicians want access to medical content on demand. [01:17] But the industry still relies largely on a push model. [01:20] And since then. [01:21] Pharma has definitely progressed with its digital transformation and it’s moved toward Omi channel marketing. [01:26] but one thing that probably remains the same is that [01:29] gaining an Audience with and trying to connect with clinicians [01:33] remains a challenge so we’re going to talk more today about what Physicians see what YouTube specifically see. [01:38] as it disconnect with the current farming engagement model [01:41] and what’s missing you know and practice that Pharma could deliver and solve for Dr Green I’d like to start with you here. [01:48] Can you talk about your interactions with Pharma you know? What is that like these days? [01:52] Well, these days my interactions with farmer are not as frequent as they used to be when I first came out approximately 19 years ago. [02:03] There was a lot more interaction and [02:07] promise to the representatives were more engaging and they [02:10] took a lot more initiative to reach out to providers. [02:14] There’s significantly less face to face interactions as well as fear invitation to pharmaceutical dinners. [02:22] So, it’s a lot less personal than it used to be. [02:25] From my experience these days. [02:27] Interesting so you’re seeing sort of a pull back on those those dinner meetings types of interactions and correct not just dinner. [02:35] meeting just [02:37] to face taking the initiative and order to [02:39] reach out to providers to say hey and introducing themselves. Let me know. [02:44] What products are offering in? [02:47] Having that drive or that. [02:49] Initiative to educate providers these days in comparison to before. [02:53] interesting [02:55] Dr Hashmi where do you see things from your perspective? [02:58] Yeah, it’s it’s funny. I kind of see a similar threat as Dr Green so just [03:03] Yesterday I was in clinic and there was a Rep came and they dropped off lunch and clinical is running over so I was done with clinic around 12:30. [03:12] I went the lunch was there but the rep was gone. [03:14] And I’m it’s it’s interesting because you know I’ve had about the rep before was it was looking forward to speaking with her. [03:22] to know anything about the the drugs that that she was there to talk about but [03:26] I see. [03:27] Kind of Both Sides both from empiricus as well as from a physician one on a physician side yeah things are getting. [03:32] A lot less personal, I’m seeing more LinkedIn ads more kind of social media ads. [03:37] But at the same time. [03:39] They’re also not getting as targeted or as educational as I need. [03:43] So oftentimes I do see a Linkedin ad it’s for a drug that you know I’ve never prescribed or even for the wrong specialty. [03:49] And so there’s almost like this push away from personalization and in person. [03:53] meetings, but it seems like [03:55] they haven’t found the right personalised correct way to reach Physicians [03:59] as an in-between and so [04:01] there’s definitely something that we’re trying to solve at empiric is but something that I see kind of on a day-to-day basis, where I’m in practice. [04:07] No, we’ve seen in our own survey research work. You know a pullback. [04:11] In some of the traditional engagement methods like those dinner meetings. [04:15] speakers Bureaus that kind of thing and more money being put [04:18] into [04:20] connected television streaming audio and video [04:23] those types of you know digital types of Engagement channels. [04:26] And perhaps that’s you know you’re seeing that in real time. [04:30] But we also saw I think that the thing that was supposed to have kind of filled the breach here. [04:34] Was that more it was supposed to be more activity from the Medical Science liaisons the clinical affairs teams. [04:40] Kind of reaching out to you you know. [04:42] clinician to clinician type of you know not just a sales rep but more of a [04:47] of a clinical scientific based [04:49] Touch point are you not seeing that? [04:51] either [04:53] parsley haven’t seen any of that I can’t tell you the last time and Medical Science liaison even attempted to contact not only myself but any of my colleagues so [05:04] even though ideally that may have been the route that companies would have wanted to take. [05:11] Actually putting that into play forgive me they have dismally failed at it. [05:17] Yeah, so really great point and especially with the [05:20] advent of medical and the increase in focus on medical [05:24] From what I’ve seen especially with empiricus is that medical oftentimes has much more. [05:29] Targeted lists of people that they’re reaching out to so that physician to physician peer interaction. [05:34] Is not something that they’re going to do with every single physician. They’re going to do it with the top 10 kols quote unquote that they’ve that they’ve reached and you know it’s a whole discussion around are they mapping their kols correctly or the people that they’re speaking to actually the ones that have influence but regardless of