Purple Cow or Bull in a China Shop?

How to make change stick

A colleague once generously called me a Purple Cow.

I say “generously” because he used the phrase as Seth Godin did, to mean someone/something intrinsically different. As a Pharma marketer, I constantly pushed for new marketing approaches. However, much of the time I tried to drive change, I probably behaved more like a bull in a china shop than a remarkable purple cow.

In fact, the Pfizer Health Literacy principles were launched internally two times because I had not fully involved my marketing colleagues the first time. After the initial launch, less than 25% of the patient literature coming out of my own department adhered to the principles. When even the people you directly supervise refer to a pamphlet written according to health literacy principles as using “dog food language” you know you haven’t done a good job socializing the concept.

As the founding partner of extrovertic, a health care consulting firm focused on delivering innovative marketing solutions, I continue to seek out new marketing approaches. However, I now appreciate the importance of involving others and managing the change process. So extrovertic has enlisted the help of a former colleague of mine, Susan Domotor, an expert in change management, to help extrovertic clients to successfully implement the change they seek to build their businesses.

According to Susan, studies show that business initiatives rolled out with less than adequate focus on the employee aspects of the change have about a 30 – 40% success rate” (Blanchard, IBM). As I found out in rolling out the Health Literacy Principles, this translates into significant amounts of wasted time and money.

Here are Susan’s top three recommendations for getting your colleagues to embrace the change you seek:

1. Create a strong business case – A business case helps people understand the importance of the change, conveys a sense of urgency for what you are trying to achieve, and generates a sense of ownership for a successful transition. A strong business case answers three questions: Why is the change necessary? What is the change? How will we achieve the change?

2. Ensure that Leadership is visibly engaged and is driving the change – Visible leadership support is critical for success and it cannot be delegated because employees will only commit to efforts that are driven by their leaders.

3. Develop a focused Communication Plan – An effective communication plan is critical to influencing employee behavior. The plan must create understanding for the initiative; provide employees opportunities to question, digest, and internalize the change; and as the initiative progresses, celebrate successes, share best practices, and capitalize on opportunities to highlight the performance and behavior that are valued in the new way of doing business. It is important to build the communication plan before kicking off your initiative. You can modify it along the way.

Change is being continually foisted on the pharmaceutical industry. Chances are that no matter what your job function, it now involves change. Whether it is to instill a new patient-centric mindset into your organization or to get your colleagues to embrace multichannel marketing for physician outreach.

Lucky for me (and patients struggling to understand health care information), my colleagues gave me a second chance. After the re-launch, over 95% of the patient pieces produced met the Pfizer Health Literacy Guidelines. But with a strong change management plan, you don’t have to count on being lucky, just being prepared.

Data is king but emotion rules

Seems every other article on marketing I read says data is king, but if you want your brand to be differentiated, you have to get emotional. While the basic tenets of “brand building 101” requires generating both rational and emotional insights, the emotion I am talking about here is different—it is about letting yourself get emotionally involved.

As business people we are taught to prize distance and rational thought. But my experience working on a Hepatitis C brand taught me that allowing yourself to get emotional generates uncommon insights and that these insights are what power brand differentiation.

Here are three ways to start the differentiating sparks flying.

First be willing to explore your hunches. Trust your gut. My client had a hunch that understanding what Hepatitis C patients went through to overcome their addictions would generate uncommon insights. About 50% of Hepatitis C patients have experience with intravenous drug use. So we conducted a deep dive into all sorts of addiction: food, drugs, alcohol and tobacco. We spoke to addiction experts and the addicts themselves. We came away with a paradigm shift in how we viewed our customers, from people with disabilities to people with special abilities. This new perspective colored our entire communication plan.

Second interact with your customers every chance you get. Get uncomfortably close. It is one thing to read that hepatitis C patients often have trouble with basic life skills. It is another to be the recipient of a panicked call at 6:30 am from a patient advocate worried about fronting the expense on an invoice slipped under her hotel door.

By getting close, you experience the patient’s issues on a deeper level. As the saying by Confucius goes, “I hear and I forget, I see and I remember, I do and I understand.” Incorporate experiential learning into your research plan along side the traditional A&U studies. You can even contract with one of those researchers that arrange for marketers to spend a loosely structured weekend with patients.
Be forewarned though, you may feel uncomfortable or awkward at times. It was personally painful for me to come face to face with my unenlightened views of addiction and evolve my thinking.

Third, try to empathize with your customers. I still remember the anguish I felt listening to one man I met at a Hepatitis C patient meeting. A former intravenous drug addict, this soft-spoken, dignified man told his story of “falling off the wagon” when his two beloved Chihuahuas died unexpectedly. But he climbed back to sobriety. We heard story after story of patients staying off drugs.

