Issues and Challenges in Marketing to Physicians

Darwin and Corporate Ethics

Recently, I read an excellent book by David Sloan Wilson, a biologist teaching at Binghamton University. The book, entitled Darwin's Cathedral, addresses the origins of religion from an evolutionary perspective. Without belaboring what is a fairly intricately argued proposition, Wilson makes the following point:

When humans grow in numbers and numbers of social interactions beyond the scope of hunter-gatherers, the complexity of the interactions requires institutions that exceed in scope and span of control the things that develop in a face-to-face society. Institutions such as religious institutions evolve at a HIGHER LEVEL than the gene or the individual in order to serve the needs of people to organize their lives in a scarce-resource environment.

Corporations are another type of institution that evolved to address complex human social needs, in this case, the organization of economic behavior. As with religious entities, corporations have their own internal belief systems, values, rituals and processes. They also identify and punish proscribed behavior. In fact, these "rules" and rituals are essential to mobilizing internal activity, achieving external goals, and limiting the actions of "free riders".

One of the problems in medicine and medical education [that is, the CME world] is that the agents of change and social fulfillment have little or no experience in or exposure to corporations and corporate ethics, although they are forced toencoutner and deal with these organizations every day. I am talking about doctors and other professionals. Clinicians are trained in what amounts to a guild system, emphasizing individual prowess and insight over collective decision-making. These types of competencies are most beneficial and critically necessary when the physician, as a clinician, is representing the interests and well-being of a patient.

But those very same qualities stand in the way when it comes to organizing and managing a complex organization such as a corporation. Physicians distrust and suspect the motives, even the very rationale for the existence, of corporations. Corporations offer a very poor medium for dealing with the issues of individuals, such as individual patients. But they are inevitable and highly functional for meeting the economic and social needs of large numbers of people. We read every day about the criminal and self-serving actions of the few--Ken Lay, Richard Scrushy et al. But most corporations don't work that way. The internal ideology and corporate culture serves to contrain the actions of management for the most part to pursue the legal and ethical objectives for which the corporation was created. If that were not the case, corporations would not exist and other group-level entities would emerge to take their place.

This is just food for thought. I will say more in my next blog appearance.

Bob Sweeney

posted by Robert E. Sweeney, DA, MS @ 8:34 AM