whether or not they’re actually macbride’s. [05:55] basically untouched [05:57] and [05:58] how do you get peer-to-peer information or those interactions to those Physicians [06:01] when you’re [06:02] physical force is so small you can’t hire every single doctor in the world to detail every other doctor in the world is definitely a challenge that that this could become more and more apparent. [06:11] Absolutely, I would just discussing this the other day with. [06:14] An agency that’s in the medcomms area and they were saying we’re using. [06:19] AI to better and take an analytical approach to our kol mapping. [06:24] And who really has influence. [06:26] Is it traditionally may have been thought of you know only Physicians working at an academic medical center for instance? [06:31] but now it’s it’s kind of [06:33] there’s a recognition that there’s more than one type of influence and it’s instead of community level within a local level. [06:39] in certain populations there’s influence so [06:42] really good points there and it sounds like [06:45] Industries falling down you know and in a few different areas here so [06:50] Let’s drill down a little bit further. What do you see specifically? [06:53] As a disconnect with the current farming engagement model we started to talk a little bit of that up but and how you operate. What was the disconnect there between the what they’re doing and how you operate on a daily basis, Dr Hashmi started you started to talk about how you know the even the drugs that they were trying to detail you were not a match to your specialty to talk more about that. [07:12] Yeah, it’s interesting you know why was the rep so effective and why are certain reps so effective? It’s because they know me they know my practice they know how I want to get information. They know the types of patients that I see and so you know I’m seeing a patient on Monday I see a Rep on Wednesday [07:27] They’re talking specifically to that patient’s journey, so that’s kind of like why the rep was effective. [07:32] And now that there’s less face-to-face interaction. We’re trying to replace that with digital. [07:36] Oftentimes we’re missing those kind of really important data points on that position and how we’re delivering that information to that position, so it can be as big of a mistake as I’m getting marketed a drug that. [07:46] For a specialty I’m not even in but even small things as you know this pace in population is not the right patient population for for me or these patient assistance programs. You know if I’m seeing a lot of medicaid patients. They aren’t going to apply to me and [07:59] almost every physician still getting that same message so I think. [08:02] Personalization really needs to be there. [08:04] And then the second piece is you know for Physicians who aren’t getting those interactions. There’s a large number of Physicians that are wanting interaction right, but you look at a any pharmaceutical brand website or any pharmaceutical website. [08:14] it is [08:15] A million different links a million different clicks and eventually you get to a- contact form and half the time nobody responds to that contact form right, so there’s just a lot of areas where this can be improved, I think. [08:25] Absolutely Dr Green you’re shaking your head you want to build on that. Yeah. [08:29] absolutely just a piggyback off of Dr [08:31] Hashmi [08:32] disconnect [08:35] we need [08:36] and what they are attempting to [08:38] provide to us. [08:39] It’s a major disconnect case in point. [08:43] Just last week a pharmaceutical company or pharmaceutical rep. [08:47] Left me a voicemail about the newest COPD medication. [08:52] And as a neurologist that is something that I am absolutely not even interested in and so that goes to show that. [08:59] the [09:00] rep did not take the time the research I guess they just looked and saw that they were just [09:05] provider that’s currently in the Alpharetta area and then take the time to actually see what. [09:11] I did as a specialty and what my specialty was also in doing that research to see if they could assist me in any way so [09:18] I think making sure that you get to know so Dr harsh mean mentioned earlier. Get to know your providers get to know what their needs are get to know if they have. [09:27] A specific area of sub-specialized with neurology of course we have MS specialists we have dementia specialists we have. [09:35] neuromuscular specialists so [09:37] There are a lot of different aspects and areas of neurology just within itself. [09:42] That depending on the company there could be several opportunities for engagement that a lot of companies are just missing the ball on. [09:50] And the other thing. [09:52] that I don’t think a lot of [09:54] companies understand is these days especially for providers that are working at a lot of these academic institutions? [10:00] A lot of these institutions are limiting their providers. [10:04] exposure or interactions with pharmaceutical companies [10:07] I’ve previously. [10:09] worked at the kapp medical and prior to them joining with Emory