KIND WORDS FOR BIG PHARMA’S SALESMEN. How do you persuade nurses in a hospital in India to warm every new baby by placing it on the mother’s chest? Gawande says that the decision to make changes is a social process. Pharmaceutical salesmen are often disrespected, but Gawanda singles out the success of pharmaceutical salesmen in persuading doctors—“notoriously stubborn”, says Gawande—to adopt new medicines. He cites one salesman who told him of “the rule of seven touches”. You must personally “touch” a doctor seven times so that he will come to trust you. That trust is needed to persuade somebody to change. Gawande’s BetterBirth project teaches teachers in India, training teaching nurses how to teach and spread new procedures. Gawande concludes the article with a moving story of how one Indian teaching nurse persuades other nurses to change their ways by building trust. He talks to one nurse about how she had been persuaded by the teacher to adopt the new ways (hand washing, warming the baby by placing the baby on the mother,…). “Why did you listen to her?…She had only a fraction of your experience,” he asks the village nurse. The answer the nurse gives is: “She was nice.”

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