Human purpose is the catalyst for better healthcare communications

How creativity helps providers, patients and carers

The rate of medical discovery is increasing exponentially, technologies that previously existed only in science fiction are now a reality, and the vast potential of data has finally been unlocked. The future of healthcare is exciting, and patient outcomes will improve. But by how much and how far will be based on our work as a creative community. The reality of the best and most advanced treatments making their way to patients across the globe depends on our ability to raise awareness, drive education and ensure universal adoption.

Not long ago, we were suffocated by #BadPharma and the historic conduct of our industry. We were guilty of championing our pills, our commercial success, our self-importance. As such, we were dismissed by the brightest creative talent, who instead chose to advertise the latest fashions, lifestyles, must-haves.

During the last decade, we have made incredible progress to change the behaviors, philosophies and ambitions of the pharma community, and as such, external perceptions. Human purpose is our priority, making a meaningful difference the catalyst to attract the most empathetic, the most passionate and the most brilliant creatives to our cause. Those who deny tradition, champion change and demand more.

Our job is to transform healthcare professionals (HCPs) into innovators, so they are the rule versus the exception. Ensure patients are educated and engaged—activists for their own health and that of others. Help unpaid carers to become project managers of care and the champions their loved ones need.

Every year, we see tens of thousands of HCPs retire to be replaced with a new breed of digital natives. For millennial HCPs, scientific knowledge remains the foundation of their profession. But as you would expect, their ability to use technology has transformed how they operate. The concept of learning via a textbook is now archaic, yet some of the best science is still hidden behind overwhelming reports, publications and data. To better support HCPs in this world, we need to leverage the latest technologies to ensure that for the right patient, at the right time, they have the right information. We also need to recognize the evolution in their characteristics. Today’s physician is more open to collaboration, many of them now harbor entrepreneurial tendencies, and, like wider society, they are visually conditioned. As we learned at Cannes, pharma can no longer celebrate our creativity, we need to deliver creativity for good powered by human purpose.

As part of my research series, I published a white paper Smiles That Save Lives, which explores the vital role of creativity on the subjective well-being of patients. Google discusses winning the moments that matter, and we need to do the same in healthcare. We need to make sure patients feel supported in the broadest sense, and that they are part of their solution. Engaged and empowered patients are the influencers. They are the heart of the community and broader crowd. They are critical in the credibility and cascade of information to the global community. For too long we have failed to connect with many of our patients. The clichéd smiling patient has been the easy solution. Today we must build partnerships at an emotional level, with understanding, empathy and human insight.

The third group we must consider is the “invisible army” of healthcare—carers. In the U.S., the value provided by informal caregivers—families, friends, neighbors—was estimated to be $470 billion in 2013, and increasing. Unpaid carers are the glue that holds healthcare systems together. To doctors they are the partners turning treatment plans into reality; for pharma companies they are the catalyst to success; and for patients they are everything. To unlock the true potential of carers, we must broaden our focus. We must tell better, more relevant, readily understandable human stories to ensure there is a true information exchange between the HCP, patient and carer, so that carers become the advocate patients so desperately need.

Purpose, empathy, humanity have always been the foundations of healthcare. It must now also be the building blocks of our communications.

Agency of the Year

Cannes Lions Healthcare Agency of the Year – championing change and demanding more…

Havas Lynx Group are Cannes Lions Healthcare Agency of the Year 2018

I am exceptionally proud of the progress that we have made, while equally excited about the work we are still to do. This is not the end, nor is it the beginning. During the last decade we have made incredible progress to change the behaviours, philosophies and ambitions of the pharma community, and as such external perceptions. Not long ago, we were suffocated by #BadPharma and the historic conduct of our industry. We were guilty of championing our pills, our commercial success, our self-importance. As such, we were dismissed by the brightest creative talent, who instead chose to advertise the latest technologies, fashions and lifestyles.

Since the inception of the Havas Lynx Group, we have been leading the charge in defining a new approach to pharmaceutical communications, one which champions transparency and considers healthcare holistically. We embrace breakthrough scientific discovery, emerging technologies and meaningful data, as well as the individual experience of all stakeholders in care.

Brilliant, empathetic, vulnerable; creatives. The spiritual partners to stakeholders across healthcare that deny tradition, champion change and demand more.

