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Case Study: Of Image, Images And Imagery

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Dr Tara Chaitanya was numb with shock. The Rs 65-lakh ultrasound imaging machine that had just been installed promised to be a lemon. She had no idea what her next move could be. About 16 months ago she had asked herself again and again: Am I risking too much too soon?

Now, as she stared at the machine she would not believe that poor service, poor selling skills and poor attitude on the part of the vendor had inhibited her.

But Tara had been on a performance high, so that anything less than the best was unthinkable, for even her research and her academics had propelled her towards excellence.

Tara had raised her mind towards women’s health, and Rs 65-75 lakh was worth the cause, even if she had to borrow. She had seen the hesitation and social conditioning of women, the way girls were brought up, the inhibition that surrounded women’s health and consequently the mountain of superstition, hearsay and approximations that had compounded their health. Empowering women to know their bodies and their health needs was supreme to Tara, ranking above many other offerings of life.

She had worked 12 years, and of these seven in public hospitals, deliberately choosing them at first over the glossy private ones. The experience she gained catapulted her to heights of research, even she had not imagined. Encouraging her was her husband who taught her to fulfil dreams no matter how lofty and if at all she looked back in doubt, he urged her onward.

Then, she had moved to private hospitals as those were the only ones that had high-end equipment. She had marvelled at the intelligence and agility of these machines and what they promised. But soon she felt trapped in the private hospitals’ revenue target tyranny. Tara was a people’s doctor, she spent time listening to her patients and this improved the quality of her scans. But her employers at the Orient Hospital pressed their consultants to increase revenue per hour by reducing contact time per-patient, and, of course, steadily increasing consultation fee. The latter made it tough for the lower income patient to even consider good healthcare.

In parallel, her own plea for quality of medical investigations was both laughed at and aggressively discouraged at Orient. Her scans took perhaps the longest time, and her reports were very detailed. But then, she also came to be trusted among the specialists, many of whom advised their patients to go only to her.

Tara then decided to set up her own clinic to meet her own quality standards, patient expectations and also create space for a few needy patients every day. She contacted three reputed manufacturers of ultrasound imaging machines. Since medical school, and thereafter during her 15-year career including seminars and overseas fellowships, she had worked with several brands of scan machines — from monochrome to colour displays, from 2D to 3D to 4D-capable machines, and every kind of sophisticated feature. She was a natural with almost all of them.

The machine she wanted needed to have spirometric capability, N-D and M-D imaging, and a specific minimum set of probes to be able to accomplish different types of scans. These features were offered in the highest end machines of a few MNC vendors. Comparing notes with fellow doctors, Tara shortlisted vendors A, B and C, all reputed MNC giants. Her calibre and her dream matched the excellence of these machines.

A’s machine was called the AA-SW13, B’s offering was the BS232 and C’s model was the CCU-X. All were upwards of Rs 55 lakh.

As they always did, Tara and her husband Shiv, a senior ad agency director, debated the purchase decision.

Shiv: You are trying to set up a clinic with the S-Class Merc equivalents, and on feature and price, they are even like the Maybach. Why not start with something a little lower?

Dr Tara: Then, I will miss being able to do some of the critical scans that I want to offer. For some patients, these might be the difference between knowing exactly what to do next, and a ‘can’t say for sure’ report. Then again, the equipment is crucial to my continued research. The precision of its measurements will improve my inferences and, hence, eventual diagnosis. I will put in my life’s savings, take a loan, do whatever it takes, but I wish to buy the best.

Shiv:  If you are so clear, then, we just go and buy the machine!

Tara’s feedback-seeking discussions with her peers and seniors showed that products of A and B were somewhat superior to C in sophistication and features. Thanks to all those medical conferences, Tara had the coordinates of all the equipment companies and their sales heads, and she assumed that she could connect easily with them.

Three days later company A’s regional sales manager responded. Sameer Sequeira sent brochures with his recommendations.