Decatur [10:14] there was already that start to limit. [10:17] physician interaction with pharmaceutical companies [10:21] so in situations like that when there’s Limited in Casement with the academic institution. [10:26] Then you leave and you neglect those community providers and a solo practitioners such as myself. [10:32] That would love to learn what’s going on in the research world in the new world of medications. [10:39] And they just missed the ball in that often times. [10:41] Sure you being in a community doctor a solar practitioner. [10:45] You have just as much of not more of a need you know to know what’s going on in the research and with new medications. [10:50] As those who are affiliated as you say with the academic medical center. [10:54] And yet industry is missing those those MirriAd opportunities to connect with you. [10:59] And just doing a little simple research as you said, what are your subspecialties? What your main specialty for that matter? [11:05] Is being neglected? [11:06] And so I’m sorry I forgot to ask you Dr Green is are you an MS specialist? Are you migraine specialist? What is your particular so specialty? [11:16] Jealous specialised I have a colleague that is a couple of miles away. He’s a neuromuscular specialist. [11:21] one of my good friends, she’s a multiple sclerosis specialists so [11:25] they’re in you know and just speaking with them at. [11:28] They have not had in many interactions these days with farmer’s clinical companies and they said to quote them in forever. [11:36] Well, so that is Echo amongst your colleagues. [11:40] And Dr Hashmi what is your specialty? [11:43] I do general dermatology so I do work in a large multi-specialty practice. [11:47] So we have a lot of different type of dermatologists derm paths most surgeons as well. [11:52] and we have a fairly high number of [11:54] rep interactions but to that point it’s it’s a very Broad [11:58] kind of shotgun approach when it comes to our practice people come and drop in cards leaving lunches, but [12:03] very few real conversations [12:06] And that’s really surprising giving a given everything I’m hearing you know from. [12:09] the client side or the agency side in terms of The Hunger the appetite [12:14] To have you know those conversations. You know we here to doctors are so busy. [12:18] And we need to kind of target them very selectively and judiciously. [12:23] That the right time with the right message. [12:26] But it sounds like there was some larger problems here. [12:28] Do you want to articulate those? [12:31] In terms of what you see is missing. [12:33] Today and you’re practicing doctor he can stick with you on this one. Do you hear this a lot from your [12:38] Germ college as well. You know that the farm is missing the market and specifically what should Pharma like kind of deliver and solve for what’s the low hanging fruit? [12:45] I know this is like really tough to say and it sounds very high level. [12:48] but [12:49] going back to the what why the reps were successful. [12:53] It’s less about viewing me as an mpi number or as a certain script generator. Yeah, I’m a high volume for psoriasis or low volume for eczema. [13:00] But more so looking at me as an individual. [13:03] Or as a person who for me I graduated I was a chief resident Emery I’m still very involved on the academic side of things even though I work on a better private practice. I’m very involved with Pharma when it comes to empiricus but you know Farm a company’s when they talk to me. They know nothing about the empiricist stuff they know. [13:21] Very little about kind of my residency. They know very little about my current interactions with my peers. [13:26] And when you try to translate that into digital it gets lost even further it’s the equivalent of all of us getting sold to buy you know billboards or Instagram ads. [13:34] it [13:34] Is not targeted it’s kind of very broad and sometimes it feels creepy. [13:39] While on the other hand we as Physicians where we understand how this ecosystem works there’s so many drugs for us to keep track of it’s important for us to get that information. [13:47] But I don’t want to. [13:48] Deliver to me in a way, that’s like. I’m a sales person or I’m here. Just to like shove information down your throat it has to be kind of more personal and [13:55] if it’s related to things that are important to me as a person than it’s it’s better received, but I have yet to see a company do that when you say really related to you as a person meaning just some of those basic things you know Taylor don’t. [14:06] Detail me on on a drug that falls outside of my specialty you know autoimmune disorders when it’s eggs in our psoriasis that kind of thing or you saying. [14:14] I want to be approached. [14:15] in certain, you know Media channels, you know if I’m researching something and I mean Pharma has to really think clearly and we do this a lot of empiricus because we have SMS we can get to a communication but [14:26] When a Physicians talking to a Rep and you’re thinking about the metrics of how you’re measuring that rapid you