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Making switch from pharma-nervous!-opinions welcome!

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Anonymous

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Pharma rep here- I currently work in pharma for a mid size company, but have recently been offered a home health sales position with a privately owned agency. Base salary is actually comparable to what I'm making now, but commission is nowhere near what I'm making now. I have read the other threads and appreciate all the feedback so far, and I'm just wondering if any other reps can shed some light on hhs. Pharma has just become so micro-managed, unstable, a zillion admin things to do, territory has doubled, and day to day is so boring. With home health, I have asked around and I know that a lot of doctors own their own agencies, are on board of directors, etc. Is the competition in this field a hurdle that you can't get over? I'm also concerned with access to docs. Do they roll their eyes when they see a hh rep? I would love to have interaction with patients, freedom to see who I want, and not have all the other bs pharma co.'s make you do, so it seems like a good fit for me. If you knew then what you know now, would you still have switched from pharma to hh? I really thank you for any feedback/advice!
 




I made the same switch 2 yrs ago and still love what I am doing. We have more of an impact on direct patient care than with pharma. I have not seen physicians owning their own agencies---maybe that is a locality thing. All agencies have a physician on their board as a Director. They are not paid much for that task but it is necessary. SOme physicians are more active than others in the role of Director. And I have found the offices, nurses, physicians all take homeHealth very serious--no eye rolling as you mentioned. In fact, I can walk into an office where several pharma reps are waiting to get in and I get taken in without waiting at all--right past those pharma reps. We are in the business of caring for people--and keeping them in their homes for as long as possible. When I go into an office I am not there to make small talk--I am there to discuss their patients and the care they are receiving. I am there to get verification of medical orders and to report any concerns about these patients. Taking care of patients in their home is a priviledge and they are our priority, first and last. It was a good move for me and I hope it will be for you also.
 




I am having the opposite problem. In pharma 10 years... got laid off after leaving my cushy job to a supposed better Specialty job. It is micromanaged and ridiculous in pharma, but in HH most agencies to not give you a company car, a very big allowance for one, no cell phone, low budget, no internet paid for etc. It is very bare bones. It depends on the agency. What happens is, the facilities have their favorite HH agencies, and unfortunately their is alot of 'under the table" stuff going on that you will be going against. For example, you call on a SNF, and they have a list of all attending physicians and you MUST call the agency next to their name. Probably means they are medical director of that agency. So you don't have a prayer. That is also unethical, but nothing seems to be done about it. It is called the Stark Law, and the PATIENT is supposed to be given a chance to pick, but since most no nothing about the companies, the social worker will pick their favorite, or who the doc is medical director for and that is who they get. I don't mean to play devil's advocate- I thought it would be a nice change too. Just want you to see both sides. Anyone can open up a HH agency so look at how many are in your area. I have 527 agencies in my area. That is nuts. AS far as docs, I have relationships with the docs, and I am finding that the area I was given is very closed to reps of all kinds so you must do lunch. Well, on a HH budget- have fun! Especially for large offices. And many of my docs are not taking Medicare patients anymore (what you get paid on usually) so you have to try to get your existing medicare patients. It is weird, I won President's Club 3 times in recent years, know docs well, but in my area, they don't want to deal with HH. One more thing to deal with. They would rather send them to hospital for an ailment they feel is out of their control, and let hospital make decision. There is your next access issue. A lot of hospitals you must be "credentialed" (TB shots, etc,.... plus a fee)to walk floors, and access to case managers, hospitalists are almost impossible.... you can do it if you network, but I am just being as honest as I can. If I still had my pharma job, at least I know I have a company issued computer (another thing most HH do not give you) a printer, cell phone paid (some HH do pay but maybe $75- mine is zilch), car or big car allowance, internet paid, and you can at least have docs to call on and give samples too. I used to hate that structure, now I feel like they threw me out to the wolves with no data (rep before was not good) who writes our HH, etc. I am looking to get back into pharma, or something else... oh, unless you are with a national company--- insurance sucks. Mine is catastrophic. Also no 401K. Check into all of this first. As bad as pharma was getting, the ride alongs, the tests, the bs, I actually would go back in a heart beat now. If there was regulation that was mandated that would be a different story. These Alfs will rent out "rooms" to a HH or 2, and so you have no chance..... NOt trying to depress you, just giving you a different side from above rep. I am glad they are having a much better time. I was a top performing pharma rep for years, so I thought this would be a welcome change and a I would kick butt. It is hard to try and kick butt and find out that no matter what you do, dine and dash, get 3 medical directors, the many people you call on are being called on also by tons of HH reps. Yes, it is rewarding to get the referral and talk to the actual patient. It is extremely hard without really working your medical director to tell you about patients about to get discharged so you can get to them before another HH does. I feel like an ambulance chaser at times.
Good luck. If you company is doing welll (pharma) and this is just about the micromanagement..... I am enjoying the freedom from that but you do work twice as hard and half the pay- no national meetings, no president's trips, no contests, so I feel like I am working just for my pay, no recognition. Sorry to be so opinionated.... I needed a job. I had a friend who was in pharma who just quit her HH for same above reasons. I don't have the luxury, but glad to have a job in this economy. Good luck in your decision.
 




