Mock Call: Habit-Change in Primary Care

The scenario

Dr. Susan Hartley, a busy primary care physician who has prescribed the same generic standard-of-care diabetes regimen for over a decade. She's warm and not hostile to reps, just comfortable, low-awareness of newer options, and pressed for time between a full patient panel. She cares about keeping her diabetes patients controlled without adding work to her day, and she is wary of anything that sounds complicated to start.

You're catching Dr. Hartley in her office between patients for a brief, friendly visit. She currently writes a moderate volume of type 2 diabetes scripts, roughly 25 per month, nearly all going to the well-established generic standard she's used for years; she has written zero scripts for Cadenzil to date. She believes the generic "works fine" for most of her patients and has never had a strong reason to consider anything else. Prior-interaction thread: on your last visit she asked, almost in passing, whether newer therapies were "a hassle to titrate" — simplicity is clearly what she cares about — and there is a box of expired samples from a previous rep still sitting in her supply closet, a reminder that things she agrees to vaguely tend to go nowhere. Her office manager mentioned she rarely changes her regimen unless a patient specifically asks or a clear coverage/access issue comes up with the generic.

What gets scored

A scoring syllabus, not a vague impression.