Doctor, I’ve been having this pain in my back…
A few years ago, the rest of this consultation would have been relatively straightforward. I would ask some questions, run a couple of tests, recommend a treatment and the patient would feel reassured. Nowadays however, it tends to go rather differently.The patient will, more than likely, have already been on various websites looking for a diagnosis. They may also have looked into the different treatments available, even compiled a folder of information for discussion. They want and expect to be actively involved in their diagnosis and treatment plan. And if they aren’t completely satisfied with my opinion, they’ll get someone else’s. In short, “trust me, I’m a doctor” no longer holds much water.
Never before have patients been so well informed, so involved and influential in their healthcare. With a finger on the public pulse, the government is planning for personal healthcare budgets so that each patient can choose their hospital, consultant and treatment. Since I graduated 10 years ago, the face of medicine has become almost unrecognisable. It’s more like going shopping than to the doctor.
How does this make us healthcare professionals feel? I’ll be honest; a little mixed. The quality of information available to patients varies enormously and can sometimes do more to confuse than to clarify the situation. On the other hand it’s likely that a patient who feels invested and in control of their wellbeing will live a healthier lifestyle and engage with the required treatment. Isn’t that the aim?
Whatever the implications, the NHS claims to hold the needs and wishes of the patient at its core. This makes sense ethically and politically. The question is, why are healthcare communications agencies still servicing healthcare professionals before satisfying the public interest?
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Tim Scorer said (January 24th, 2008 at 2:35pm)
Medicine has and always will be about the patient, but it wasn’t always the patient who was making the decisions. Finally it seems healthcare and the communications industry behind it are catching up with today’s consumer-centric, socially driven vision.
This means huge potential for brand success. No longer should we be satisfied with forcing brands along narrow one-way trajectories (client brief – new image and headline – matching follow-on materials - new campaign - start again). We should invest in results by installing brands as part of the community, and forming communities around brands. And that’s why we’ve created a hive.
SaraF said (January 24th, 2008 at 3:20pm)
Spot on about the power of the drug bandwagon, the upsurge of patient power healthcare in Europe etc. However, isn’t the market also hugely influenced by an aging population who may not be as hands on as the rest of us? What is the consumer-centric model looking like in this context and what are the implications for service provision?
Tim Scorer said (January 24th, 2008 at 3:55pm)
There are potential health literacy gaps in the market that may be difficult to quantify, although I have seen tens of 60- and 70-somethings logging on to disease forums to seek and share advice even in what might be considered stigmatised areas. http://www.saga.co.uk/magazine/ourexperts/ourexpertsQandA.asp?subject=sc
Putting online aside there is an increased permission in society to discuss health. Not just permission to seek out expertise online, but an increased comfort level in to discuss health with friends, family, colleagues etc. This issue warrants an article of its own – watch this space.
To flesh out what I was saying about creating brand communities: it’s about creating a story that diffuses over different media channels. That means individuals aren’t bombarded with information but pick bits up according to where they are at the time. As they become part of the brand community they are filled in by other streams of conversation – the big idea is pulled together.
So instead of a campaign starting with one channel (typically in healthcare a print ad) and feeding all further elements of the campaign, the planning process sounds something like:
Who wants to hear our story? What parts of the story will each audience be interested in? How to best deploy each part? Is each part good enough to stand on its own? Will they encourage people to seek out the other parts? Who’s going to talk about it and what will they say? Are we ready to let them choose their own outcomes – to give them input into this brand?
This is powerful thinking that’s being led by some of the world of consumer advertising, but to our knowledge, very much a youthful concept in healthcare communications. Hive is here to change that.
MJ said (January 28th, 2008 at 5:58pm)
I see massive value in a communication philosophy that is far beyond integrated, where every piece of communication is part of the big idea rather than simply fitting into it or being wrapped up in the same packaging. I agree too that there is no reason for communication to be specific to a channel, and therefore it seems bizzare to start in advertising and merely expand the method of communication to reach more of your audience - a truly cohesive communication lends equal importance to the receivers of every channel in terms of its representation of the big idea.
However, there’s one bit I don’t understand. As Tim mentions, different parts of the story are told in the most appropriate places, and individual people pick up elements depending on where they are. What about the rest of the story? Assuming that membership of a brand community is not instant, and people are supposed to pick up all the parts of a story in a gradual, bite-sized fashion, will a single encounter with a piece of communication from a brand be sufficient to communicate a message? Is there anything to be said for hitting people with all the information whenever you’ve got their attention, and allowing them to choose what to pick up?
Lara said (January 28th, 2008 at 6:34pm)
Interesting point about hitting people with information vs letting them choose what to pick up. It reminds me of that scene in Minority Report where the adverts start to talk directly to you….. scary! It also makes me wonder whether communication should be about putting out a message with the aim of promoting a product?