Re: Making switch from device/dme-nervous!-opinions welcome!

I am in the process of interviewing with a large home health agency and although the change of pace is appealing, I am nervous to make the switch. The manager seems amazing (hands off; not a micro-manger) but the culture seems totally different. The base is great, with a good 401k and stock options but there is a small mileage reimbursement (no gas card) and no chance to be recognized at presidents club. I make about $90k not but I want to make over $100 consistently. How realistic is this? Also, how stable is the industry and how seriously are the reps taken by the hospitals and internal medicine offices. I currently work in a glamorous industry that is has a great outside peception and I don't want to loose this but the quality of life provided by home health is very appealing. Can someone provide "honest' insight?

Thank you!
 




OP here. Wow, two very different opinions! I am still going back and forth. I have done a ton of digging, talk to the reps currently working for the same hh agency, and know all about this particular company. The insurance is fair (current insurance is fair as well), 401k with full match, $400 car allowance, gas card, mileage reimbursement, budget of $500 a month, and a good base. The only thing that could not compare is the commission, and that's because I've had a darn good year with my current position. There are about 13 agencies in my area, give or take. I could not imagine competing with 500! I am very nervous to switch... I don't dislike my current company. They have been pretty good to me. I just am sick of all the travel, POAs, meetings, over the shoulder stuff, admin, go here do this-no wait, do that stuff, and bs work. We have been bought out twice since I've joined the company, and nothing is ever stable-including our goals/bonuses/managers. On the flip side, I do hear what the other is saying. I know access can be difficult. I know there's a lot of back door politics going on. I'm still up in the air!! Thank you both so much for replying!
 




Look up Home Health companies in your area. There are more than 13 unless you are in a rurual area. anyone can open up a home health. If they do, they usually have friends, pay off a medical director to get referrals... etc. The reps you talked to may have meant 13 players, but once again, unless you are in a small town, there are more than that. In my ONE COUNTY there are 527. In another county there is 400. Bonuses are hard to achieve- I have friends that have worked for small and larger Home health... they get a decent base but can't make the commission. It is unrealistic. I would seriously think about this. Find out how many medical directors will be working for you in your territory. That gives you access and referrals. If you don't have a med director, it will be much harder. much more politics than pharma as there really are no rules that are implemented. (there are- the Stark laws- but no one follows them or gets in trouble). Just think, Hippa is big on patient privacy, yet we are interviewing actual patients, have all their history and personal information. that is amazing to me. I dont' know- I would find out how hard it is to make commisssion- it is hard to do if your company is not well " connected", even a national one. They usually have the crazy quotas. I know the back flips and the bs of pharma.... Home health is NOT glamorous. I went from my nice company car, gas card, cell phone paid, last two years in Presidents club= (before our division got sold and I got laid off) - there are no President clubs, contests, it is all bare bones. And kudos to second poster. Your company must be well connected. You can be the best sales rep in history but they will not let you in if docs are already assigned a HH (they are usually med director getting paid) or at the ALF's they "rent a room" and pay the ALF who then tells the patient in the hospital or SNf after they picked you, that oh, you don't need ABC HH because we have one that is "in house". Right.... any home health can go see the patient in their facility, they just tell these mostly senior patients that they already "have one". I have honestly never seen anything like it. I get my referrals from my medical director giving me patients to interview, he "suggests" us, (it is patient choice- haha ha ha) it is supposed to be- and the others I grovel for- work twice as hard as a pharma rep for less money------ just think about it. I would like it more if I could get in, and the internal medicine clinics in my area you must do lunch for 30 people with your low budget- that is what - 2 lunches? You have to be in their face REGULARLY- they won't just start writing off the referrrals after one lunch, because even though they liked you as a pharma rep, they have plenty of HH reps they have favorites and been working with for years too. Just warning you...... your package is good for HH, but I would check to see how long they give you to start making those referral quotas and how attainable they are. I have a 50 percent paycut from last job, even with car allowance. Not trying to be too discouraging, but if you read these threads... you will get the drift. Pharma has negativity on here, but the posts on HH are much more true to form. Good luck! (google gentiva 101cafe pharma ) posted from a pharma rep who transitioned to Home Health... good info
 




I went from pharma to home health due to a lay off situation. The job was very disappointing to me. Yes, I was tired of all the micromanagement of pharma and the reps who brag and brag and really do nothing at all. Unfortunately, the flip side is that home health is filled with many untalented folks. At our meetings, when it was time to have a discussion about patient care and actual disease management, there was no discussion. It is service and games and that is it and you live and die by the nurses that your company provides. I worked at Great Lakes Home Health and they were always firing, hiring or burning out their staff. Not sure how it works at other companies. My advice is stay away from this industry unless you have given up on all else.
 