As for B and C, a week passed without any response from them. Tara had to call them up a second and third time to set up the meeting! Eventually she got through to B’s regional sales head Mr T.T. Bala. Tara explained, “I have used your BS214  at Orient but would like to know more about all your top-end machines,  like your BS232, which you had showcased at the Bangalore seminar in July.”

Bala said he would have someone come and meet her. But not until nine days did a man from B called her. Deepak Dillon, a junior sales person, called Tara to fix a date for the meeting; then he called her again to reschedule it. For a sale that was going to be upwards of Rs 55 lakh, to a doctor who his RM knew, from a company that prided itself for its quality and finesse, Dillon arrived 95 minutes late without an apology.

Dr Tara: Perhaps Mr Bala has briefed you? I am keen to know about your BS232 model. But is this your only model with these features?

Dillon: I think so. Did you not pick up our brochures at the conference?

Dr Tara (somewhat surprised): I did, but I was also wanting to look at the lower priced machines, which supports these same features.

Dillon: I will have to check. I was told you wanted information on the 232.

Check? Was that why they had scheduled and rescheduled the meeting? Not sure what his designation was, Tara asked for his card. He did not hand it to her, he placed it on the table and pushed it towards her. He was a junior sales person. He was not engaging in the sale nor interested, she felt.

Dr Tara: What is the price of the 232?
Dillon: They must have told you a price. It all depends on the exact configuration you want.

Dr Tara: I just told you my requirement. It is exactly what I told Mr Bala 10 days ago. Please come back with the price and also details of your other machines with similar features.

Dillon said he would call her and left. A week passed and there was no response, whereupon Tara again called Bala.

Dr Tara: A gentleman from your office met me and was to get back with price and warranty details for the 232. I have been waiting...

Mr Bala: Oh! He did not get back to you? We have been busy with our reviews last few days. I will have somebody call you back with the price.

Next day, Rajesh Bambote called Tara with the price for only the 232, but not about other machines she had asked about. “Oh! But I am not from the sales or product division. I will have someone from sales call you,” said Bambote.  Yet, what he quoted for the 232 was higher than what her senior had paid for it recently.

It did not make sense to Tara. She was going to fund a part of the purchase with a bank loan. But Bala said this was their best price, with no discounts for paying full upfront. He said he would get back but he did not.

Tara was now quite frustrated with Company B. She narrated all this to her husband. “What an unproductive meeting! They don’t seem interested, Shiv. After all the calls, meetings and SMS-es I still don’t know much more than what they told me in Bangalore! So much for my time and follow-ups. It is a Rs 65-lakh sale for them... Do all you corporate sell like this? The guy was unprepared, had no information, was not enthusiastic about getting back with data, and he does not respond to my SMS. Bala says he is busy with appraisals! I am confused. What am I to do? Ultrasound machines are bought only by calling an organisation. You can’t buy them at a drug store...” she ended sourly.

Read Analysis: Dr Chandra Rosha & Rekha Ranganathan
 
 
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Shiv: Sales guys are usually armed with every kind of data. They also follow-up. I too am surprised that they are not eager.

Dr Tara: I wonder if it’s got to do with me being a woman. It’s like when I had gone to buy the air conditioners for my clinic, till you landed up, the shop guys hardly gave me options on the models, or compared features, nothing. But when you joined us, it was, ‘condenser, compressor, anti bacterial sir’, ‘Yes Sir’, ‘Certainly, Sir’, ‘three bags full, Sir!’ chairs were brought out, the soft drinks offered.....

Shiv: I know what you mean... but this is India. There is a set attitude you get to see. Dillon, Bambote must be really poor salespersons...

