When east meets west, north and south

It is essential that the pharmaceutical industry, and likewise medical communications agencies, develop productive relationships with international opinion leaders. This can pose a number of challenges, as both language and cultural differences might lead to problems or misunderstandings.

Consideration of the language and cultural differences, plus the individual personalities, before a meeting and managing communications accordingly will facilitate a productive and trouble-free event. This article provides a glimpse of the potential pitfalls in thinking global but acting local at key meetings, whether large conferences or smaller advisory boards.

A few years ago, an important village elder from a small pacific island was late for an important meeting. The European head of the meeting became annoyed at his non-appearance and the excuses given by the other local attendees. Eventually, one man stood up and explained the elder had been eaten by a crocodile while fishing the previous day. To the European, this reluctance to explain quickly why the elder would never attend was bizarre and time-wasting. For the locals' part, there was extreme embarrassment and reluctance to impart such bad news about such an important man.

The benefits of international participation in meetings are obvious, but the consequences of cultural barriers are not always so clear, as the above anecdote illustrates.

It's not what you say, but the way you say it
All key opinion leaders (KOLs) deserve respect and the acknowledgement that their participation is valued. However, for some cultures, such as those from the Asia-Pacific, Middle East or Russia, this respect needs to be more overt. Invitations and briefings to KOLs regarding their participation in a meeting and confirmation of the meeting objectives must be clear and concise – it is essential to use simple language with no abstract or slang terminology.

Cyril Maurice is regional group product manager – Targeted Products at Ipsen Pharma Intercontinental Operations, which frequently invites KOLs to attend meetings at international locations. He said: "It's critical to optimise discussions between KOLs from different specialities and from different cultures to reach strategically relevant outcomes. I value working with agencies that have international experience and who understand how to communicate with different nationalities."

Logistics
Recognise that most countries are associated with either a monochronic or polychronic culture. The former – such as Americans, Brits, Germans and Scandanavians – will tend to arrive on time, keep to schedules and be task-oriented. KOLs from polychronic cultures, however, may arrive late to meetings, miss deadlines and are relationship-oriented – for example those from Spain, Mexico and Africa.

It is better to give too much information about the meeting location and travel requirements than too little. Even some world-renowned and well-travelled KOLs are not intuitive travellers. "I have arrived but I cannot see my driver" is an example of a phone call received from a KOL. The logistics team had to explain that the driver would be at the arrivals department, holding a sign, but that the KOL would have to get his luggage and go through customs first.

Practical aspects in organising meetings
The following aspects should be considered when planning a meeting for a cross-cultural audience:
• The need for clearly defined meeting objectives with attendees who will help achieve them
• An explanation of programme and format, with details of contributions required from all participants
• Avoid inviting KOLs with known personality clashes to attend small meetings. More time will be wasted trying to control egos than achieving objectives
• Unless part of the programme strategy, use seating plans to avoid both country groupings and perceptions of unintended KOL hierarchy. Place-cards with the KOL's name and country also help
• A good facilitator can diplomatically discourage KOLs – perhaps from the USA, for example – from dominating discussions and encourage quieter KOLs, perhaps from China, to voice their opinion
• Each member on advisory boards should always be asked for his opinion directly. Focus on his answers through both his verbal and non-verbal responses.

A German co-chair at a meeting of 100 international physicians once said: "You have two extremes of chairmen here. The Italian who will be animated and interactive, and me, the German, who will be very quiet. But I will be storing things up and will strike out with my opinion at the end!"

Presentations
Effective presentation relies on the ability to impart key messages succinctly and clearly to an audience who may struggle to follow detailed scientific data in a foreign language. If a presenter speaks in a non-native language, it is important he articulates clearly and does not speak too quickly. To assist an international audience further, slide content should reinforce much of what is being spoken, so that the multilingual audience does not have to depend so much on the audio of the presentation.

Avoid the effect of jet-lag by allowing presenters enough travelling time. An extra night's accommodation will be welcomed by presenters and improve their presentations.

At a recent meeting, one presenter's skills were impressive as was his knowledge on the content of his presentation, but he had little information written on his presentation slides. He did not require the details to present from, but the audience, the majority of who were non-English- speakers, would have found the more visual reinforcement of the material helpful.

Communication and contact in person
At smaller advisory group-type of meetings, attendees are usually introduced in a formal setting. However, at larger meetings, the onus is often on the individual to introduce himself. This can be very difficult for some nationalities. Russian, Asia-Pacific and Arabic attendees in particular may become a little isolated, so organisers should facilitate introductions during coffee breaks and dinners.

Physical contact is not appropriate in business in some cultures. At a conference, a female pharmaceutical executive from Iran told the story of a female physician from western Europe who had collaborated via email with a group of male Iranian physicians. When she eventually met them face to face, she hugged them. "They became like statues and went very white," the executive laughed. But, at the time, it had been very awkward, she said.

Typically, relationships with Spanish, Italian, Portuguese or American KOLs can become informal quickly, but those with French, German, Swiss and Middle Eastern KOLs often remain more formal. While this may be a generalisation, one should ideally follow the lead of the KOL regarding the level of formality in communications.

Feedback from KOLs
In general, KOLs are very appreciative of invitations to participate in strategic or educational meetings with pharmaceutical companies. However, they may sometimes be unhappy about something and whether, or how, they complain, will differ as a result of cultural influences.

Asia-Pacific KOLs, even those with no language issues and previous international experience, tend to be very appreciative of everything and are unlikely to complain. In contrast, Americans and Germans tend to complain in an animated fashion. Middle-Eastern KOLs complain but in a formal manner via their local contact, so involving a senior member of staff may be required.

The Author
Marian East is a director at MedSense
She can be contacted on +44 (0)1494 816313 or at marian.east@medsense.co.uk

To comment on this article, email editor@pmlive.com

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