Wow - this is the first thread that actually tells it like it is. Been there - done that. 20 plus years pharma. Laid off, went to home health out of desperation. Now in a completely different field. Both sides are correct. Before jumping ship, have you explored other fields? Hiring managers look for upper moves not lateral moves. Some might view this as a lesser move. Especially when you give up all the perks because you can't stand all the BS. (I've been there) Can you segue your college degree?
 




If I could make a lateral move or upper move in this economy I would!!!! I won 3 straight President's Clubs at last job, was about to go to management training (only 3 of us picked) and I had to resign due to spousal transfer. No openings in the area we moved to. So, I have lots of experience, and after 9 MONTHS all I could find was home health. Do you read the newspapers or watch the news? Of COURSE it is a lesser job- but much more competitive, you actually have to work more than pharma for half the pay and none of the perks. that part sucks. Gotta feed the family and stay in the same field so at least I if economy gets better, I have 10 years of successful pharma and home health calling on hospitals and specialists...
 




you can do all the analysis you like but it comes down to this. I worked in pharma for 10 years and I am working currently with a large HHC now who happens to be under investigation for medicare fraud. For the most part all HHC companies are the same. Most offices run by the seat of their pants. In home health you have to be able to sell and truly develop strong relationships with your referral sources to get a small piece of the pie. Most areas are satured with HHC's.
 








Re: Making switch from pharma-nerv11ous!-opinions welcome!

poster 11, it is obvious you have never been a pharma rep and are jealous. It is hard to get President's club once, not to mention 3 times in a row. Yes, no pods... I was alone. I got quotas raised every year. I actually sold, didn't just chat and bring lunches. I actually worked, went to the right targets, gave actual clinical information. Don't bunch all pharma reps together. Some of us actually worked our asses off.... Sorry you never had the chance.
 




I was laid off from big pharma last year and have been working for a home health agency since March. I have to say, a lot of what your experience will be in home health is dependent on where you are located and the reputation/stature of your agency.

In the south, home care utilization is high and theress a lot of competition because anyone can open up shop and call themselves a home health agency. In the state where I live, home care utilization is lower than the national average AND agencies are required to have a Certificate of Need (CON) in order to service various counties in the state. Obtaining a CON is difficult and expensive, so HHAs who have them, like the one I work for, have an competitive advantage. Because there are so many patients who are not getting homecare that could benefit, there is huge potential for more business in my area.

I agree with previous posters, it can definitely be challenging to crack case managers and social workers in addition to physicians to get referrals, but to me, that's not much different than pharma. You gotta schmooze the gatekeeper, find out what matters to them and leverage a window of opportunity. That's sales! I sometimes think some of my former pharma colleagues have forgotten how to sell. Yes, there are agencies that are already entrenched, but there will always be a time where they slip up and you want to be the one there to capitalize when they do. The longer the competing agency reps have been around and grown comfortable not having any real comp, the more likely they are to bypass the little things that got them in the door in the first place and that is where you strike.

I have had a smooth transition into HH and I think it was a great move for me. Yes, you sacrifice the company car, perks, etc that comes with being in pharma. However, I have gained job stability, respect and increased access to physicians, more control over my numbers and a greater fulfillment and sense of purpose in my career. And my compensation has been comparable. I sometimes miss dressing to the nines for work (people are much more frumpy in HH) and the prestige of being a pharma rep, but I remind myself that I no longer have to worry about losing my job. I hit the field around 10 and head home around 4 to finish up paperwork and my mgr is hands off. Patients really need us and the need for home care is only growing. When I walk into an office, the staff and doctors actually want to see and talk with me because they know I am there to offer a real service that benefits their patients and makes their job easier. They don't care if I'm bringing lunch or not - I am always welcomed.

Finally, make sure you investigate any potential employer as you should any other. Negotiate your base salary - if you were a good rep, you are walking in the door with valuable relationships with potential referral sources. Make them pay you for that. And definitely talk to your customers and other reps to gauge the perception of your agency in the community. You will only be as good as what your referral sources think of your agency and it's staff. Just like many other industries, people in home care float around between companies and facilities, so if you do a little research, you should get a good sense of whether or not the agency you are interviewing with is a good one or not. If it isn't keep moving, but remember to think about what's most important to you in your career.
 




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