Getting Them Hooked

There is this company that markets products like diapers for babies, amongst other things. This company approached the elected head of the town and got a recommendation to be allowed to distribute to all mothers in the postnatal ward a pack of two 'world class' baby diapers, a photo frame, and a pamphlet describing importance of keeping a baby dry during the night so that it slept peacefully (and hence so did the mother). The institute chief advised us to allow the company to do so, and I presume they gave some mothers at least the diapers and a pamphlet. Four years later, they came back with a photocopy of the previous letter and wanted to do the same activity. The sister-in-charge of the ward brought them to me.
"Please show me records of how many times you did this, and when was the last activity" I said. "We will need the Boss' permission again, and the Boss will ask me these questions."
"I will send our boss to meet you" said the company representative and went away. The boss arrived the next day.
"We are just going to give a hamper of two diapers to each baby" he said.
"Your letter says a photo frame too" I said.
"Um... that was the previous scheme" he said. "Now we won't give any photo frames."
"OK. You need a new permission from the civic body" I said.
"Won't the old permission do?" he asked me. It looked like he did not want the hassle of obtaining a permission again."
"I am afraid not" I said. "The last time the activity was forced on us. Now if I get a directive to allow you to distribute your diapers, I will point out the problems to the civic body."
"What problems?" he asked.
"The mothers believe that whatever is given to them in the hospital is by the hospital, and is totally safe. If any baby gets an allergic rash with your product, the parents of the baby will sue us. The other problem is that I look upon this as unethical marketing."
"How?" he asked without much force. He probably knew how.
"You give two diapers free. The mothers like the idea of keeping the baby dry and not having to get up in the night to change wet diapers. Then they have to buy these expensive diapers. It is somewhat like drug peddlers giving free samples to school children to get them hooked. Once they get hooked, they have to buy the drugs."
His face was a study in emotion. I had hit the nail on the head.
"Can't we find a win-win solution to this impasse" he asked. The guy was good. I could not see how it could have been put better and still not appear to be offering a bribe.
"No," I said "the unethical marketing part cannot change even if you do anything for the institute. We don't need anything at the cost of making poor patients buy expensive diapers. I have nothing personal against you. I am just doing my job. I understand marketing your product is your job. Your best bet is to approach the civic body for a permission. I will put my remarks on the paper when it reaches me. My conscience will be clear, even if the civic body chooses to permit you to do what you want to do."
He went away, probably not very happy. I sat there, happy that I had seen the problem in time, and wondering who had allowed this activity the previous time, probably when I was on leave.

Opportunistic Marketing

It was Saturday afternoon. I had been working and got late. I packed up my things, and left. As I was locking my door, two medical sales guys came from inside the department, having met whomever they wanted to meet, or having missed that person because it was Saturday afternoon. As I turned to go, they fell into step with me and one of them started,
"Doctor, we are from GSK."
"Oh, hello" I said, maintaining my pace. They kept up with me.
"Please prescribe our three products ...."
"I am on my way home. Surely I will not prescribe any medicines to anyone from my home" I said, interrupting him.
"One of the products important to us is ..." he kept up, ignoring my interruption. He must believe perseverance would achieve sales.
"This is called opportunistic marketing" I said. "Like we have a saying in Marathi - देखल्या देवा दंडवत", which means one offers a brief prayer to God when he come across a temple on his way somewhere, not while visiting the temple for offering a prayer."
They seemed to know what the saying in Marathi meant, and its analogy to the current situation.
"Doctor, your door was closed. So we thought you were busy" he said by way of an explanation.
"I was indeed busy" I said "and now I am going home. Bye bye."
I increased by speed, and this time they did not try to keep up. They seemed to know when to give up.

Ranbeer, Deepika, and Martindale

I had written about one pharmaceutical marketing campaign taking disadvantage of goodwill of Harrison's Medicine textbook. Today they came up with another such campaign. Their representative showed me a visual about one of their products. There was a box shot of Martindale's pharmacopoeia, suggesting the entire book was devoted to this product of that company. This one was right next to the old one with Harrison's Medicine.
"You are still showing around box shots of famous books to promote your products?" I asked.
"Yes" she said in a low voice. Poor representative had to show what the bosses ordered.
"But Martindale would not help you" I said. "These young doctors sitting here in my outpatient clinic would not know what it was. If you put photos of Ranbeer and Deepika (two actors in Bollywood who are quite popular at present) and suggested they were using your medicine, you would have a great promotion of your products. Every youngster knows them."
She looked skeptical.
"I am willing to bet these young doctors won't know Martindale. If you will wait until I finish seeing these other medical sales representatives,we can ask the the doctors if they know Martindale."
She went away anyway and was nowhere to be seen soon after. I asked the doctors to write on a piece of paper who or what Martindale was. All House Officers, Registrars, one Assistant Professor (she gave a tentative correct answer after a while) and all but one Intern said they did not know who or what Martindale was. One intern wrote the name as Martin Dale. Another intern wrote it as Martin Dane and said he was a gynec researcher. I was aghast. The only Intern who answered it correctly looked quite bright.
"You are good" I told him. I don't remember seeing you during my lectures, but that does not matter."
"You would not have seen me" he said. "I am an extern."
""Ah!" I said. "Where are you from?"
"I am from B. J. Medical College, Pune."
"I have found guys from B.J. to be always good" I said. "Tell them I said so when you go back there. You will specialize in Internal Medicine, I suppose?"
He looked surprised for a moment and then said "I hope to."
I was not wrong about our crowd and I was not wrong about him either. Do I have a sixth sense or am I just experienced?"

Generic Medicine Prescription

"Sir, the union health minister has said that Deans of all medical colleges have been informed to inform doctors working in those hospitals to prescribe only generic medicines" one colleague said.
"I read about it in the newspaper" I said. "It seems to be the decision made by the medical council to prevent doctors being unethically influenced by pharmaceuticals to prescribe their products."
"But the chemists do not have generic medicines."
"I know" I said.
"So when we write generic names, they will dispense brands they want. So now the pharmaceuticals will woo chemists rather than doctors."
"That sounds likely" another colleague said. "Anyway, some chemists are known to substitute one brand for another- one that gives them greater profit margin."
"But what do they mean by asking us to prescribe generic medicines before making generic medicines available?" someone asked.
"That is to reassure people that measures are taken to curb unethical practices" a cynic said. "Mind you, it is 'measures' without any mention of the effectiveness. People want to hear something, and when they hear that, they get satisfied and move on to another topic."
I had heard the preceding arguments from different people before, but that last thing about psychology of people was a new one.
"There is nothing to worry about" someone else said. "The Deans have not informed any doctors to do so yet. And even when the doctors are so informed, there is no machinery in place to check if they follow instructions, or to take action on doctors who don't comply."
There were a few knowing smiles at this.