Category Archives: healthcare

The CDC’s Twitter Swine Flu virus

One of the remarkable things about Twitter is how versatile 140 characters can be. When Jack Dorsey held the first brainstorming meeting at Odeo, where Twitter was born, he suggested calling the service “” for updating a small group of friends. No one thought it would turn into a mass networking communication system.

Now the U.S. Centers for Disease Control has adopted Twitter as a personal, AP-wire-style news feed for updates on the Swine Flu. But the CDC Twitter stream goes beyond wire reports; it provides behind-the-scenes access to how health professionals are fighting the H1N1 virus, including links to planning conference calls if you wish to listen in and downloadable messaging to help cascade the flu-fighting message. It’s going to be a difficult flu season; the vaccine isn’t quite ready yet, and Americans who wish to get inoculated will need three total shots, one for the regular seasonal flu and two more to keep the pigs at bay. The feed is a good reminder, and taking Americans behind the curtain to show how health leaders are developing plans to fight an outbreak is a nice touch.

Disclosure: the CDC is a past client. Mediassociates is not affiliated with this Twitter program. We update you on their flu effort both for the marketing angle and as a public service.

Via: Benatgeo

Why people are screaming about health care (it’s all about the middle)

Marketers could learn a thing or two from the ongoing debate on U.S. health care. Namely, in public communications battles, you don’t have to convince everyone — just a few percent in the middle.

First, the news: The United States is embroiled in arguments over whether and how to reform its health system. About 18% of Americans under 65 lack health insurance, and the United States is the only Western industrialized nation that does not provide universal health care. Universal coverage does not necessarily mean socialism or extreme taxes — there are actually four very different economic models which can be mixed to pay for it, including single-payor, private insurance, public insurance, and compulsory insurance. In a way, the U.S. already has universal coverage: emergency rooms provide last-resort care to the ill without insurance, and hospitals must offset those unprofitable cash drains by earning more in specialties such as cardiology and orthopedics. Critics of reform respond that healthcare will account for 21 percent of the U.S. GDP by 2020, that the free market is the most efficient check and balance on those costs, and that government bungling would lead to rationing and diminished services.

No matter. The issue is complex, so both the left and right have created glowing/demonizing language around the issue. Liberals have coined the positive-feeling “Public Option” title, minimizing future rationing or tax costs. Conservatives have suggested a federal plan (which includes end of life counseling) might kill old people and is downright evil. And so this week townhall meetings erupted into fights, putting people in hospitals. Everyone pointed fingers, with liberals blaming conservatives for inciting riots and conservatives suggesting liberal union thugs were threatening Middle America.

Tipping the scale requires pushing the middle

Why such extremes? It’s good communication science. Hyperbole works because in politics or crowds where the average opinion must be swayed, public relations doesn’t have to change everyone — just the central balance of the scale.

For example, the U.S. population remains relatively split between the two major political parties. While the 72 million registered Democrats now outweigh the 55 million Republicans, the recent presidential election was neck and neck until the economy collapsed in September 2008. If the Dow had gone up instead of down, McCain would now be president. The even split, plus general apathy on most issues, means any political consensus could swing either way with enough push.

Communicators influencing the masses know that in the middle of any spectrum, there are a few who can be swayed. Liberals and conservatives are already dug in. But if 1 in 20 people in the central base believe (pick your reality) that healthcare reform could protect the lives of 46 million Americans who don’t have coverage / will risk the lives of millions by rationing their current insurance, the issue will tip toward victory or defeat.

Which explains extreme messaging. Everyone on the edge of an issue already hears you. So you have to shout to get to the center.

Image: Room 116

American Well: Finally, the online doctor will see you now

Today hospitals face enormous financial pressure. Much like the U.S. Postal Service, which lost profitable shipping business to FedEx and got stuck with costly letter delivery, hospitals’ best customers are being cherry-picked away by specialist cardiologists or orthopedists with niche practices, leaving them with unprofitable, uninsured consumers in emergency rooms. Meanwhile the aging boomer population is a wealth of potential patients — but they avoid the inner-city hospital locations and go get their knee surgery at a boutique in the suburbs.

This is all a bit comical, since the solution is so easy. U.S. hospitals still have the best doctors in the world, but patients simply can’t find them. Studies such as Pew show with hard data that 113 million Americans search online for health information each year, and most (66%) begin at a search engine. Hospitals not advertising online and paying for Google keywords are missing more than two-thirds of their potential audience. Smart specialists, meanwhile, are piling on: Google “bariatrics” and you’ll see vast competition among niche surgeons who are now wise to the internet game.

The online doctor will see you now

One company stepping into the void is American Well, a service that gives consumers remote access to healthcare over the internet. Consumers visit a web site, punch in their condition, and can pick from a list of doctors to have an immediate web video conference on their home computer. The service has numerous benefits: no appointments are needed; the system will forward the recommendation to your regular primary care physician via fax, email or mail; American Well even records each session, so you can go back through your health records to recall what the doctor recommended.

Virtual home visits may be more attractive to patients than seeing an actual doctor. If a man wants to discuss erectile dysfunction, or a woman a urinary tract infection, a little squirming is involved confessing the issue to a doctor. But a face in a moving web pane, why, that feels a bit detached — creating a comforting illusion of privacy.

More hospitals could do this. The cost to e-serve all patients might be abnormally high, but highest-contribution service lines such as bariatrics, cardio, or ortho could fit nicely. In the perfect marketing world hospitals would use a broad presence on Google with thousands of paid keywords to pull potential patients toward online video chats, where prospects could be quickly screened and scheduled for appointments.

In an age where half the planet has cell phones and every senior citizen is familiar with a PC, hospitals that don’t allow patients to find them online do more than a disservice to the public. They’re also hurting their bottom line.

