The healthcare industry is speaking in jargon. It's trying to convey a message, and consumers just aren't getting it.
Healthcare communicators already know that most consumers are health illiterate.
They know that consumers develop emotional connections to products, and concepts like "brand loyalty," ludicrous 10 years ago, are now part of the game plan.
They're so good at what they do that they've convinced consumers to open up about embarrassing diseases they didn't know they have, and ask their doctors about products they never knew existed.
The public has become fascinated with health. Consumers are savvier than ever, and media attention to healthcare has increased accordingly.
But it is no longer enough for healthcare communicators to translate terms such as "deep vein thrombosis" to "blood clot" to speak the consumer language. The message that healthcare PR hasn't figured out how to put in consumer-speak is a cost analysis.
By thrusting itself and its products into the consumer fray, the healthcare industry has also opened itself up to criticism as debate rages about the cost of healthcare.
Healthcare is becoming more expensive - and for many people, more out of reach - for reasons that are both organic (new technologies and the aging population) and circumstantial (fewer private employees offering health insurance.)
So it's only natural that consumers want to know why. Why are we forcing senior citizens to choose between drugs and food, and is there a better way?
Fair questions. But the direct-to-consumer (DTC) "arms race" has become the scapegoat du jour.
Industry has tried to frame the pricing discussion in terms of the high costs of research and development. But to the public, the raw numbers - the hundreds of millions of dollars spent on advertising - seem astronomical, and not the drop in the development bucket that they really are.
Even the most significant healthcare story this year - the recall of Merck blockbuster Vioxx - was in its own way a question of drug marketing.
After the Vioxx recall, newspaper and magazine articles linked Merck's zealous advertising (one newspaper report places it at $500 million) with an over-drugging of America - the quest to convince consumers to pop an expensive pill, when they would do equally well with an aspirin or a few lifestyle changes.
Savvy consumers know that doctors, health insurers and especially the government are supposed to serve as a check on commercial interests.
But as the Food and Drug Administration succumbs to infighting over whether it can adequately monitor drugs post-approval, public distrust in these other parties will take a nosedive. And that doesn't bode well for industry.
Experts already see a greater emphasis on PR, specifically social responsibility programs and initiatives to create positive associations in the community.
The industry - which has so deftly inserted terms like "erectile dysfunction" and "irritable bowel syndrome" into common vernacular - is again trying to find the right words.
This column is about chopping through the big words and the big ideas, and paring them down into simple messages. It's about speaking a common language.
There's a lot of work to do.