AUTH/2519/6/12 - GP v Lilly

Conduct of representative

  • Received
    06 June 2012
  • Case number
    AUTH/2519/6/12
  • Applicable Code year
    2012
  • Completed
    06 September 2012
  • No breach Clause(s)
    2 and 15.2
  • Breach Clause(s)
    9.1, 15.2 and 15.9
  • Sanctions applied
    Undertaking received
  • Additional sanctions
  • Appeal
    Appeal by respondent
  • Review
    November 2012

Case Summary

A general practitioner complained about the unprofessional and unacceptable conduct of a representative from Lilly who had visited his surgery with a poster. Following instructions from his/her manager, the representative insisted on photographing members of the practice team underneath the poster.

The complainant stated that the representative's aim was to get 10 photographs of doctors and nurses with the poster in order to win a prize. The complainant refused to go along with this, as did a nurse. The complainant stated that the representative then became quite shirty and insistent so the complainant left. Three other staff members had since complained that they were also unhappy but had their photographs taken rather than make a fuss.

The detailed response from Lilly is given below.

The Panel noted that the poster was derived from Lilly's diabetic peripheral neuropathic pain (DPNP) foot symptom assessment tool and asked readers if they were diabetic and ever got odd or painful feelings in their legs or feet. The poster was designed to raise awareness about the symptoms of DPNP. Health professionals might want to display the poster in the waiting room. There was no mention on the poster or the briefing document that representatives were to take photographs of a health professional with the poster.

The Panel noted Lilly's submission that one sales manager had implemented a customer engagement incentive competition for his/her team. This sales team was briefed using a presentation entitled 'The Wall of Pain Hall of Fame Competition' which explained that the competition was 'A project to engage representatives and customers to display the Foot Screening Poster in appropriate target surgeries' and 'An opportunity to enable the representatives to learn other functionalities of the iPad'. The aim of the competition was for each representative to have the poster displayed in 10 practices and to photograph the poster 'with or without your customer'. If 10 surgeries per representative was reached then the team would be rewarded with 'our usual cocktails'. One point would be awarded for each photograph of a poster in situ without a health professional and two points if a GP or nurse was in the photograph. Prizes were a £25 cinema voucher for the representative with the most points and a further £25 cinema voucher for the representative with the best, most amusing photograph including a GP or nurse. There was further reference to the 'bonus prize' of cocktails if each representative reached 10 surgeries. The presentation gave instructions on how to take and email the photographs. There was no mention of any professional discussion of the poster with health professionals or of the benefit of theposter to patient care. There was no guidance about when/whether to request a photograph nor to respect the wishes of the surgeries/health professionals in this regard.

The Panel was concerned that the name of the competition, 'The Wall of Pain Hall of Fame Competition', trivialised a painful complication of diabetes. The representatives were encouraged to amass points by placing the poster in as many surgeries as possible and provide photographic evidence of their success. There was no professional element to the competition.

The Panel considered that neither the sales manager who had instigated the competition nor the primary care sales team (which, on the balance of probabilities, included the representative at issue) that took part in the competition had maintained a high standard of ethical conduct. The presentation on the competition advocated a course of action that was likely to lead to a breach of the Code and high standards had not been maintained. Breaches of the Code were ruled, as acknowledged by Lilly.

As Lilly had not been provided with information to identify the representative it was impossible to determine precisely what had occurred. The Panel thus ruled no breach of the Code in relation to the allegations about how the representative in question had described the competition and the representative's behaviour.

The Panel noted Lilly's submission that the sales manager at issue had acted independently and that Lilly had not briefed its sales force to undertake the activities at issue. However, the Panel considered that the sales manager's encouragement of representatives to collect points by taking photographs of health professionals and rewarding this with cinema vouchers and cocktails was an activity that demeaned both the health professionals and the representatives and in that regard was likely to bring discredit upon the pharmaceutical industry. A breach of Clause 2 was thus ruled. This ruling was appealed by Lilly.

The Appeal Board noted that the sales manager had independently devised the competition with the aim of engaging his team to encourage display of the foot screening poster in surgeries so that patients might be better informed about DPNP and report symptoms. The Appeal Board considered that greater awareness of foot problems would be helpful to diabetics.

The Appeal Board was extremely concerned that someone as senior as a sales manager, who had line management responsibility, considered it acceptable to direct his team to try to include a GP or a nurse in photographs in surgeries to gain points towardswinning cinema vouchers and cocktails. The Appeal Board was also concerned that additional points would be given to photographs with the health professional and a prize was to be given for the most amusing photograph including a health professional.

Participation in the photographs was potentially demeaning to heath professionals. The Appeal Board considered that the sales manager had displayed very poor judgement and the competition as a whole was distasteful.

 The Appeal Board noted that on receipt of the complaint Lilly had ceased the competition and no prizes had been awarded. Lilly had not condoned the behaviour of the sales manager and had accepted the Panel's rulings of breaches of the Code. The poster competition had been initiated and devised by a single sales manager without the company's knowledge or approval and it had taken place in a limited geographical area.

Although Lilly had been ruled in breach of the Code, including failure to maintain a high standard, the Appeal Board considered, on balance, that the activities did not amount to a breach of Clause 2. This clause was a sign of particular censure and was reserved for such circumstances. Thus no breach of Clause 2 was ruled. The appeal was thus successful.