know. [14:31] How long they’ve talked what information that has been delivered? [14:34] But I’ve yet to see a farmer company come back and make a metric on how much information have you gotten back from that physician about themselves and how are you using that information to tailor the next response to that physician? [14:44] And how are you using data or AI at scale to do that? [14:46] some of the work that we’re doing at empiricus but [14:49] It’s definitely not widely adopted amongst. [14:52] even the top Pharma companies and so [14:55] the conversation and evolution of an individual as a physician is is continuous. [14:59] and so having that 2A interactions like really important so for example with Dr Green [15:04] previously lots of rep interactions. [15:06] Still very interested in having correct interactions with pharmaceutical industry yet. [15:10] Is having limited interactions and so there’s a huge disconnect here that’s obvious. [15:14] And there’s a huge opportunity, so you know if any Pharma company wants to reach out to Dr Green she’s here. She’s on she’s on LinkedIn but [15:22] you know there’s you know hundreds of thousands of Dr greens out there that are just getting missed. [15:26] Yeah, what do you think is the low hanging fruit so to speak for the industry to better address your information needs? [15:38] That farmer could have delivered our the frequent updates regarding newer medications and particularly the savings programs. [15:45] also [15:46] and just how do I get in contact with the right person if I need something? [15:52] For example, I recently had an issue with getting approval. I mean these are newer medications of course with the migraine medications. [16:00] Does cgrp inhibitors? [16:02] They’re more expensive than say you’re older medications like the Amy tripling the japes that have classically been used for headache prevention. [16:10] and so [16:11] I was curious to know how do I get in contact with a Rep [16:16] to help me to guide my patients towards a patient saving programmes. [16:21] what [16:22] Offers they have or any information regarding newer medications. [16:26] from this cgrp world [16:29] and I honestly of course went on websites went on Google try to do the research. [16:34] And it’s Dr Hashmi mentioned. You’re just bombarded with so much. [16:38] Stuff and so much. [16:40] just [16:40] excuse my language crap [16:42] Then it’s hard to Narrow down and pinpoint and get the information that I need specifically for my patient so that’s a major gap that Pharma could help to could help me personally in regards to addressing. [16:56] But again I just in regard to getting that information and having it available quickly. [17:02] It’s not there and it hadn’t been there. [17:05] recently [17:06] sure and we’re seeing like some of the research work that we’ve done to sort of. [17:10] Unpack Pharma budgets and where the companies are spending money in their in their endeavours to engage with https like yourselves. [17:17] They’re taking money from the sales force. [17:20] Which is probably maybe perhaps by you’re seeing less of that personal engagement? [17:23] And they’re putting into what’s known as npp you know non-personal promotion. [17:28] Which you know at its most basic level probably includes things like email but it could also include anything from go targeting. [17:34] To other kinds of digital forms of outreach. [17:37] That are you know as the name implies non-personal? [17:40] But like you said what they’re missing the boat on is that even with npp? You still got a personalized it? [17:46] And so you need more data. [17:47] and that takes just old-fashioned research like you’ve been speaking about let’s kind of [17:52] switch gears for second and talk about how you see [17:55] Pharma engagement evolving [17:57] as we move forward Dr Green stick with you on this one. How do you see? [18:01] the Pharma engagement methods kind of playing out in the near-term hopefully improving [18:06] Yeah, and that’s on the same. I mean giving the increase in social media utilisation. [18:11] Email other means of digital communication ideally. [18:15] Digital engagement should be growing. [18:18] And continuing to grow exponentially. [18:20] many providers have a social media presence and so [18:24] when [18:25] ideas in order if [18:28] there’s less budget for those dinners or lunches whatever the case may be. [18:34] ideally a pharmaceutical representative could [18:37] research or provider and reach out to the provider via social media just to say hey this is who I am this is the organization that I represent. [18:45] I see your specialty is this and I see you do a lot of work with this. [18:50] Thus I’d love to talk to you about new products and we may have and our patients savings programs that we offer. [18:56] for these products that are catered towards your [18:59] patient population [19:01] great that’s great advice. [19:03] Dr Hashmi [19:04] yeah, I mean we we do this every day with with empiricus which is thinking about how to make. [19:08] things more personable to the hcp leveraging data leveraging AI to