The digital environment means consumers generate or choose the communication they want. So communication becomes less about putting the message out there and becomes more about creating an experience, a relationship, a conversation (like this - I guess!) with permission to participate. It probably means that we need to get cleverer at crafting that kind of communication for healthcare brands.
Nice idea with the Blog guys. Good luck with the new venture.
Tim Scorer said (January 30th, 2008 at 2:48pm)
To hope to answer MJ’s query , It’s helped I think, when we are a bit more realistic about what our brands can achieve. It’s pretty rare for any product brand to be at the center of any group of humans, and more likely for a brand to be have membership of a community, with multiple channels of communication open to it. My belief is that to have an elemental/iterative story rather than one repeated conversation is a better approach. As this allows individual elements of the story which could and often are more suited to specific channels/media have that space to perform. In is simplest form your ad communicates - X, the direct mail - Y, your online - W and so on, but your story (X,Y, Z) is assembled by your audience. Rather than chucking XYZ at them every time they meet your brand. Does this help clarify it?
Dr J said (January 31st, 2008 at 11:38am)
First of all congratulations on website, refreshing and informative with very good ethos. Having been in general practice for 30 years, I too have seen major changes in consultations and their outcomes. It is not at all simplistic to assess and make progress . There is vast variation both regionally and socio-economically in one’s patient group which needs to be factored in to achieving the best outcome. Yes , patients do have better access to information but this is by no means universal. Also, this information is not always medically sound (ref; controlled trials etc) and does not always help the discussion. Patients can also search with obscure symptoms and obtain an internet diagnosis that the doctor may not have heard of which, although completely understandable, may not inspire confidence. My experience is that although one may present to patients all possible options for e.g treatment to them to make their ” informed choice”, the commonest reply I received was “what would you do Doc”. We are in danger of giving too much responsibility to patients in an effort to allow them to make choices regarding their condition when not all are in a position so to do. So each case needs careful assessment at “user end point” - wherever that is. However, I am totally in favour of more public education if the source is robust and commend you in taking up that challenge.
F Rocher said (February 4th, 2008 at 7:37pm)
This onslaught of (mis)informed patients will be difficult if not impossible to stop. I am not sure how one reconciles the need for a society to have health conscious and responsible patients, who actively seek improvements in their health, and an information environment that can occasionally be misinterpreted by these same patients. How can this work in practice? And who is ultimately in charge of the information provided?
Debbie Cramer said (February 6th, 2008 at 4:16pm)
Hi Ferrero(!), I reckon the baseline rules are the same. Doctors ultimately take responsibility for clinical decisions, so we’re generally protected from our mistakes. Best practice should involve acknowledging the self care efforts of patients while replacing their erroneous beliefs with accredited facts/telliing them how to find more reputable information.
I hope this isn’t too much to ask for under time constraints in consults. What do our doctors think? Does consulting with correctly informed patients save time? Would it be appropriate to devote this to patients who need a bit more help in getting it right next time?
Bambi said (February 10th, 2008 at 9:05pm)
So the world of branded comms has turned on its head - matching luggage and buying people’s attention is so pre Web 2.0. I salute team Hive for being forward thinking however I see some specific challenges for healthcare brands in this democratised age
1. Radical transparency is going to be tricky for pharmaceutical companies, who (is it fair to say?) have traditionally been more secretive and taken more of a PR battering than FMCG manufacturers or providers of services.
2. How will conversing with the healthcare end-user translate to brand equity when as yet we’re not allowed to promote POM products DTC
Great to hear your views.
Dr J said (February 12th, 2008 at 8:08pm)
Having read all the latest comments, I reply to a few.In my experience informed patients do not shorten the consultation process- they add to its length and can consequently make it over-complicated but it is important that this occurs if one has the time. It is the brief of the health care professional to direct the consultation appropriately to achieve the best outcome. Less-informed patients can sometimes arrive at the “appropriate “conclusion more readily. It is up to us to assess in to which group they fall and steer them accordingly.
I have huge respect for pharmacists and the prolonged and in-depth training they undergo to achieve their qualification- in fact I have been involved in the training of pharmacists and nurse practitioners to gain their supplementary prescribing qualification. In my view, what is required for a more rewarding and satisfying professional status and job satisfaction (and also clearly for the benefit of patients) is a much more professional environment in which to practice- that is a dedicated room for consultation- a practice that may already be occurring in a small number of outlets. How many times have we queued up for a regular prescription of eg paracetamol behind someone who is having to discuss the nature of their sputum or the description of their cough. Until this is put into general pharmacy practice, I do not think that the general public will afford to pharmacists the professional status which they deserve.
Ian Busby said (February 14th, 2008 at 1:58pm)
I think everyone would wholeheartedly agree with you. The good news is that the new Pharmacy contract makes it clear that consultation rooms are essential to the delivery of enhanced services, prescription intervention and MUR, and that the consulation area is distinct from the main area of the pharmacy, allowing professional and patient/ consumer to sit together confidentially. Whilst in practice this is not everywhere, it is now most and will be coming to all, and very soon.