ble debate for the healthcare PR sector comes at a time when the industry is witnessing great change. The rise in sophistication of how the healthcare sector uses communication and the widespread interest in healthcare marketing from PR consultancies that have invested in 'the only recession-proof sector' in recent years have only added to the momentum.
To discuss the way healthcare PR practitioners are dealing with a range of new challenges, seven leading specialists in healthcare PR were drawn together to share their views.
The issues in the roundtable are their choice. Patient empowerment, recruitment and evaluation were chosen as the most pressing of the day from among a range of topics. Other topics suggested for inclusion were terminology - a discussion of the fundamental question: How should the industry define healthcare PR as opposed to medical education? And a debate upon the increasing involvement of pharma companies' procurement departments in the agency appointment process, under the heading: How has this trend affected the client and agency relationship?
The seven panelists who attended the debate are among the leading practitioners in healthcare PR, representing a range of responsibilities for healthcare PR within their roles in both pharmaceutical companies and consultancies.
They were: Carolyn Brown, director, Countrywide Porter Novelli; Emma Crozier, associate director, Cohn & Wolfe; Julie Flexen, managing director, Munro & Forster; Tessa Lush, head of public affairs, Bristol-Myers Squibb; Sarah Matthew, managing director, Sugar Consulting; Edel McCaffrey, communications manager, AstraZeneca; and Catherine Warne, managing director, Red Door Communications.
They met PRWeek's associate editor - features Mark Johnson to debate the key challenges of the day.
Patient groups are an important part of a growing movement in which patients are demanding reliable information and data on the treatments available for their conditions.
The trend is part of a wider call by the UK population for greater empowerment in the decision process of how their healthcare is managed. But under restrictions currently in place, pharmaceutical manufacturers are banned from providing information about therapeutic drugs to patients, despite this growing demand.
The healthcare PR industry is left in a quandary - facing demands for information, but unable to provide it by law. Our panel of healthcare communicators held strong views on the topic.
SM: 'Patients want to know more and more about health as we move to a much less deferential culture. This generation is miles away from their grandparents' generation on their attitudes to health and a lot of issues. There was an excellent study conducted in the US at the end of the 19th century. They asked parents what was the most important quality they wanted their children to have and they said: obedience. The same study was repeated at the end of the 20th century and parents said: independence. How do we deal with more demanding patients?'
TL: 'We should be pushing for DTC information - that's the key - moving away from this buzzword "DTC" to DTCI. Get people to go to the experts on these products, the people who took it through phase 1/2/3 and 4 trials and who have all the information you might need.'
SM: 'The UK industry stance is DTCI, not promotions. It's about information provision - allowing patients to call and make enquiries themselves.'
EC: 'There is increasing responsibility for patients to take control of conditions like asthma and diabetes, as well as addiction, but we don't give them the tools to make their decisions.'
Of major concern in this debate is the availability of information online, predominantly supplied from the US where DTC is permitted, and which can sometimes be misleading as drugs available in the US may differ in potency and exact chemical composition compared to those in Europe.
CW: 'The Internet is not regulated and it's a great shame as it is easy to find unattributable rubbish, especially about MMR, online. So we must move with the times. Look at diabetes now, you're expected to be in control of your condition and yet there are a lot of laws that tell us not to tell patients anything. We need to do much more careful education.'
SM: 'Speaking to journalists this year, they assume pharmaceutical companies can make whatever claims they like about any drug - they have no idea how heavily regulated this industry is. But the manufacturers have more knowledge and information on that drug than anyone else and yet they cannot communicate about it. That has got to change.'
Criticism of the relationship between drugs companies and patient groups has led many on the panel to suggest an initiative to correct perceptions.
SM: 'People who say that patient groups are told what to say by the large pharmaceuticals companies are so far wide of the mark; it's completely wrong. You can't tell a patient group to say something it doesn't believe in. There are areas where professional groups such as nurses and doctors, pharmaceutical manufacturers and patient groups all agree around an issue, but agendas may differ. It's a completely ethical approach, but I don't think we do enough to tell the media what we do.'
TL: 'It's very important for us to understand the goals of patient groups and align ourselves with where they're going and what we can do to help them get there. Bristol-Myers Squibb has very large resources among our many departments and we can, as an advocacy group, help them to strengthen and build. It's a two-way programme, but to do it you have to do your homework on the group and the issues it faces or you'll go in blind.'
CW: 'It's sometimes said that we force doctors to do things, but we're afraid (as an industry) to answer that (accusation) and do our own PR. But the truth is, if we didn't do our job there would be millions of people who don't know about particular therapies. If we don't have that route to reach end users, we will never get information to them. Patient groups are just one route to them, as are the media, but they are a very important route.'
EC: 'I think we have to be more honest and open about how we work with patient groups and ethical groups. That might be a way to explode the myth (that there is something unethical about these relationships).'
EM: 'Some of the greatest communicators in healthcare work in patient groups. They have a great role in setting the record straight on how they relate to different parts of the industry.'
Healthcare is one of the fastest expanding PR sectors but there is a dire shortage of recruits to the industry. Some blame lack of awareness of PR as a career path for graduates and potential candidates looking for a career path change.
The topic started with the question: How can the industry attract scientifically-trained recruits?
EM: 'It isn't just scientifically or medically trained people who we need in healthcare PR.'
CB: 'It's important to consider people without science but arts and English backgrounds because the ability to understand language - someone who can communicate the language and concepts of medicine - is valuable and I think we need to encourage people like that into the industry.'
