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‘We are told to refuse gifts from patients yet we accept marketing gifts from drug companies’

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Marketing surrounds us, wherever we are. It is always there, like a parasite. We may mistakenly think that it is a business issue and has nothing to do with public healthcare.

But take a look around your working environment. You will see a mountain of gifts provided by generous pharmaceutical representatives – pens, diaries, cups, mouse mats, clips, clipboards, badge holders and a host of other goods.

Our working environment – which is often also our patients’ environment – is slowly and discreetly becoming dominated by the company logos slapped on these marketing gifts.

Let’s think about why companies are so kind as to provide us with all of the above. I can assure you it is not to save your hospital budget or deliver better care. Businesses are profit-hungry. To create or boost demand, the values, beliefs, opinions and emotions of prospective customers must be altered by marketing that uses psychological strategies. These powerful tactics aim to create a belief that consumers need or want a particular product, regardless of its necessity, quality, effectiveness or benefit.

One way to achieve this is to create a psychological attachment between the brand name and the consumer. This will lead to a subconscious wish to buy the product, when the consumer thinks: ‘They gave me that lovely cup, so I should appreciate it and use their products.’

While doctors are the most targeted, nurses and other healthcare professionals are not excluded. For instance, in a situation where fresh water may resolve simple constipation or stomach ache, a nurse who received a drug company’s lovely diary yesterday may subconsciously go for a laxative or painkiller supplied by that company. The nurse has been brainwashed to use the drug.

These drug companies surround us subtly, in our offices and wards, a quiet Big Brother with a powerful influence. Although we cannot always see him, our patients often can. In mental health care, we sometimes care for people who are aware of business strategies and of the long-running war between drug firms and complementary medicine. They do not feel happy surrounded by all these drug corporations’ toys with logos on them.

One detained mental health patient at our hospital, a former GP who had failed to obtain a discharge from his consultant, looked at the consultant’s diary – with a psychiatric drug logo on it – and exploded: ‘Where has that diary come from, doctor? You know it’s all about money, don’t you?’ He was discharged the following day.

We also care for patients who are paranoid and may see nurses as persecuting agents. It’s a bad idea to give them an opportunity to see us as drug companies’ agents.

A dentist with schizoaffective disorder shocked me by throwing at me detailed information about the company that produced her medication. She later accused me of cooperating with the brand, as I was holding its pen. She was subsequently treated with complementary medicine, has been free of medication and mental illness for three years now and is back at work.

We must admit that most patients, whether on psychiatric or general wards, hate their medication. It certainly does not help them to see nurses, doctors and other staff drinking their tea from cups that bear the same logo as that bitter medicine.

The issues of unethical practice and conflict of interest should also be raised. We are taught to refuse gifts from our patients, for many reasons. One is that it can influence their care. Yet we accept a mass of professional-judgement-altering presents from companies.

Truly, the only logo that would survive this ethical dilemma is that of an organisation one is working for. I suggest that it would be wise, ethical and, most importantly, fair to patients, if we clear our wards and offices of all marketing tools.

Marek Vojcik is a third-year mental health nursing student at Thames Valley University, London

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