Great Advice from Great Minds


Invisible Influence: Dr. Jonah Berger on Adherence,Trust, Incentives and MoreBy Jill Donahue, Principal, Engage Rx

Why do some products, ideas, and behaviors catch on while others don’t? Dr. Jonah Berger researches the behavioral science behind how people make decisions, how ideas diffuse, and how social influence shapes behavior. His ideas can help us in pharma improve patient outcomes by driving new product adoption, sharpen effective messaging, and develop marketing strategy.

Jonah is a marketing professor at the Wharton School at the University of Pennsylvania and bestselling author of Contagious: Why Things Catch On and Invisible Influence: The Hidden Forces that Shape Behavior. He’s published dozens of articles in top-tier academic journals, and his work frequently appears in the New York Times, Wall Street Journal, Harvard Business Review, Wired, Business Week and The Economist.

He helps organizations, as he says: “get their stuff to catch on.” Inspired by James Cordon’s Car Pool Karaoke, we interviewed Jonah in the car on the way to the airport after his talk at the Rotman School of Management in Toronto. We had some questions about how we can influence more effectively in pharma to help create better patient outcomes, specifically around:

  1. Helping doctors improve patient adherence
  2. Changing physician habits
  3. Building our trustworthiness
  4. Creating better incentive programs
  5. Spreading the mindset of patient centricity


Jonah said there is one simple thing HCPs should ask patients, but most don’t, to increase adherence. He explained that the biggest problem for adherence is lack of a trigger. A trigger is a reminder in the environment that encourages us to do something. For example, when you think of peanut butter, you automatically think of…. jelly, right?

When I learned about this trigger idea after reading Charles Duhigg’s Power of Habit, I was trying to build a new habit of taking Omega 3 each day. I decided the trigger would be my placemat. I drew a circle on a plastic placemat where my pill should be each time I sat down for dinner. It worked!

So what does the doctor need to ask? “What will you associate this pill with?” Or in the case of getting a test or a shot or a treatment, “When and where will you go to get this shot?” Jonah assures us that asking this one small question could make a tremendous difference. And that’s often the way it is with influence. Sharing this concept through your sales and marketing teams can have a big impact on sales in what would be a small investment for a big outcome.


Jonah suggests we focus on the wrong thing. We need to start with what the physician and patients need, not with what you are selling. He urges us to go beyond listening to truly understanding. When we focus on their needs instead of ours—that’s when we will have our best chance of influencing their habits.

We have seen evidence of this first hand, when after teaching teams to focus on the patient, they create significantly better engagement with the physician, increase their access and time and therefore their ability to change behavior!

The one thing that has defined every pharma sales model to date has been a focus on getting “the script.” What if that is the one thing that is getting in the way of generating more scripts? The paradox of modern pharma selling is that the best way to grow scripts is to keep them out of your mind when you are selling and instead focus on patient needs. Simply put, stop selling drugs, start serving others. When we do good, we will do well!


Imagine you had a friend who said she had the right answer to everything. You would soon stop believing her. Same thing for pharma reps. How can your product be the right answer for everyone? If you want to be the trusted advisor, you need to invest some of your energy in educating your physicians on when another product or solution would be better for a patient.

Jonah shared a great example. He described his real estate agent in Philly who he loves and refers to others whenever he can. He even gave him a plug in our video. Why does he love him so much? He’s Jonah’s ‘”go-to” guy when something needs to be done on his house. So when Jonah’s AC breaks down, or he needs to get rid of junk, or when his roof needs repairs, he calls his agent. Jonah’s agent has broadened his offering to include more than just selling or buying homes. By building his network of good home service providers he does a better job serving his clients and increases the likelihood that his clients will recommend him!

So let’s say you have a product in diabetes. You should be the diabetes go-to person. You should be the person the doctor thinks of for all challenges related to diabetes. You should be the trusted advisor in diabetes.


Jonah and I also talked about the practice in pharma of paying bonus or commissions to achieve sales objectives. So many industries use this approach, but in pharma it really stands in the way of becoming a trusted advisor. If you incentivize number of scripts, that’s what you’re saying is most important—instead of better serving patients. You will be encouraging behavior to get the script even if it undermines trust and longer term success.

See interview here:

Part of the problem may that pharma sales departments tend focus on short-term goals. The 2016 Aurora Project: Patient- Centric Benchmarks Survey found that 72% of sales reps or managers said their department’s goals didn’t extend beyond the current year. Companies need to see sales rep’s goals in a longer-term context if we are going to become trusted partners.

I pushed him and asked how do we switch away from financial incentives when they are so baked into our business models? He suggested we help them change the way they see their job. Obviously, this can’t be as simple as a memo, he laughed. Imagine a meeting, he suggested, where everyone sits down and says—“what do you wish… how could we do it better? What is our purpose?” This will help peers influence each other and draw the intrinsic motivation forward.

Another problem, Jonah explains, is that by putting so much extrinsic reward on the rep’s work, you diminish the very important intrinsic motivation which can be more powerful. The intrinsic motivation; the connection to the difference they make for patients; the difference they make in the world. All these need to be enhanced. We need to talk about patients more and make rep’s work more personal.


Before we parted ways, I explained to Jonah that I was the co-founder of The Aurora Project, a group of pharma leaders trying to illuminate our path to patient centricity. I wanted his advice on how we could spread the mindset of patient centricity. He suggested we try to make the stories of success more visible. Many organizations want to be patient-focused. The more we can show them how others have done it, the better.

Like any great conversation, I left the interview excited about the possibilities. What if we focused all our energy on meeting patient needs? What if we became trusted advisors by talking about how solutions other than our own fit into medical practice? What if we eschewed short term financial gains for longer term wins? Whether you’re a rep, an MSL, a sales manager, a marketing manager, or any number of roles in pharma, these questions will help you become more needed by patients, physicians, and your companies.

Jill Donahue, HBa, MAdEd is on a mission to lift our industry, building purpose-driven, influential people. Through her keynote talks, workshops and award-winning mobile-learning programs, she is helping pharma people build trust, open doors and make a bigger impact. She trains people why and how to engage instead of sell.

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