What helps burn victims may hinder advertising

Physicians at the University of Washington have created a virtual Snow World to help burn victims ease their pain. It seems the human mind, when immersed in stimuli, bends the body to its perceived reality.

The intriguing aspect for communication professionals is that brains can only handle so many data inputs. Just as a burn victim processing a video game where he hurls cool snowballs at penguins forgets about his real agony, consumers taking in one form of communication may not register other messages. It’s not a stretch to be reminded of the failure of advertising models in social media sites, such as Twitter or Facebook — where users are too busy creating content to peer at banner ads on the side.

This has dire implications for marketers as people begin grazing multiple media formats at the same time — watching TV while reading an iPhone while listening to music while texting a friend. Ad impressions are no longer impressions. Unwanted signals are filtered out. Why? We’ve found new social stimuli to ease our pain.

Via Dirk Singer. Backstory here.

The doctor placebo effect

A new study finds nearly half of doctors in the United States regularly prescribe placebos — pills that do nothing but make you psychologically feel better. It’s kicked off an ethics debate over whether the mental health benefits outweigh the nuance of a doc outright lying to a patient.

Which makes us think of most product and service marketing. People tend to buy things (or, this fall, vote for candidates) that they believe will please them — and consumers use preconceptions to judge the value of their choices. The vast majority of advertising is designed to create a placebo-type artificial reality around a product. Is a Lexus with leather seats really better than a Toyota with leather seats, if 90% of the parts in the vehicles are the same? Somehow the brand badge on front makes people feel better about the purchase.

Bottled water, vitamins, gas stations, coffee, supermarkets, leather jackets, men’s suits, toothpaste, personal computers, non-smart cell phones, consulting groups, hospitals — the list of commodities differentiated only by our expectations is long.

Setting expectations is more important in marketing than meeting them. You can order shoes from after reading about their incredible customer service — which is true — but you’ll probably end up with a shipping box containing shoes. The reality of true service or product differentiation is almost non-existent … but if you believe it exists, you’ll feel better.

Photo: Brendan Adkins

The Parkinson’s spoon

Someone we loved once had Parkinson’s disease, a motor system disorder that causes severe tremors in the hands and legs, sleepless nights, loss of balance, and immense frustration for the people who have it who otherwise should be in the prime of their life.

It’s so hard to convey what these people feel. This ad does brilliantly with a single image.

Work by Euro RSCG Life, Shanghai, China, via I Believe in Advertising. If you know someone with it, resources are here.

AARP recruitment: Brilliant up front, no boom in the back

You’ve probably seen the U.S. blitz promoting AARP’s, in which handsome folks 50+ talk in 30-second TV spots about the need to do something about healthcare.

The funny thing is, you need to do something, but what, AARP doesn’t say. Visit the AARP destination web site, dig around, and you’ll find advice on setting up community groups or writing letters to your editor to promote DividedWeFail. But no stance, no solutions, no policy suggestions. Universal health care? Health savings accounts? Reduced hospital expenses? Stronger oversight? The AARP is deathly quiet on any possible concrete point of view.

We wonder if this is really just a recruitment drive. AARP now has 39 million members and the aging Baby Boomer population is tipping in its direction … but the group has a bit of a stale brand rap. AARP is known as an organization for old people, and the cool Dennis Hopper types now growing silver may not itch to be active participants. Active membership is important; the LA Times has noted the AARP derives more revenue from insurance sales to its members than from membership fees.

If so, the AARP campaign is a nice Trojan Horse for grabbing attention. Take a hot issue and get people to sign up. For what? Maybe that doesn’t matter.

If your boss is over 60, slap this in the PowerPoint

World of DTC Marketing gives us the brilliant matrix above (really, just take a second to digest it) which explains the migration of attention and content. In a world of lots of choice, and little attention, the media plan has to change. Industries steeped with older execs and the plans of yore, such as pharma and healthcare, are often the most resistant to change … if they are not watching the customer data. Via Bill Green.

The cost of pushing pills: $61,000 per physician

A new report finds the pharmaceutical industry spends twice as much on promotion in the U.S. as it does on research and development. The numbers work out to about $57.4 billion in total advertising and sales promos, or $61,000 per physician, or about $190.82 for every man, woman and child in the United States. Just under 7% of the total, or $4 billion, was spent on direct-to-consumer advertising.

There are three ways to look at this. On one hand, Merck, Pfizer, Bristol-Myers Squibb, Eli Lilly, Aventis, Sanofi-Synthelabo, AstraZeneca, and Wyeth could be driving healthcare costs through the roof with these huge investments in promoting new drugs. On the other, stimulating market demand for emerging remedies builds the revenue funnel that allows breakthroughs in medicine to happen — and without a profit motive, new drugs would never make it through the complex pipeline to save you from cancer 20 years from now.

The third conclusion: Healthcare is a field in which advertising and promotions work. No one invests $57 billion without getting a return. We’ve heard regional hospitals argue, sure, that’s great — but we don’t have billion-dollar budgets like pharmas. Well, if pharma spends $13.30 per U.S. consumer for D2C advertising, and you have 200,000 consumers in your hospital footprint, the equivalent advertising budget for a 300-bed regional hospital would be $2.6 million. That’s manageable, and if you’re spending less, you’re underperforming.

There’s a lot of debate inside hospital walls over whether consumer decision pathways and physician referrals can be manipulated. We find it interesting that big pharma bets so much that they can.

(Credit to Marc-André Gagnon, the Département de Sociologie, Université du Québec à Montréal, Montreal, Quebec, Canada, and Joel Lexchin, the School of Health Policy and Management, York University, Toronto, Ontario, Canada.)