I remember thinking; I can’t even muster the discipline to resist a second helping at dinner, would I ever be able to overcome drug addiction? These people are superhero fighters. It was this insight that led to a very distinctive “boxer” campaign. The power of empathy to generate differentiating insights is abundantly clear when you compare the boxer campaign to that of the product’s main competitor.

As compelling as I hope these examples are, it is not easy to ask for money for activities that don’t have a straight linear path to the bottom line. However, know that if you do the same sort of research as your competitors, then you will end up with the same insights. Having the data on customer habits is necessary but in the end it is the emotional insights that differentiate your brand.

Tom Brady and Atul Gawande: Designing a Different End Game

Tom Brady and Atul Gawande, two Bostonians with wildly divergent careers, both take the same approach to designing a different end game; they flout the conventional wisdom to achieve their objectives. For marketers wanting to change the trajectory of their brand, company, industry or career, these two prominent Bostonians show the power of doing things differently.

Tom Brady, the New England Patriots quarterback, has always been vocal about wanting a different end game, one that would keep him playing high-level football in his 40’s. So according to a recent New York Times Magazine article, Tom defies conventional training practices designed at building strength in favor of those that create more pliable muscles. He credits his unique training practice with sparing him from career ending injuries, ultimately enabling him to win 4 Super Bowls (so far).

Atul Gawande, Boston surgeon and best selling author, challenges the more medicine is better medicine dogma that runs deep in our American cultural veins. Gawande addresses the literal “end game” in his best-selling book Being Mortal, to propose a radical new approach on appropriate care in our last years. Rather than doing everything possible to ensure maximum patient safety and longevity, Gawande contends that instead, a doctor’s role is to ensure that people leave this earth in a way that respects their values and priorities.

To do this, physicians and family members need to understand what constitutes quality of life from the patient’s point of view. In one example, Gawande tells of a daughter’s surprise at her father’s definition of quality of life as “being able to eat chocolate ice cream and watch football.” Her father had been a professor emeritus so she assumed he would not have wanted to live unless it was as a fully functioning intellectual. It was this knowledge that helped her make an entirely different choice for her father when faced with a life and death decision by her father’s surgeons.

I wasn’t so lucky with my father. The idea that more medicine, more effort, is not always appropriate was a totally foreign concept to me for most of his illness (and most of my life). So the poor guy cycled in and out of the hospital to rehab a number of times, getting weaker with every visit. By the time a palliative nurse friend of mine, helped me to see the light, it was too late. Having made the decision to bring him home after our post-dinner talk, I received a call the next morning that he had died in the Rehab institution.

While I can take comfort that my father seemed to enjoy all the attention he received at the Rehab facility, I often wonder if he would preferred a different ending. With my 88-year old mother, I have an opportunity not to make the same mistake.

The lessons of Gawande’s Being Mortal and Tom Brady’s historic Super Bowl victory transcend their individual career choices. Their work is testament to the truth of Einstein’s definition of insanity–doing something over and over again and expecting a different result. These two different men offer the same valuable lesson about the need to challenge the status quo to achieve a different result.

In the pharmaceutical industry where my company, extrovertic, does most of its work, there is a lot of organizational dogma about how to drive sales. It includes “HCPs write prescriptions, not patients,” or the time honored “the sales representative call is the best way to reach physicians.”

I know a lot of talented and progressive marketers who are confronting these doctrines on a daily basis. It’s hard work to be the one constantly going against the grain. But the experiences of Tom Brady and Atul Gawande are proof that a successful end game is worth the fight.

Building Great Brands by Talking Less About Them

You work so hard to achieve so little. Despite the amount of herculean effort involved in launching a pharmaceutical brand website, most patient never visit them. Any way you want to measure—unique visitors, click thrus, time on site— most pharmaceutical sites suffer from lack of significant consumer engagement.

But there is hope. Many brands in CPG have found a promising way to drive consumer engagement on their websites: by talking less about their brands and more about topics of more immediate relevance to their target consumers.

These brands engage in content marketing, which the content marketing institute defines as:

“the marketing and business process for creating and distributing relevant and valuable content to attract, acquire, and engage a clearly defined and understood target audience – with the objective of driving profitable customer action”

Some of the more notable examples are the Red Bull Media House, Oreo and Coke. An example closer to home is the J&J’s Global Motherhood site, which runs on the Huffington post. Half of the content is written by J&J, the other half by Huffington Post writers. Content marketing can either be developed in-house, by an agency or increasingly, in a partnership with a media company like the Huffington Post.

