“Doctor, do you have five minutes? Our country manager has come to meet you.”
It was a sales representative of a company that sold cervical ripening and uterine stimulating drugs. By country manager he must have meant sales manager, not prime minister or president of ruling party, I presumed. I had no time. But what with the Boss talking about public-private partnership enthusiastically, I decided to let them talk to me. I did not expect a ball point pen or a writing pad from them, as I used to when I had just qualified 31 years ago. I had stopped that as soon as I the medical council said it was unethical, and the civic body service regulation said may be we could take a flower from them. I buy my own pens and remain away from flower markets.
“Doctor, we want to know about your prescribing practices of our drugs” she said.
“Our practices are detailed on our website. They are same as what is written on your product inserts” I said.
“Yes doctor. We want to know the correct practices” she said.
“They are correct. They match ACOG and RCOG guidelines, which are available on the net” I said.
“Doctor, do you use oxytocin for active management of third stage of labor?” she asked.
“No. We use methyl ergometrine or misoprostol” I said.
“But I have a reference which says otherwise” she said.
“Which one?” I asked. She told me the name of a popular guide read by undergraduate students.
“I suggest you read Williams’ Obstetrics. It is costly, but scientific. For a pharmaceutical like yours, the cost is not an issue, I trust” I said.
“Doctor, what do you do when you are in a hurry to induce labor and the cervix is unripe?”
“We use intracervical balloon catheter or PGE2 gel” I said.
“DO you wait for 6-24 hours?”
“We wait for 6 hours” I said.
“But for an urgent case?” she asked. As if the waiting period could be shortened.
“You cannot shorten the waiting period, because the drug requires that much time to act” I said.
“Even if the case is urgent” she asked. Obviously she wanted another answer.
“Are you suggesting we use double the recommended dose or something?” I heard myself ask and was surprised to hear it. I was further surprised when she said that was what some doctors were doing.
“Who? Where?” I asked.
“In Bxxxxlxxe” she said. I have put xs to protect the identity of the city she mentioned.
“Tell me the doctors’ names. I cannot control their practice which can kill the baby and even the mother. But I can put their names on my blog” I said.
“No doctor. If you do that, they will not entertain me again” she said.
“But if they are consuming twice as much drug as they otherwise would, you should be happy because your sales are up” I said. “Anyway, what is the point in asking me about what others are doing?”
“Someone like FOGSI should correct them” she said.
“I am sorry I am not in the managing council of FOGSI. The medical council was going to bring out standard management guidelines which were going to be compulsory for all doctors. They had announced that a year and half ago. Perhaps you should approach the medical council” I said. “Now will you kindly excuse me? I have to finish quite a bit of work before I break for lunch”
“Thank you doctor” she said “have a nice day.”
They went away without offering me a ball point pen or giving me a flower, or giving a fat cheque to my institute as a token of appreciation and support. Well, it was not the first pharmaceutical which had picked my brains without doing anything for my institute, definitely would not be the last.
