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Rudyard Kipling was a very wise chap. He was in San Francisco towards the end of the 19th century and noticed that in some bars and saloons the house was giving away free lunches for every patron who first purchased at least one beer. At first he could not understand how it would make financial sense to do this, but before long he observed that the food served was so adulterated with salt that it was almost impossible to finish without purchasing at least a further two beers. In this manner the house made back the money lost in giving away free food, and then some more again.

This was 125 years ago, however, and since then strict salt limitations have come in force around most of the developed world and this ruse would be very difficult to carry out. But free lunches still exist. Even free dinners. In fact, one of the joys of attending congress is to attend an industry sponsored dinner every evening. There is fun to be had in comparing dinners: who has the best venue, who has the most interesting talk, who has the biggest budget. And, of course, with the ABPI regulations in place, we can be very confident that no underhand tricks can take place, so we can relax. Besides, we are all professionals and are totally incorruptible anyhow, whatever anyone says. So by and large the dinners are pointless from the point of view of the industry. Aren’t they?

So during congress this year I met an old Nigerian friend who now works in Manchester so I rarely bump into her; as well as several other colleagues who had signed up to have dinner with a Japanese pharmaceutical company. The industry representative seemed most keen that I join them and some important international glaucomatous figures were present so I thought I would attend too. For the lecture. Obviously.

It was nice to catch up. We chatted as we followed a line of fellow ophthalmologists, like sheep, out of the ACC in Liverpool into a waiting coach, which then took off along the dockside road. We had been chatting for a while before I suddenly noticed we were passing warehouses and were by now some distance away from the ACC and my accommodation. I was not alone in realising this, but just as a consensus was starting to grow on the bus that we had travelled beyond walking distance back to the convention centre the bus pulled into a high walled warehouse conversion and let us all off. We were told there would be taxis to take us back afterwards. The venue was nice, with dramatic stairs in the style of the Titanic ascending from the lobby to the lecture hall. Food was also nice, and the lecture was okay too. There was a bit about the history of the company and the guest speaker spoke about the human touch in ophthalmology. I don’t think anybody learnt anything new, but it was not a boring talk. The lecture overran by 20 minutes and, as my friend had to get back to Manchester she quietly left at the time the lecture was meant to finish, as did a few others, but I dutifully stayed until the end.

“If we are so incorruptible that the free dinners do not make us more likely to prescribe, how can the reverse be true?”

Imagine my surprise then at seeing my friend still sat in the back of a taxi after I finally made it out at the end. She did not look too pleased neither. “The taxi man refuses to move!” she complained. “He says the reps haven’t signed off the fare yet.”

As soon as some representatives came within earshot she angrily called one over to her. I waited patiently for another cab to arrive along with a growing throng of ophthalmologists, when suddenly my friend gets out of the taxi and slams the door. “They’re not paying to take us back!” she squealed. A murmur ran through the crowd. Another ophthalmologist called over a drug rep and was evidently told the same thing. The crowd was distressed. Others decided to make their own enquiries and once it became clear that in fact we were not to be taken back, I decided to start walking. This was mainly as I had not brought a wallet with me, this being an irregular thing to happen, and surprisingly I found myself leading a group of us back to Albert Dock utilising a map given to me at the Premier Inn.

I felt like Moses leading the Israelites from Egypt to Canaan. I took them past abandoned warehouses, past a boxing club, along a small road which seemed to house some kind of illegal accommodation; though that turned out to be a wrong turn on the map and we had to pass that place twice. The chatter of My People was the same along the entire journey. They would never use that particular brand of prostaglandin ever again so incensed were they that this had occurred. Never!

But, hang on! (Well it was more of a pondering on my part than saying it out loud.) If we are so incorruptible that the free dinners do not make us more likely to prescribe, how can the reverse be true? Perhaps this was different as a fundamental rule of congress dinners had been broken. What then were the rules? After much further pondering I figured that they gave us transport to and from the venue, food, a half decent talk that never finished on time but was expected to finish within 20 minutes of the end at least, and a glass of wine, but not really much more than that. What then did we give them? This was harder to answer. Eventually I reasoned that it made their product memorable in our eyes. It is said, usually in support of studying for exams, that you can only diagnose what you know. So similarly, you can only prescribe what you know. If an industry event can have such an obviously negative impact then surely the others must be positive? I’m not too sure of the answers to any of these questions. But I think I will catch up with friends at restaurants of my own choice at congress next year. Or bring my hiking boots.


The views expressed are those of the author and do not represent those of the editorial team or the publisher.




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Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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