Analysis: Gender Bias And ‘Jugaad’

Dr Tara Chaitanya’s unfortunate experience during the purchase of an expensive medical device is by no means an isolated episode.

She has clarity in terms of specifications, functionality and price of the device and high expectations regarding ethical and professional performance. The cost effectiveness of the ultrasound equipment is critical to the viability of Tara’s investment and practice. That she is sensitive to gender-related disadvantages to women in India that impede access to affordable healthcare and plans subsidised prices for them is noteworthy.

There is an apparent disconnect between a motivated and target-driven senior management and mid-level and field staff who exhibit delayed responses and poor preparation for meetings. There was marked improvement in behaviour when Company A’s sales staff interacted with Shiv, Tara’s husband, revealing gender bias. This unfortunate and widely prevalent attitude is due to cultural conditioning in the male-dominated Indian society where professionally competent women are consistently at a disadvantage.

Company A’s management approach is lacking in many ways:
a) Information was highly compartmentalised between the technical team and the sales staff leading to lack of a holistic picture of available options for Tara.

b) The company did not inform Tara regarding delays at Customs, which was mandatory.

c) Site assessment and determining the cost of any modifications required was not addressed in multiple meetings.

The suggestion from the installation engineer to repeatedly press keys to make the device function reflects another typical Indian mindset of jugaad in the absence of reliable quality parameters. Does the high-end Company A’s management know about this?

The Indian medical electronics industry, currently valued at $1 billion, has been growing at an average of 17 per cent for the past couple of years and is expected to grow to nearly $6.5 billion in size by 2020. “There are so many orders. What all will I remember” is a telling comment from Company A’s Akhilesh Awasthi, indicating the attitude of a sellers’ market.

To reduce the pain of purchasing expensive medical devices, doctors like Tara can take some steps: The buyer needs to have a thorough knowledge of the functions and exact specifications required. The specifications should be categorised as vital, essential and desirable so that price-functionality payoffs can be easily decided. Feedback regarding performance and the after sales service provided is essential.

Buyers should be armed with a format listing out every parameter that can impact decision-making, including price, insurance, transportation, taxes, customs duties, AMC (annual maintenance contract) with and without spare parts, possibility and incentives for upgradation, annual and lifecycle operating costs to enable realistic comparisons.

While one expects that the vendor will be diligent about site evaluation, but based on Company A’s conduct, it is best for buyers to obtain information about regulatory site requirements — spatial, electric,  temperature, humidity, etc.

One valuable advice to doctors like Tara: Form a consortium for purchase of medical devices. This pools expertise and enables volume discounts like centralised purchase in hospital chains.

Tara and Shiv should also have negotiated so that the final instalment of 10 per cent is paid only after satisfactory functioning of the equipment for some weeks, thus removing jugaad while operating the equipment.

As for gender bias, this will not go away for a very long time in India. Lady doctors can, in the interim, hire/ persuade a tough looking male to sit in on their purchase sessions, learn to talk turkey and develop a thick skin.

Shocking, but one has to advise vendors to include gender acceptance in their training, as well as how to respond promptly to calls, be on time, go prepared for meetings, etc., by role playing sessions and simulations.

Finally business success will demand that companies like A, B and C adopt process standards that will reduce buyer angst.

Good luck, Tara!   

The writer is a medical doctor from AFMC with a PG in Hospital Administration. She is Dean, Faculty of Health & Allied Sciences and Director, Amity Institute of Hospital Administration

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