make sure that the [19:14] messages that are being sent are relevant to the hcp. [19:17] The other pieces and and this sounds so basic, but something that I didn’t expect coming into working with far most empiricus. [19:24] Is there is really a lack of Physicians in the room at the table? [19:28] involved with even metric creation [19:31] How are we measuring whether a campaign is effective or not effective outside of just scrip lift? [19:35] whether it’s [19:36] in terms of patient impact [19:38] We recently just sponsored an award at fierce Pharma where it’s an hcp innovation award where we have a group of Physicians actually. [19:46] Rating and judging marketing campaigns saying hey was this useful was this innovative was this interruptive. [19:52] And it’s more things like that. I think farming needs to be doing I think. [19:56] traditionally Pharma [19:57] almost has self-diagnosed itself in a way. That’s like. Oh we can’t be interruptive we have to be you know on the side. We have to be really careful about working with the doctor’s but I think really. [20:07] Far many needs to understand that we have to work handed hand there’s so many medicines. There’s so many different you know insurance programs are so many different financial barriers to patients. [20:16] And so there’s a lot of value add that can be created but we all have to be at the room together. It can’t be. [20:21] Me at as a doctor on one end. [20:23] And you trying to yell at me and shove lunches at me to make me understand something and it has to be more of a two-way collaboration I think. [20:30] insurance innovation definitely requires partnership and collaboration [20:34] and as marketing evolves, it’s really telling to hear you say. [20:39] that that loss of personalization is is being felt and so [20:43] I think it just there needs to be a redirection a Resurgence of that in the appropriate channels like Dr Green was saying through social. [20:51] There’s ways to do it and intelligent way. [20:54] And as you said Dr ashmi 22 measure the impact. [20:57] On patient outcomes from the opinion of you doctors of your clinicians to find out whether those marketing campaigns are really hitting the mark. [21:04] Instead of self as you said self that diagnosing themselves. [21:08] So, let’s just kind of finish up with one last question here with you on this doctor asked me. [21:13] How can Pharma deliver more personalized experiences to hcps? [21:17] Use empiricus no. [21:19] The real the real answer I think. [21:21] We’ve worked with so right now at empiricus we work with. [21:25] dozens of Brands 17 of the top 20 Pharma companies [21:28] there is a distinct difference between pharmaceutical companies that have the right culture and pharmaceutical companies that have the wrong culture and I want to. [21:34] Speak a little bit to that so I think the first step is from a culture perspective understanding that. [21:39] This ecosystem doesn’t exist in siloes, it’s not commercial versus medical versus it. [21:44] Everyone has to work together and bring the Physicians in the room and bring the patients in the room. [21:48] And have a culture of actual growth which is an I’m just trying to hit my metric and call my you know 12 doctors every week. [21:55] and you know detail x amount of [21:57] pieces of information but more so how do we actually move this industry in a way that’s actually. [22:03] Helping the right medicine get into the right hands of faith patients and it’s very very clear when we’re working with the Pharma company those companies that have that culture in place vs. The [22:11] Companies that are simply just trying to meet their numbers for for the quarter, so I think that’s the the first step. [22:16] And the second Step is I think just more openness to collaboration with Physicians there’s definitely a lot of innovation. That’s happening. [22:23] You know within empiricus we have you know our programs that are working within this top 20 Pharma companies, but we also have. [22:28] More innovative programs and you know those types of things. I think are always going to push the needle as we try to make this transition. [22:34] That’s already happening away from face to face but doing in a way. That’s productive and actually beneficial to doctors as opposed to you know more emails more spam. [22:42] more [22:43] lost in the maze of of websites [22:46] Yeah, and before I get your take on this doctor you’re going to just want to follow up for your doctor Hashmi you know. [22:50] You say there– needs to be more of an openness to collaborate with Physicians on the part of industry. [22:55] Obviously, there’s you know as Dr Greene was mentioned earlier A lot of institutions now. [23:00] Have no see Dr policies on the books. [23:04] And you know more and more doctors. [23:06] Are employed you know by large institutions so I think the industry is kind of coming up against that and you know years ago was the sunshine laws and you know the onerous. [23:16] Documentation needed for that and but you’re saying that nevertheless there are. [23:20] Plenty of doctors who are not operating