From Ambassadors to Messengers: Rethinking the Role of Medical Representatives in Indonesia's Pharma Landscape

In Indonesia, the role of the medical representative (MR) has evolved uniquely, diverging significantly from its origins and practices in other parts of the world. To understand this, it’s helpful to look back at the early days of the profession, which began in Japan in 1912, when F. Hoffmann-La 罗氏公司 introduced the role of the “propagandist,” or "propah," as it was called there.

The very first “propah,” Shohei Ninomiya, was a pharmacist who transitioned into this role under the guidance of Dr. Rudolf Ebering. His job was not sales-centered but focused on educating doctors about the company’s products, a principle that prioritized knowledge-sharing over direct selling. This role, though rooted in Europe’s non-sales-focused approach, gradually changed in Japan in the 1970s and 1980s as local companies leaned heavily into a sales-centered model, which sometimes led to issues.

Fast forward to today’s Indonesia, where the MR’s role resembles neither the educational approach of early propagandists nor the fully sales-driven methods that followed. Often working alone, many MRs in Indonesia encounter doctors only briefly—sometimes outside clinics or even near hospital parking lots. Here, MRs deliver brochures, quickly collect signatures, and move on, with the interaction often lasting under two minutes. The lack of substantial engagement has led MRs to function more like messengers, distributing information without fostering the kind of professional relationship the role originally emphasized.

But who’s responsible for this shift? It isn’t necessarily the doctors, who often juggle multiple roles across various locations and have limited time to spend with MRs unless new information is truly valuable. Repeated “reminders” or routine updates about existing drugs rarely pique their interest, leading many doctors to simply sign off on the tablet without engaging further. While companies have tried to modernize the MR’s toolkit with digital tablets replacing paper notebooks, these tools haven’t changed the essence of the interaction if the content itself is lacking.

This raises an important question: Is the missing link the quality of the content or the delivery method? MRs need more than just digital tools—they need compelling, relevant content that aligns with doctors' clinical interests and respects their time constraints.

Key Challenges Facing Medical Representatives

1. Limited Access to Doctors: Doctors in Indonesia frequently work across multiple clinics or hospitals, leaving them with limited time for interactions with med reps. Unlike many regions where doctors may have scheduled hours for pharma interactions, Indonesian doctors often have unpredictable schedules and are inundated with patient loads, which restricts the time they can spend discussing products or innovations with reps.
2. Pressure to Achieve High Sales Metrics: Many med reps face significant pressure from their companies to meet high sales targets. This sales-driven culture tends to overshadow the educational and relational aspect of their role, which was traditionally more focused on information sharing and support rather than purely on conversions. Reps, therefore, may feel compelled to prioritize quantity over quality in their engagements, reducing their credibility as knowledgeable advisors.
3. Cultural Expectations and Trust Issues: In Indonesia, trust and familiarity play a significant role in business relationships. New med reps, or those who are unable to build a rapport quickly, may struggle to gain a doctor’s trust and attention. Without an existing relationship or strong introduction, some doctors may prefer minimal interaction with reps, viewing them more as “outsiders” or only sales-focused, especially if there is no new or differentiated value in the rep’s message.
4. Reliance on Outdated Engagement Methods: While tablets and digital tools are now widely used for documentation, the content shared is often still in the format of static brochures or general presentations. Doctors, however, expect more dynamic, tailored, and interactive forms of engagement, such as insights into patient care trends, case studies, or real-world efficacy data. Static presentations fail to capture the doctor’s attention or add much value to their knowledge, contributing to the perception of reps as mere “postmen.”
5. Lack of Localized and Relevant Content: Many pharmaceutical companies in Indonesia rely on globally standardized content that may not always resonate with local doctors’ needs. For example, treatment protocols or drug efficacy data from Western populations might not apply to Indonesian demographics, yet reps are limited in adapting the content. Doctors are looking for locally relevant insights, particularly data specific to regional health concerns, that global companies don’t always provide.
6. Regulatory Constraints: Indonesia’s pharmaceutical industry is regulated by complex compliance requirements, which limit the extent to which med reps can discuss certain aspects of products, especially those that fall outside approved indications or are not yet widely endorsed. Regulatory constraints make it challenging to deliver a complete and engaging message, leading to a more restrictive and less informative interaction.

Solutions to Address the Gaps in Engagement

1. Developing Targeted, Locally Relevant Content: Equipping med reps with data and insights that are specific to Indonesian patient demographics, health trends, and medical practices can bridge the relevance gap. Tailoring content to fit the local context, such as Indonesian-specific case studies or highlighting success stories within the region, can improve the rep’s credibility and value.
2. Enhanced Digital Engagement and Multi-Channel Approaches: Besides face-to-face meetings, companies can introduce virtual tools and platforms that allow doctors to engage with reps at their convenience, such as through online Q&A sessions, or a dedicated mobile app. These virtual interactions can support more flexible and productive engagement, allowing med reps to provide value even when in-person visits are limited.
3. Sales Training with a Focus on Relationship Building: Reorienting the med rep’s role towards relationship management, rather than just sales, can rebuild trust and credibility with doctors. Reps should be trained in communication strategies that focus on understanding the doctor’s priorities and aligning with their needs, creating a sense of partnership rather than simply selling.
4. Creating Feedback Loops: Implementing a system for doctors to give feedback on rep interactions allows companies to continuously refine their approach based on direct insights from healthcare providers. This feedback can guide reps to better understand what doctors find most valuable, adapting their approach to meet these expectations.

To truly revitalize this role, companies could consider curating insights that go beyond brand reminders, focusing instead on clinical studies, patient case applications, or current trends that resonate with doctors’ day-to-day practices.