Every year, we see tens of thousands of healthcare professionals (HCPs) retire to be replaced with a new breed of digital natives. For millennial HCPs, scientific knowledge remains the foundation of their profession. But as you’d expect, their ability to use technology has transformed how they operate. The concept of learning via a textbook is now archaic, yet some of the best science is still hidden behind overwhelming reports, publications and data. To better support HCPs in this world, we need to leverage the latest technologies to ensure that for the right patient, at the right time, they have the right information. We also need to recognise the evolution in their characteristics. Today’s physician is more open to collaboration, many of them now harbour entrepreneurial tendencies where their predecessors did not and, like wider society, they  are now incredibly visually conditioned. As we learnt at Cannes, pharma can no longer celebrate being social. Our content campaigns  must now compete with the very best of the consumer world.

As part of our research series, we published a white paper Smiles That Save Lives, which explores the vital role of creativity on the subjective well-being of patients. Google discusses winning the moments that matter, and we need to do the same in healthcare. We need to make sure patients feel supported in  the broadest sense, and that they are part of their solution. Engaged and empowered patients are the influencers. They are the heart of the community and broader crowd. They are critical in the credibility and cascade of information to the global community.

For too long we’ve failed to connect with many of our patients. The clichéd smiling patient has been the easy solution. Today we must build partnerships at an emotional level, with understanding, empathy and creativity.

The third group we must consider is the ‘invisible army’ of healthcare: carers. In the UK the estimated cost of the NHS is £134bn and the estimated value provided by unpaid carers is £132bn, a difference of just 1.5%. Unpaid carers are the glue that holds healthcare systems together. To doctors they are the partners turning treatment plans into reality, for pharma companies they are the catalyst to success, and for patients they are everything. To unlock the true potential of carers, we have to broaden our focus. We must tell better, more relevant, readily understandable stories to ensure that there is a true information exchange between the HCP, patient and carer, so that carers become project managers of care.

The future of healthcare is exciting. New technology, new science and new data have the potential to drive exponential advances in medicine. We have access to massive quantities of data harnessed from a plethora of new technologies. AI and machine learning are revolutionising how we understand and use that data, helping us to develop new, more personalised treatments more quickly and more cheaply than we ever thought possible.

In short, what we once believed to be science fiction is now a reality. But the reality of the best and most advanced treatments making their way to patients depends on our ability to raise awareness, drive education and ensure universal adoption.

Our job is to transform HCPs into innovators, so they are the rule vs the exception. Ensure patients are educated and engaged – activists for their own health and others. Help carers to become advocates and champions for their loved ones. And in doing so, ensure equal access to the latest, most progressive science, technology and data. Winning Cannes Lions Healthcare Agency of the Year is a step in our journey. We can do more, and we will do more. We know the role we must play as a creative agency to help unlock the future of medicine, today.

Generation Now – Round Table Event

When we started our journey into Generation Now I had no idea how much interest it would generate and how it would develop a life all of its own. Generation Now puts the millennial healthcare professional under the spotlight and never more so than at our most recent event – a round table meeting of key millennial healthcare professionals, at the Royal Society of Medicine.

We were delighted to be joined by some of the industry’s top healthcare entrepreneurs and millennials. Between them Dr Shafi Ahmed, Dr Stephanie Eltz and Dr Matt Jameson Evans represent some of the most innovative faces of healthcare in the twenty-first century. Dr Ahmed, consultant general and colorectal surgeon, is a leader in the use and development of augmented reality in clinical practice in areas such as sharing the latest surgical techniques through live streaming oncology operations[i]; Dr Eltz is a trauma and orthopaedic registrar and founder of Doctify – a platform-neutral online patient-doctor interface and Dr Jameson Evans, previously an orthopaedic surgeon, is the co-founder and chief medical officer of HealthUnlocked – an online community that is gaining a reputation for being the LinkedIn for patients with chronic conditions. We also had key leaders from the pharmaceutical industry and the ABPI.

The round table discussion was lively – as you’d expect with such big personalities in the room. Entrepreneurs by nature are generally outgoing and yes sometimes outspoken – but then the point of the evening was to try and discover what the millennial generation could expect from healthcare, and what we could all be doing to help it get there.

Big data came up and, not unexpectedly, but maybe not quite fairly, the NHS’s apparent struggle to cope with it. Perhaps the recent involvement in healthcare of big data big guns such as Google and Facebook can help it find its place in healthcare. ‘Wearables’ were also seen as one of the next big things. Continuous blood glucose monitors are already ‘a thing’ but imagine the possibilities for 24/7 monitoring of health predictors and the benefits that this could bring to people with other chronic conditions. And where do I even begin with the possibilities that virtual and augmented reality could bring?

