"This is not about spin, this is about change," said Steve Parrish, addressing an unlikely group.The SVP of corporate affairs at Altria was speaking about improving a company's public image at a recent pharmaceutical roundtable in Philadelphia. As the top communicator for the holding company that owns tobacco giant Philip Morris, and a driving force behind the company's efforts to have a dialogue with its critics rather than hide from them, he knows of what he speaks. Even so, a tobacco executive addressing a healthcare group certainly strikes an odd note. "I was not there to give them advice or even draw parallels between the two industries," Parrish told me in an interview. "I wanted to talk to them about the mistakes we had made and the lessons we had learned. They were free to decide whether any of it applied to them." Nevertheless, similarities between the two industries are not difficult to identify. Both are often perceived as monolithic entities, conspiring against the public good to profit at all cost. For that reason, trade associations are not always the ideal - or credible - voice to reach the public. The goals of individual companies within the associations - competitors all - can also be subsumed by the collective. Altria found it needed to set its own agenda for change. "One thing I thought we'd suffered from was this notion of 'Big Tobacco,' " Parrish explained. "Any time a tobacco company does something controversial it tars the rest of the industry - no pun intended. We're trying to find a new way to do business." Parrish also warned against a "bunker mentality" when he said, "Listen to the outside world, especially your critics, study their motivations, analyze their mindsets." He added that he doesn't know whether or not Altria's efforts have had a positive impact on the perception of the entire industry - and that's not the point. Pharma companies should embrace the same attitude of benign self-interest, as some already have. The point helps underscore a fundamental difference between the perception problems of both industries. Smokers know that the product can damage their health, and may or may not blame the industry for their habit. But healthcare consumers may have a profoundly positive relationship with their drug therapies, experiences that truly change and improve their lives, even while they disparage the industry that produced them. That disconnect, between the way a person may view the drug and the industry, is an essential point for companies trying to distance themselves from the industry's reputation woes, according to those who counsel them. "We are implementing programs for clients where it is the individual conversation between the company and the person affected by the product that has the biggest impact on the perception of the company and on changing the value equations with the company," said Gianfranco Chicco, a principal with healthcare shop Chandler Chicco. Fellow principal Robert Chandler agreed. "All healthcare is local." That message needs to be conveyed more clearly than ever in the wake of another potential trust crisis with the recall of Merck's Vioxx. While the pharmaceutical industry looks outward for perspectives from people like Parrish, drug companies should also look close to home where their brands are making a difference.