under the shackles of these kinds of no c policies or policies that restrict interactions. [23:29] With reps and Industry should be undaunted. [23:32] In you know nevertheless trying to collaborate. [23:35] We want yeah for sure address the regulatory landscape for a second yeah, and I worked at academic Medical Center we have a lot of Physicians who are part of academic medical centres within our network. [23:44] Who do have no see a policies in place? And there’s there’s two things that I’ve seen happen at. [23:48] One is even from these large. You know medical centers and from these large groups. We’ve had leadership. Come to us saying hey you know we’ve banned the face-to-face meetings. [23:55] But we understand this is still valuable for our patients. We understand this still valuable education for our Physicians [24:01] How do we make this happen in a collaborative way so I actually view it. You know there’s an opportunity for the next step of interaction there. [24:07] And in the second piece which is probably a lot more important is that? [24:10] When you are approaching a physician not as a sales. [24:14] person but more so as [24:15] a colleague whether it’s you know here’s an important piece of information for a patient that’s going to help them or some piece of financial assistance. [24:23] Nobody’s going to turn you down no administrators going to say oh, no, you can’t talk to this doctor because you’re trying to help this patient. You know get on this really expensive medicine. [24:31] But it has to be value-driven it just can’t be a lunch a lot of these you know academic centres are. [24:36] banning basically that [24:37] person coming in dropping a lunch and leaving which I actually think is totally fine. [24:41] But there are open to these interactions. They’re not going to stop and you know assume meeting from happening. They’re going to they’re not going to stop of telephone call from from happening. They’re not going to stop you know collaboration happening over email if there’s something specific on it on a patient that’s that’s typical client so [24:55] there are avenues for collaboration but [24:57] It can’t be superficial it can’t be salesy it has to be. [25:00] patient-driven impact driven [25:02] great, thank you for articulating that. [25:04] And Dr Green will give you the last word here. How can Farm a deliver more personalised experiences to hcps? [25:10] just [25:11] my personal experience I can [25:14] Emphasize iterate enough, just to get to know the ATP the provider that you want to cater to I don’t look like your typical neurologist. [25:23] so there have been several times in which [25:26] farmers have walked into the office. I’m standing right there. [25:30] I speak to the Pharma I don’t get a word back, but they look to the medical assistant or the office manager and say hey. [25:36] can I speak to Dr Green [25:38] When I’m standing right there. [25:40] So it’s interesting. [25:42] How many times that happened how many times that? [25:47] I wouldn’t get any type of Engagement from the farmers, but they would ask for Me by name directly I would be standing there and they would not say a word to me. [25:58] So again, it is super important to emphasize that you have to know who you’re coming to see in who you want to cater to. [26:09] Because you never know what your doctor looks like. [26:13] It’s a not pleasant being treated like the invisible man. I would imagine oh. [26:18] we [26:24] find a no go for me because [26:26] I’m what I’m not and I believe in treating everyone equally so if you treat your position as such then. [26:37] who knows how you’re going to treat the next person on the street and [26:41] I personally. [26:42] do not believe in entertaining that type of Personality [26:46] yeah, so sorry people you don’t. [26:48] Get a second chance to make a first- impression that yeah forgiveness is something I’m still working on. [26:55] that time is is way too valuable for that sort of nonsense so [26:59] I hope that situation you know is improving and doesn’t happen too often anymore, but I could see it does and that’s [27:07] that’s definitely a shame but know who you’re coming to see you know you’re coming to visit do your research. [27:13] It’s not complicated folks. [27:14] I want to thank you both for articulating so well the importance of using data and an AI if it makes sense to make sure that messages are relevant to hcps. [27:25] And the avenues for collaboration and the right ways to do it you know making sure it’s value-driven. [27:30] patient-related message patient system assistance program [27:34] not just a lunch. [27:35] You know once we have that hopefully we can get hcp engagement back on the right track and correct. [27:41] Some of these areas where it’s falling down frankly. [27:45] Pleasure talk to you both. Thanks so much for your time. [27:47] All right, thanks for having us. [27:49] absolutely [27:50] okay, so that was doctors Hashmi and green. [27:53] And it was a great conversation come back for another one. [27:55] This is been Marcus with for the M&M podcast to take everybody.