To me, the key for successful content marketing is that the content be rooted in the brand, but have relevance beyond the brand. On a practical level, it means taking the one word “brand essence” from the positioning document and identifying its application to the larger world.

For example, one pharmaceutical brand extrovertic did some spec work for had the brand essence of “security.” The brand at its core offered a sense of security in treating a disease with a very unpredictable course of progression.

It is easy to see that “security” has strong relevance in the wider highly unpredictable world. So a broader but very relevant communications platform for this brand would be: How to function in an unpredictable world. This content area is what I call a shared agenda, because it is both interesting to the reader and relevant to the brand.

This communication platform could spawn a wealth of interesting articles such as:

“How to tackle financial planning in uncertain times”

“5 keys to why some people handle uncertainty better than others”

“White Noise: Don Delillo’s fictional look at living with unpredictability”

“How to feel more secure in a large crowd”

Sadly the one thing that is predictable is the amount of resistance any new marketing approach will meet with in a pharmaceutical company. The direct brand building approach is so engrained. However, the results from the less direct, more content rich approach are compelling reasons to change. Content marketing can drive millions of viewers to your site. Consider J&J’s Global Motherhood campaign, which according to an article in Digiday, generated “4.3 million unique visitors and more than 570,000 social interactions on Facebook and Twitter” in its first three months.

In the digital age, great brands talk about something more than themselves if they want to be heard. So if you are unhappy with amount of patient engagement in your websites, think about using content marketing. It’s better than having to explain year after year why your numbers are so low!

Three Prescriptions for Patient Centricity

Patient Focused. Patient Centric. Patient First. There are lots of buzzwords companies use to describe their aspirations for a renewed focus on patients. But as my 8th grade Latin teacher once told me,

“The road to hell is paved with good intentions.”

Whatever phrase your company uses, here are three prescriptions on how to “walk the talk” of patient centricity in 2015 (and avoid a dance with the devil)

1. Fully infuse the voice of the patient into drug development. Historically, patient marketers are among the last to join pre-commercial or even launch teams. To be more patient focused, teams need to be staffed with patient experts early in the game.

And once in the game, patient marketers should make development of customer service and adherence programs the first order of business. As payers and patients have to increasingly make cost/quality trade-offs, it is critical that marketers can prove that their patient services actually make a difference in adherence rates, patient experience and clinical outcomes.

In fact, patient services already a factor into 3rd party purchase decisions. For example, according to a Duke physician I heard speak at a conference, Eliquis, a medication in the very crowded stroke prevention category, was chosen over competitors because the brand had the strongest co-pay assistance program.

Or just listen. Patients in clinical trials are already shaping opinions of the drug through their online conversations. An extrovertic social media analysis found an average of 30,000 patient conversations taking a place every month by patients involved a clinical trial.

2. Partner with providers and payers to meaningfully improve the patient experience at the point of care. HCPs, Integrated Delivery Systems and Payers are going to be judged on outcomes and patient experience. Pharmaceutical companies have the know-how and resources to help their customers meet the triple aim of improving patient experience, lowering costs and driving better outcomes. Take a look at all the governmental metrics requirements and pick a few to partner on.

It will also be important to have an expansive definition of point-of-care, both in terms of place where care happens and the people who provide the care. Care is now being highly distributed, it’s happening at home, at the retail pharmacy, at work, at Costco and at urgent care centers. And with the looming primary care physician shortage, care will be increasingly be delivered by nurses, physician assistants and even lay health workers.

And let’s not forget the increasing role patients are playing in their own health with the explosion of wearable technology and the whole quantified-self movement. The point of care is now everywhere and the smart pharmaceutical marketers will be conducting pilots to figure out how they can add to the patient experience.

3. Adopt a cross-channel patient experience framework to conduct marketing activities. A good patient experience is one that is consistent throughout every interaction, whether it be through a website, a phone call or in person meeting. Many of these touchpoints are managed by different functions in a pharmaceutical company, yet to the consumer it all comes from the same company. So the company has got to start acting like one company.

And this one organization needs to be reoriented towards driving patient satisfaction rather than driving sales. Driving satisfaction doesn’t mean revenue generation takes a back seat. There is a whole body of literature that proves that higher customer satisfaction scores result in higher sales and profits, in industry after industry.

But first the voice of the patient needs to be heard. This will require an integrated system of collecting patient feedback in a way it can be acted upon. For example, how well is the medical information call center doing in meeting patient needs? I would guess most marketers don’t know.

So take these 3 Rx’s and make 2015 the year that pharma companies turn patient centric talk into action. (And to my eighth grade latin teacher, Mr. Riggs, I really did “disce diligentius.”)