EM: 'You need a balance of both backgrounds.'
JF: 'We currently have a pharmacology student from Cambridge working with us. She doesn't yet know where she wants her career to go but she says she is not sure that she wants her career path to take her, in the end, into a laboratory. So I think it's important to encourage students to consider healthcare PR as a potential career.'
JF: ' I think it's a bonus to have someone who has something other than a scientific background - say with consumer brand experience, because with the industry moving towards patient empowerment it's important to understand the consumer and how they interact with brands.'
JF: 'We've just hired someone who worked recently for Max Clifford and they have come to us with great media skills - I mean they really do understand the media - and that has helped upgrade the media skills across the team.'
EM: 'A lot of people in healthcare PR seem to find themselves in it by accident and when they get bitten by the bug they tend to stay. As an industry I really think we need to do our own PR better in order to encourage people into the industry.'
SM: 'We have invested in a graduate recruitment programme specifically because of this. Of course, we're not big enough to do all the milk rounds with all of the universities so we selected a list of universities and colleges to target and created a package that we sent out to all of them with information about us, healthcare PR, and careers. The first time we had four places but received more than 650 applications. People don't realise it's a career choice. We've been doing it for a couple of years now and in the last in-take we took two people with PhDs and two with arts backgrounds.'
The issue of retention is also crucial in an industry with few recruits but plenty of opportunities.
CW: 'There is an ongoing cycle among recruits where they get a year's experience and then move on, and I actually wonder: do they get enough experience doing that? I would say they absolutely do not. But it's generally the case in this industry that there are about ten jobs per person.'
EC: 'Actually, it's not difficult to recruit but retain - especially at the account director level and above. We do a lot of work placements where we send people to work on the Independent on Sunday or the Daily Express, for example, as part of a plan to help them build their experience and ensure they continue to develop their role at the agency.'
EM: 'The industry must stop this thing where they promote people in order to retain them. It's really doing the industry no favours when there are people in senior positions who do not have the experience they require.'
The work-life balance issue is affecting healthcare PR too, according to some panelists, damaging both retention and recruitment to the field.
TL: 'I've found that recently a lot of consultants have started to go freelance and that sector is growing every month. I think it's a lot to do with the work-life balance issue, particularly as this industry is very female dominated. In Bristol-Myers Squibb we're really trying to accommodate it. Flexibility is one thing both agencies and pharmaceuticals companies can offer to retain people.'
EC: 'We take a lot of people's time at our companies - people work late and go to conferences at the weekends - and yet the industry hasn't been giving back this time in terms of offering occasional late starts, or time off.'
Healthcare PR is no less embroiled in the debate on the value of evaluation than any other sector. But there appears to be several myths about why healthcare PR in particular does not lend itself to ease of measurement - mainly because of the broad range of campaigns in both ethical and OTC and consumer work.
CB: 'It's frustrating sometimes because outside healthcare, PR evaluation means press relations - particularly in the US.'
JF: 'The main focus is always media relations, but consumer brand campaigns have massive sampling programmes, DTC, and we need to look at things such as the number of people reached, the age groups, what impact PR is having on trends.'
TL: 'If you look at the news recently, about 60 per cent of coverage has been about health, so if you're in FMCG, sport, consumer, a lot of people are identifying their products and stories with health issues, and are using health angles to get a story out to the press. But because of that, evaluation is becoming an internal challenge. The marketing department may think you've had the best story ever, but there may be a sense of media fatigue on a particular disease, say heart disease or hypertension, and that story will not be reaching your key opinion leaders unless you can find a new angle that will interest the journalist.'
SM: 'We have to ask: What do we want to achieve? And ask our clients: What is the end point? Only when we have such information should we ask: What do we do when we get there? As an example, we were launching new data on a drug and the client said the objective would be that in six weeks, 95 per cent of consultants in that area would be aware of the data. We did some research both before and after the launch of the new data among the specific audience. Not only did we ask if they were aware of the data (first unprompted and then prompted) but we asked: "How did you become aware of the data", because they may have heard about it from a medical rep or the media. Eighty per cent of the consultants believed they were made aware of the data because of things they had read in the trade and consumer media. That's crude - they could have heard about it in a meeting - but that was tangible stuff and it was incredibly cheap because it was tacked onto the end of a few surveys.'
CW: 'And the thing you find with exercises like that, once they've done it, they are converted. Just a questionnaire at a meeting before and after is not rocket science. PR people are very good at doing the wrong thing very well - great events and press conferences - but it needn't be complicated, it can be quick and easy.'
SM: 'But the issue is: is evaluation benchmarked? And what happens if a product or data is delayed, as so often can happen in healthcare PR? It's important too to build evaluation systems that are flexible when a plan changes dramatically. I have no issues with the concept of payment by results - and I don't think most agencies have - but we need an effective evaluation system first.'
The panel concluded that there is a clear opportunity for planned research and evaluation to improve practice in healthcare PR.
Back row left to right:
Emma Crozier associate director, Cohn & Wolfe
Tessa Lush head of public affairs, Bristol-Myers Squibb
Sarah Matthew managing director, Sugar Consulting
Carolyn Brown director, Countrywide Porter Novelli
Front row left to right:
Julie Flexen managing director, Munro & Forster
Catherine Warne managing director, Red Door Communications
Edel McCaffrey comms manager, AstraZeneca