From an article written in 2009

Quid Pro Quo and Tchotchke Economics: PhRMA ‘09 and the New Convention Experience

Translated from Latin, quid pro quo essentially means “something for something” and has been the unspoken basis for physician-exhibit interactions at conventions for years. New PhRMA guidelines will make us rethink that “something” that will change the convention experience for ’09 and beyond.

Say Goodbye to the Quid in Quid Pro Quo

New guidelines issued by PhRMA for marketing to physicians take effect in January. Some of these guidelines, paralleling the growing momentum in state reporting laws for physicians, will require a change of strategy, tactics, and ultimately behavior for both attendees and exhibitors at healthcare conventions.

One of the more impactful new PhRMA guidelines is the elimination of most gifts or premiums, commonly referred to as tchotchkies. Many of us in convention marketing are holding our breath to see how physicians react to our exhibits when they discover that all we are giving away is product information…what? Will the convention center be empty? Will my exhibit be empty? For those marketers who judge the performance of their exhibit by those lines of physicians waiting to pick up that personalized journal, that laser pointer or even a latte, you will have to look for other ways to measure the success of your efforts. With the new PhRMA guidelines, the unspoken quid pro quo (listen to my detail and you’ll get another laser pointer for your collection) is now officially dead.

Specifically, the new guidelines eliminate all “gifts” and promotional giveaways to physicians that do not provide educational value to the physician or patient, including reminder items like paper pads, USB drives, coffee mugs and pens even if they are accompanied by a fair balance statement or other forms of education. This includes gifts that aid in patient treatment: stethoscopes, thermometers, scales, tongue depressors. Anything with a personal benefit is considered a gift including food. (More information and the complete PhRMA Code on Interactions with Healthcare Professionals can be found at http://www.phrma.org/.)

The Great Exhibit Pen Grab

Beginning in January, look for some disorientation by both physician attendees and exhibitors at conventions. Although that Pavlovian bell will be ringing for physicians who see sales representatives in their booth eagerly awaiting a detailing opportunity, there will be some time required for physicians to understand that when the detail is finished – that’s it; no laser pointer, no latte, no nothing.

Unfortunately, this disorientation is our fault: in the efforts to maximize the number of attendees in our booth, we have trained physicians with a sense of tchotchke entitlement. This entitlement has been built through an arms race of competing exhibitors who continually tried to out-tchotchke their competitors in order to lure the most physicians to their booth. Now trained, when the word gets out that a booth had just opened a box of travel mugs, unusual behavior brakes out from some highly educated and well paid physicians as they jostle for a place in line.
Gustave Le Bon could have been describing this behavioral phenomenon at conventions in his 1896 work; The Crowd: A Study of the Popular Mind:

“Despite the individuals that form a crowd – no matter their occupation or character or intelligence, when in a crowd they are transformed into a collective mind. They feel, think, and act in a manner quite different from how they would individually.”

In other words, somehow that travel mug seems to have more value at the convention than when one gets back to their hotel room.

Although the commercial exhibit floor is critical to the financial support of conventions, increasingly it is less of a priority for most physicians and many an exhibitor laments that they aren’t seeing the key prescribing physicians. Perhaps these physicians have been avoiding the commercial exhibit floor exactly for this reason: Navigating the crowds at the great exhibit pen grab in order to squeeze in a legitimate product question with a rep is too frustrating and seems like a world far from the decorum at the rest of the conference.

Tchotchke Economics

So here’s where the underlying economic system breaks down. Let’s call it Tchotchke Economics. First, in this hypothetical economic system at conventions, price ceilings that sets the value for tchochkies at about $20 have been adopted by exhibiting companies (as a result of suggested but voluntary PhRMA guidelines). So the “quid” – our nominal payment for the physician’s time – has devalued the commercial exhibit experience, creating a carnivalesque environment that seemingly equates the value of your “quo” - product information - to the value of a physician giveaways. Consequently, by participating in the quid pro quo process, physicians are complicit with this valuation of their time spent in a booth as well.

Like many price controls, ultimately there is disequilibrium between supply and demand (think 1970’s oil price controls and long lines at the pump) because, as we could imagine, physicians value their time greater than $20 for a visit at an exhibit and exhibitors certainly value their investment in a convention higher. The market wants to offer more but cannot.
Secondly, USB drives, travel mugs, and laser pointers make up the currency in Tchotchke Economics. On the convention floor, like any currency, it is highly coveted and the resultant attendee behavior makes any product discussion only a means to quickly get to the end...of the line. Add in the uncontrollable herd mentality and one can understand why some physicians avoid the exhibit floor and exhibitors scratch their heads when analyzing their convention ROI.

Post-Tchotchke Economics

New PhRMA could be the best thing that has happened to pharmaceutical conventions in a long time, because although the new PhRMA guidelines eliminate most premiums, the most valuable exhibitor offering is still available: information or the real science as marketing that helps differentiate your product against the competition.
With the price ceiling removed in the Post-Tchotchke Economy, exhibitors can focus their exhibiting strategies and tactics on maximizing real value to physicians. In the long run, more physicians may return to the commercial exhibit floor when they discover that the new currency is now valuable information like the outstanding efficacy or safety profile of a product. The competitive landscape will most likely change as well as physicians will tend to flock to exhibits with newest or best presentation of information, not because someone is giving out umbrellas in Seattle.

The New Convention Experience

Medical conventions are still the prime nexus of new medical information, are a key source of CME credits and provide unparalleled peer networking opportunities that continue to attract the important physicians in large numbers. As such, for health care industry exhibitors, conventions are the only marketing channel where your prospects come to see you. Conventions also offer the ability to engage a physician in meaningful educational experiences in a more relaxed environment using creative media and compelling interactive tools for greater time than the average field sales call. In fact, as exhibit marketers now focus more on their message and less on where the tchotchke line goes, experiential learning will become an important way to communicate with physicians in exhibits.

Think back to a family vacation when you were a child, maybe that trip to Disneyland or a World’s Fair. Chances are that even today you remember riding a roller coaster with your brother or sister but not the stuffed toy your parents bought you. Compelling experiences transcend the moment and sink lasting anchors in the memory unlike that stuffed toy that was sold in next year’s garage sale. Likewise, a 3D first person schizophrenic experience in your booth, for example, may change how a psychologist interacts with his patient (and remembers your brand), not a USB memory stick with your logo. This is the new quid that we have to consider for the future of medical conventions.

Over the years, Tchotchke Economics and resultant herd mentality has obfuscated the real purpose of convention exhibits for both exhibitors and attendees and has taken some of the luster off this very valuable face-to-face marketing channel. In 2009, when calm breaks out at the commercial exhibits, disorientation should turn to satisfaction because both attendees and exhibitors can get down to the real business of scientific information exchange.