Wearing Multiple Hats at Alosa Health: Detailing Clinicians, Managing Programs, and Training Staff

An interview with Tony de Melo, RPh, Director of Clinical Education Programs, Alosa Health
​by Anna Morgan, RN, BSN, MPH, NaRCAD Program Manager

​Tags: Detailing Visits, Opioid Safety, Program Management, ​Training

NaRCAD: Tony, thanks for chatting with us today about your role at Alosa Health! What’s been the most exciting part of the work that Alosa has done this year? 
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Tony: Our partnership with Aetna, a managed health care company and health care insurer. We’ve been working with them to provide educational outreach to providers on chronic pain, acute pain, and opioid use disorder (OUD); supporting them in managing pain using non-opioid drug options; appropriately dosing opioids when they need to be used; tapering down patients who are on existing high doses of opioids; and helping to identify patients that may have opioid use disorder.  We’re now working in Pennsylvania, Virginia, West Virginia, Ohio, Illinois and Maine.

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NaRCAD: That collaboration does sound exciting!  Now, let’s talk a little about your role at Alosa.  You actively detail, you manage academic detailers in the field, and you lead trainings at Alosa. Which aspect of your role is your favorite, and why? 
 
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Tony:  When I’m training and managing detailers, I see myself more as a coach than a trainer.  I’ve always liked educating and teaching—I enjoy helping others develop their skills and seeing them improve.  Training folks and coaching them in the field is rewarding to me because I feel that I’m impacting what they’re doing in their own communities.  It brings me happiness to see others succeed.  

NaRCAD:  As a coach, how do you know when your work has been impactful?

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Tony:  When I work with detailers in the field, I can see firsthand that they are able to be impactful with the providers because they are bringing about behavior change with their message delivery and confidence.  We can also measure how impactful our work is by reviewing our Salesforce data.  I can see from the detailer’s visit notes when providers have agreed to a behavior change, and this is a true measure of our work being impactful.

NaRCAD:  With success comes challenges.  What are some of the major challenges you see academic detailers face in training and in the field?

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Tony: The major challenge is teaching detailers to have a conversation with clinicians rather than a lecture. Making the visit more conversational doesn’t often come as naturally as presenting the information in a lecture format, but the conversation must be about understanding where the provider is now, what their needs might be, and how to deliver content to make behavior change.  

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In the field, the major challenge is access to providers. Many health systems have regulations and restrictions for those who want to meet with providers, because representatives in the pharma industry have bombarded and overloaded providers throughout the years.  As a result, we’re often seen as an outside influence or an outside visitor, so we aren’t always given the opportunity to meet with a provider. 

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NaRCAD: With these challenges in mind, how do you instill confidence in academic detailers as a trainer and as a manager?

Tony: We spend a lot of time practicing and providing feedback during trainings.  We practice individually, with partners, and with outside folks who are playing the role of providers.  Practicing multiple situations, multiple times, over multiple days, builds confidence.  We also videotape the trainees so that they can see what they’re doing well and what they can improve upon. 

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As a manager in the field, it’s quite similar. I usually sit down with each detailer after a visit and discuss what worked well and what they could do differently in their next visit, so that each visit becomes a learning opportunity.  Providing feedback and being a mirror for the detailers helps them to build confidence and skills as time goes on.  I also offer the detailers my perspective; having spent time doing this myself and observing others, I can share the tricks, skills, and wording I’ve heard throughout my time with the detailers.

NaRCAD:  Those are all great ways to build confidence among detailers. What’s one piece of advice that you would give to academic detailers?

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Tony:  Don’t be afraid to ask for a specific behavior change, and remember to follow up to make sure that the behavior change occurs.  One thing that I find to be hard for academic detailers is the “ask”, where detailers are asking for commitment or behavior change from a provider at the end of the visit.  I always tell detailers to frame it as, “based on what you’ve heard today, what is one thing you’d do differently?”  Follow-up then ensures that providers are committed to change and holds them accountable for what they said they would do.  

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NaRCAD:  That’s extremely helpful advice for detailers. What’s the best thing a program manager could do to maintain high levels of engagement among detailers?


Tony:  As a manager who’s coaching or guiding others, it’s important to build trust between yourself and the folks you’re coaching or managing. It can be lonely when you’re in the field detailing by yourself, so managers need to have touchpoints with their detailers.  Building trust and having your detailers know you’re all working together helps them stay self-motivated; it makes them want to go out into the field and do a good job because they know someone is backing them up.

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NaRCAD: Thank you for taking the time to chat with us today. We value your unique perspective on detailing, managing, and training!

Biography.
​Tony de Melo manages field staff and leads academic detailer trainings at Alosa Health. He attended Massachusetts College of Pharmacy and Health Sciences in Boston, where he received a BS in Pharmacy with a minor in Business Administration.  This business interest led him to work for several pharmaceutical companies as a sales representative, account manager, training manager, district/regional manager, associate director of managed markets training, head of sales training, and development & marketing product manager. He has also worked for smaller businesses that were looking to grow their sales and marketing programs. Throughout his career, Tony has successfully sold, marketed, trained, led, designed, developed and executed solutions to meet business objectives.

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