We may all be used to viewing healthcare as an immovable object, but everyone in the room was in agreement that much of the technology, either under development or already available to support the millennial HCP, will disrupt this status quo. As an industry we have so much to offer the millennial HCP and help them become positive disruptors, that can take new technology into healthcare for the benefit of all of us. One thing is clear – the future is most definitely coming, and with it huge steps in our understanding of patients, diseases and treatment.

While there were far too many great points made throughout the course of this event to talk about here, there are a few key things that really stuck in my mind. It’s clear that we all need to increase collaboration to encourage the uptake of these innovative technologies.  We need to stop thinking we have to maintain the status quo – our entrepreneurial HCPs are delivering some amazing new approaches and, if we really embrace them, they have the potential to add enormous value to the way our healthcare system works. Probably the most important point though, was that while innovation should be welcomed, we must remember not to leave people behind. After all it is the millennial healthcare professionals and millennial patients that make our health service what it is; and what it will become.

Thank you to everyone who made this such an exciting and insightful debate.

Participants involved include:
Dr Shafi Ahmed, Consultant and Surgeon, and Co-founder of Medical Realities
Dr Stephanie Eltz, Founder of Doctify
David Hunt, CEO Havas Lynx
Dr Matt Jameson Evans, Co-founder and Chief Medical Officer of HealthUnlocked
Dr Rebecca Lumsden, Head of Science Policy, ABPI
John McCarthy, Vice President, Global Commercial Excellence, AstraZeneca
Dr Claire Novorol, Founder and Chief Medical Officer of Ada, Founder and Chairman of Doctorpreneurs
Sarah Price, Senior Planner, Havas Lynx
Hiba Saleem, Partnerships Director of Doctorpreneurs and CO-founder of Medtech Student Network
Dominic Tyer, Editorial Director, PMGroup and Chair

The Generation Now Round Table event will be featured in the November edition of PME, available online from 8th November 2016.

[i] http://www.wired.co.uk/article/wired-health-virtual-reality-surgery-shafi-ahmed

 

Millennials, who’d have them?

Building an agency, by David Hunt

Born in 1980, I’m a borderline Millennial depending on your preferred interpretation. Regardless, I can still feel like an old man when it comes to Millennial engagement in the work place, which is why I’m so proud of our retention rate. Many agencies struggle to retain bright, ambitious talent, whereas at Havas Lynx, we prosper.

We believe Millennials want to make a difference and at Havas Lynx, we are committed to doing just that. We focus on improving patient outcomes; to drive commercial success for our partners. But our efforts don’t end with the client budget, we go much further. In 2015, we’ve already funded the education of 42 children in Africa.

We believe that Millennials want to exist within a vibrant community. #LYNXLife was launched to preserve and enhance our culture. It includes a tea lady, breakfast club and Summer Fun day offline, and Facebook and Instagram, online. To get involved, join us by following #LYNXLife.

Each year we conduct an internal survey.  Of 200+ participants 30 %  said professional development was their key priority. Many people challenge our investment in #LXAcademy accusing it of being excessive but I’d challenge us to spend more.

We try our best to shun excessive structure and hierarchy. Yes, the ultimate decision resides with the senior team but you won’t find us hiding in an office. To my knowledge, no-one at either Havas Lynx, or formerly Creative Lynx, has had their own office, and it’s my intention to maintain this record.

It’s up for debate how many of these principles are specific to Millennials and to me, it simply sounds like good business. But then again, maybe that’s just the Millennial in me.

Campervan

Every week should be Carers Week

Following on from Carers Week 2015, we reflect on the need to do more to support caregivers and introduce our study into the holistic needs of those who care for people with long-term conditions.

‘Being a carer in 2015 can be incredibly tough, taking a huge toll on health and mental wellbeing, finances and relationships. More and more people are taking on a caring role – 10.6 million over the course of this Parliament. So getting it right for carers has never been more imperative. Carers can’t carry on doing this alone.’

– Heléna Herklots, Chief Executive of Carers UK.

Last week was Carers Week in the UK, an annual campaign that raises awareness of caring, highlights the challenges that carers face, and recognises the contribution that carers make to families and communities throughout the UK.

All week, at events and via the internet and broadcast media, stories of the commitment and devotion of carers have been shared. As was the case at Local Solutionsannual information event at St. George’s Hall in Liverpool on Friday, which brought together charities and organisations to showcase the services available to carers. It was wonderful to see so many people coming together in support of the caring community, and it raised reflection on whether pharma does enough to support carers.