Dr Tara: And Bala? He knows I am serious about buying. Yet he sends a junior fellow? The chap was clueless, disinterested, cancels the meeting twice, comes late, does not even apologise or explain, then comes with no information... has no price offs to offer. Dr Kalra bought the 232 6 per cent cheaper and on instalment. I am willing to pay upfront and he has no cash discount ? Why so? Does not have a nice ring to it, Shiv. They quote nearly Rs 2 lakh higher than what they have offered Kalra! And they are not even following up, I am the one who’s been chasing them.
Shiv: Don’t be eager to buy. Let us look at C and A. Let me join the next time you have your discussions.

Company A’s regional head Sameer Sequeira had forwarded Tara’s queries to his colleague Akhilesh Awasthi who called on Tara and Shiv.

Tara was most familiar and comfortable with A’s AA-SW13. But it was priced far higher than B’s 232. Shiv growled a bit and Awasthi threw in a small discount. Shiv twisted him for a second year’s warranty to be added within the negotiated price. So far, so good. But the machine’s cost was still well above Tara’s budget, especially when the three types of probes were taken into consideration.

Sequeria did not reply, but Awasthi e-mailed her: 50 per cent advance payment for a delivery date, which was two months away. Shiv refused the offer. Only 10 per cent against order, and balance on delivery, another 3 per cent off on price, he pushed. Awasthi laughed happily and agreed feigning reluctance.

Tara confirmed her order but she pondered over the unusually restrained, unyielding nature of the sales people. She was buying a very expensive equipment in a difficult economic time, and had expected them to be eager to sell. Brand B had been more like “here are our terms, take it or leave it”. Brand A would have done the same had not her husband joined the table, but it rankled that Sequeira had chosen not to interact or respond to her mails.



Nine days before the delivery date Tara called Awasthi to check. She wished to have the room assessed before installation for any detail. His reply was, “We will be there.”

On the promised day, despite having taken advance payment, Company A did not deliver!
Tara could not help feeling let down. That they did not even call her the day before to tell her they were delayed, bothered her. She had paid... they owed her that much courtesy.

Tara called Awasthi, and he said, “Yes, there has been some delay in despatch from Steonus (the country of origin),  and, then, it also got stuck in Customs.”

Read Analysis: Dr Chandra Rosha & Rekha Ranganathan

Three weeks later, the machine was delivered but no installation plan was shared. Tara had to call Awasthi who said, “I will look into it.”

Dr Tara: You are going to ‘look into it’ now? I thought you would have a ready answer for something that is in your watch!”

Awasthi: There are so many orders, what all will I remember?

Wow... Awasthi’s voice now had an edge! Something told Tara this was the beginning of a very bad experience. Two days later, she called Awasthi and he said, ‘man is on the way’.

For its top-end machine, Company A sent a very junior person. He first found fault with her clinic room, then he said the plug point should have been closer to installation point (something that Awasthi should have evaluated much earlier).

With several patients waiting in the lobby, Dr Tara ran around for basics like rewiring of her electrical points.

When the installation began, the UPS that A had supplied did not work adequately and each of its six batteries had to be replaced one by one.... Tara watched goggle-eyed. How could a vendor be so irresponsible? This was India, power failed and tripped more than it worked! Having a UPS was part of existence! Shiv, who had been watching her growing angst day after day, said to her, “Do you know, that is how UPS manufacturing is a thriving industry in India, with a market size of $1,316.5 million in 2014.  The UPS that A has given you is a Rs 900 crore brand! Damn! Nothing works at all in India!”

Tara: Some things do work, Shiv. We just have a deep-rooted culture of corrupt thinking.
Presently, a bigger problem was waiting to be unleashed. Several keys on the keyboard of the touch screen machine would not respond to her inputs.  Tara quailed.

The installation engineer pressed a few keys too and said, “It is new equipment, that is why.. Just press 2-3 times... it will become all right.” Tara choked. “I don’t know what you are saying. How can it be normal?”

And then the man said, “My job was to unbox the machine and set it up, I have done it. You please call the company and tell them...” And he left. 
To be continued...

casestudymeera@gmail.com

(This story was published in BW | Businessworld Issue Dated 19-05-2014)