First off, big Pharma has to admit that the current model of doing business is antiquated. Managing by objectives and metrics such as calls per day; lunch activity, frequency, speaker programs, tasked tutorials...etc is old Pharma. What value does a rep bring to an office/clinic/hospital other than breakfast, lunch or ice cream will depend on the HCP’s and how they are reimbursed for their medical services provided. Those in an IDN or hospital system are primarily closed off to reps. Unfortunately, with sunshine act and compliance matters, many activities that would bring value are obsolete. Bringing back medical education credits (CE) would be a start to provide value amongst so many other creative ways to interact. The other big elephant in the room is the notion that many new ideas would require a smaller sales force, which means, layoffs from rep to manager to area director to marketing, ops...all the way up.