>I was talking to one of our OB nurses the other day & she said
>the Enfamil Rep is coming to do an inservice on their "new" formula that has
>the fatty acids added.

Richard Feynman (a physics Nobel Prize winner, 1965) wrote a fun book,
"Surely you're joking, Mr. Feynman."  One chapter describes his run-ins with
public school textbook publishers.  Statewide textbooks are chosen by a
panel of teachers and other "important" people, most of whom, in his
experience, never actually read the texts involved.  Feynman did (and was
unimpressed with their quality).  But he found votes were decided largely on
the basis of perks provided, not quality.  The publishing companies gave
monogrammed leather briefcases, lovely dinners, and so on.

One year, having chosen Company A, his state asked if they could have the
books sooner than requested.  "Wait a minute," said Company B.  "If you're
changing the date, please reopen the bidding.  Because we can get *our*
books to you by that earlier date, *and at a lower price* than we gave
before."  They gave some silly mumbo jumbo about how printing the books
earlier was actually cheaper, and got into a new bidding war with Series A.
The state was amazed: it ultimately got its books for $2 million less than
originally contracted for, as well as getting them earlier.

Feynman realized that the publishers *wanted* votes decided on the basis of
perks, not quality, because of all the money it saved them.  Publishers
could spend a whole lot on expensive strokes for a very small group of
vote-deciders before they even began to touch the cost of quality-based
competition (think how many monogrammed leather briefcases and dinners you
can buy for under $2 million).  When the decision became value-based, the
cost came down and the companies lost much more of their profit.

Formula companies and pump companies sure seem to operate the same way.
Decisions are made for large numbers of people *through* a small number of
people (HCPs for formula, LCs for pumps).  Why on earth would a formula
company care whether nurses understand the chemistry of a new formula?  If
it's a medical issue, as they say, the nurses won't be the decision-makers.
But this is yet another chance for them to show their faces and chat up the
staff and treat them to lunch - a dirt-cheap way of buying company influence
with perks.  The substance is just an excuse.

Would we get the lovely desserts and totes at conferences if pumps were
marketed directly to the public?  Are *we* what keeps the prices high?
--
Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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