Principles and Practice of Pharmaceutical Medicine

the nature and significance of given disease states
varies by country, and the trigger to seek profes-
sional assistance also varies. The ensuing doctor–
patient relationships reflect not only the national
medical culture but also broader societal culture in
such practical matters as the patient’s ‘right to
know’, freedom of information, tendency to litiga-
tion for malpractice and so on.

Corporate culture

In any company, the corporate culture permeates
every aspect of the company’s activities, affecting
promotion prospects, risk propensity, and indivi-
dual and group behaviors.
The principal concern of the multinational cor-
poration is the extent to which corporate culture
conflicts or fits in with the societal and medical
culture(s) in each country where the company
operates. Corporate culture is evidenced by shared
values about the conduct of business, and may be
strong or weak.
The most successful corporate culture is one that
can foster leadership that is responsive to potential
conflict arising in multinational operations from
culturaldiversity.Organizationswithsuchaculture
express a clear vision that is understood and sup-
ported internationally. Such organizations benefit
from an alignment of business values among
employees worldwide, despite varied national and
cultural backgrounds. Procter and Gamble is an
example of a strong corporate culture that success-
fullycrossesbusinessandgeographicalboundaries.
Complexitiescanalsoarisewhenamultinational
pharmaceutical company engages the services of
another organization, such as a multinational con-
tract research organization (CRO), with potentially
different corporate cultures. In each country where
the two multinationals collaborate, there is a need
to reconcile their corporate cultures, while simul-
taneously being responsive to local societal and
medical cultural considerations.

Languages

A multinational corporation necessarily conducts
itsbusinessinmanydifferentlanguages,presenting

challenges of internal and external communica-

tions. Companies with a weak corporate culture

are paradoxically more likely to cause local ten-

sions by insisting on a rigid mode of operation.

Companies with a strong corporate culture are

more likely to operate according to local cultural

norms under the guidance of local management.

For example, the ‘or not’, as in ‘would you like a

drink or not’ can be regarded as aggressive when

spokenin Englishin England,and yetisintendedas

acourtesy,indicating that thequestioner is trulynot

trying to influence your decision, when spoken in

English in Singapore.

Societal, medical and corporate culture

interplay

Figure 50.1 depicts how the cultural responsive-

ness of a company in a given country is deter-

mined by the overlap of its corporate culture with

local societal and medical cultures. The more that

the circle corresponding with corporate culture

overlaps those of societal and medical culture,

the more the area available for culturally appro-

priate behavior is increased. Figure 50.1 also pro-

vides a framework for comparing central with

National or

subnational

medical

culture

National or

subnational

societal

culture

Corporate

culture

Corporate

cultural

responsiveness

Figure 50.1 Venn diagram identifying area available

for culturally appropriate behavior (source Fletcher/

PPPM, first edition)

50.1 CULTURAL CHALLENGES 647