Beginning about 5 years ago, many US medical schools introduced severe restrictions on marketing activities by pharmaceutical companies and medical device manufacturers.
These measures often prohibited representatives of such firms from entering patient care areas and even medical school facilities, with the exception of tightly controlled training activities, and then by appointment only. In some cases, medical schools have issued outright bans against industry support of educational activities.
What is the rationale behind such actions? It boils down to a concern that industry funding may inappropriately influence both medical education and patient care. For example, a physician visited by an industry representative might be more likely to prescribe one of the firm’s drugs. In announcing a ban on such activities, one school likened the industry to Don Juan, worrying that physicians might prescribe drugs because they were “seduced by industry,” and not because “it’s best for the patient.”
There is evidence that even physicians who believe their decision making is not biased by marketing are in fact affected by it. Moreover, a good deal of such marketing is not exactly purely scientific. A perusal of medical journals reveals a plethora of full-page ads featuring slogans such as:
“Simplicity is clear information at your fingertips,” and highlighting images such as a physician walking down a hallway with a tiger, describing the featured drug as a “powerful partner.”
Such marketing is not inexpensive. Placing a full-page ad in a medical journal typically costs around $4,000. On the other hand, as an air traveler I have come across a number of slick full-page airline magazines ads touting medical schools and their affiliated hospitals.
There’s always been difference between “truth” and “marketing truth,” the former being the more stringent of the two. The daily bombardment of media messaging plus occasional advertising extravaganzas (hello, Super Bowl!) has desensitized us to where consumers don’t mind the fine print that says “Do not try this at home,” “Professional driver on a closed course,” or “Screen images simulated.” Many people appreciate that Minority Report was released before screens could be controlled with fingertips; and the Tricorder has taken decades to jump from Star Trek to the X Prize.
“Marketing truth” turns irresponsible when it opens up false expectations – that is, when reality is conflated to the point that consumers can no longer distinguish between what is real and what “may be coming soon.” Great, emotionally affective commercials can do that. But emergencies – those critical moments when we feel life’s fragility – are not when we should have to stop and ask “Can they really do that?” This is precisely the burden presented by a variety of recent ads featuring Fire and EMS professionals, the most dangerous of which is produced by Verizon. Verizon’s spot risks making the public think that EMS providers and firefighters currently have access to more advanced technology in the field than, by and large, they do. The advertisement is disingenuous, which certain important facts flubbed for dramatic effect. But that happens in the marketing world everyday—why should it be any different in the case of emergency medical services or health information technology?
Quite simply, because to do so risks inculcating in the public a false sense of comfort with the state of EMS technology today; and moreover—to those among us whom seek to bring long-overdue innovations to the industry—it risks the public asking, “Doesn’t this already exist? We saw it on television, after all.”
I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads. Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business.
I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces consolidate and organizations seek to brand and differentiate themselves. We are subjected to print, radio, and TV ads extolling services, expensive technology, and that fact that each institution cares more than its competitors.
Charlie Rohlfing blogged recently about the worst in hospital advertising techniques, and you will recognize them all. They usually include a Da Vinci Robot and orthopedic surgery that will “get you back in the game.” They claim to be “state-of-the-art,” “leading edge,” or “cutting edge,” with actors playing doctors and nurses in masks.
“The cheapest form of capital is customer revenue”
David C. Jones, Altus Alliance
Crowdfunding has had success in high-tech, where people are eager to explore new models. MedStartr is bringing this concept to healthcare where it can be particularly challenging to get a startup off the ground. They have a twist on crowdfunding to address requirements of healthcare, an increasingly popular way to raise capital for startup technologies and interesting projects.
MedStartr is like most crowdfunding sites that are non-equity. They have plans later to have an equity model once SEC rules are clarified. In the meantime. MedStartr is attempting to hit the sweet spot that crowdfunding poster child, Pebble Technology hit. That is, customers get a great deal and early access to a product. Meanwhile, the startup gets non-dilutive funding and market validation to help it grow to the next stage.
“Advertising is the tax you pay for being unremarkable.”
Over the 11 years I spent building the network at Epocrates, I learned a lot about physician behavior, motivation and the use of incentives. And while influencing nearly 50% of U.S. physicians to use a product requires that it meet a true need, fit into their workflow and be extremely easy to use – building one of the most trusted brands in healthcare goes beyond the product. It’s about being fanatical about understanding your users, engaging them at the right time, helping them support you and ultimately creating incredible loyalty.
Though we had a very analytical approach to user acquisition and brand strategy, I want to focus this article on something more fundamental – behavioral psychology. Truly understanding not just physician behavior but human behavior was core to the business at Epocrates and permeated throughout our business, marketing and product strategy. We focused early on in engaging physicians as consumers – B2C rather than B2B. Though a significant percentage of MDs are characterized as “small business owners”, we saw them as consumers first – hence, understanding human behavior, motivation, and influence drove product adoption and usage.
I was reminded of this recently listening to Dr. Robert Cialdini, speak at the 4th Annual Consumer Medicine Summit. If you haven’t read it, “Influence: The Psychology of Persuasion” is one of those dog eared marketing “bibles” that has remained on my shelf for years because its lessons on how to influence people are universal and timeless. In fact, I made it required reading for some members of my team. (Future postings on other favorites such as Nudge and Predictably Irrational, coming soon!).
Can you sell health reform the way you sell toothpaste? Can you stop health reform the way you sell soap? A lot of people apparently believe so.
I would guess that in the 10 months leading up to the vote on the Affordable Care Act (ACA), proponents and opponents spent more than $200 million on TV, radio and newsprint advertisements.
These ads were produced by agencies that basically knew nothing about health care. The clients of these agencies were groups that often knew nothing about health care. The funding often came from donors who knew nothing about health care.
By “knew nothing” I mean they did not understand health care as a complex system. That means they had no idea how you could solve real problems — like controlling costs, raising quality and improving access to care. To add insult to injury, most of the people who engaged in the ad wars knew very little about what became known as “ObamaCare.”
But this lack of knowledge didn’t slow anyone down. The abiding sine qua non for ad wars is the conviction that facts, knowledge and truth are irrelevant. It is the belief that people can be manipulated and conned into believing that what’s good for them is bad and vice versa.