There are nearly seven million people in the UK who are carers, a figure that is on the rise; last week it was reported that three in five of us will be carers at some point in our lives. This isn’t a UK-specific problem: the World Health Organisation estimates a soaring demand for carers the world over, with needs rising by as much as 400% over coming decades in some developing countries.

The importance of the efforts of carers cannot be underestimated. To many patients, they are a lifeline; without carers, many simply couldn’t manage. To the British economy, they’re indispensible, saving the public an estimated 119 billion pounds a year.

Whilst the pharma industry is not immune to the importance of carers, it’s rare to find pharma-initiated interventions that target carers.

Why should pharma help?

Often the question is raised of which professionals are the gatekeepers to patient care, but arguably no one professional could be more important to the success of patient outcomes than the person caring for them every single day. Ensuring their health and wellbeing can drive greater treatment success. It’s also worth noting that carers are often ‘patients’ themselves; in a 2012 survey of 3,500 carers, 53% said they have suffered a long-term condition or illness, whilst 39% had put off medical treatment due to caring responsibilities.

Additionally, this is a group of people whose need for support is greater than ever. In spite of the indisputable fiscal and social value, cuts to financial support in recent years (such as the ‘spare room tax’ and the introduction of personal independence payment) have put carers under increasing pressure. Reports on carer wellbeing indicate that this is a strain they could well do without. Carers UK has recently published research showing that 82% of carers feel that looking after a disabled or older relative or friend has had a negative impact on their health.

The statistics are both alarming and compelling, but to uncover the full story and better understand what can be done to help we need to speak to people. It’s with this in mind that, over the coming months, we’ll be talking to carers about their needs and what impact caring for a person with a long-term condition has on their lives. These interviews will form part of a quantitative study to be included in our autumn white paper later in the year.

Pillars

Public or private, healthcare should focus more on happiness than holding on

‘Everywhere I see the mistake of ignoring that people have priorities in their lives besides merely surviving another day.’
– Dr. Atul Gawande

In Britain, the current strain on the NHS is a key topic as we head towards the general election in May. In the closing moments of a live debate on Channel 4 News last night, Health Secretary Jeremy Hunt commented that, ‘for the public, it’s not about public vs. private; it’s about good care vs. bad care’. But do we know what good care is?

The healthcare industry has been built upon treatments. Progress to date has been based on innovating around the molecular, on tackling problems in the minutiae of the atomic arena. It has brought some incredible advances and delivered great success in changing lives.

However, it’s a focus that ignores the bigger picture of the patients these treatments are created for. Patients whose conditions may infiltrate every aspect of their lives, and have consequences that they live with until their dying day. For these people, treatment is just one aspect of their journey, and the care they require extends far beyond this. They need help in communicating with professionals, understanding and accepting the implications of their condition, taking control of their health and the other aspects of their life it affects (work, finances, family). Unsupported in any of these instances, patients can feel isolated, confused, and deeply unhappy.

In his BBC Radio 4 Reith Lectures in December, Dr. Atul Gawande exclaimed that, ‘we’ve been rather limited about what we [in healthcare] think our job is, building systems of care for human existence. We think our job is to ensure health and survival, but really it is larger than that. It is to enable wellbeing, and wellbeing is ultimately about sustaining the reasons one wishes to be alive.’

We need to pay greater respect to wellbeing and happiness. It might sound trite to say that happier patients are healthier, but improved wellbeing has been shown to improve cancer outcomes, lower the risk of heart disease and stroke, encourage adoption of healthy behaviours, and even lengthen lifespans (amongst other health benefits).

In an era in which healthcare moves to outcomes based performance models, ensuring patient wellbeing could be a catalyst for improved treatment-brand success. It’s time to look far beyond the pill, from the beginning of a patient journey to the very end, and provide support at every moment in between. Support that instils patients with the happiness, confidence and encouragement to stride on toward a positive outcome.

For more on the power of subjective wellbeing and holistic support, read our latest white paper,  Smiles That Save Lives

Watch our introduction of our interview with Lucy May Middleton, holistic support advocate and educator here

Smiling cat

Good Cause

Doing Good, While Making Money

Social Success, by David Hunt

I talk about this a lot, but make no apologies for the frequency. I’m proud to work in Pharma, and see it as an opportunity to use insight, imagination & innovation to make a difference. I didn’t choose to work in healthcare, I simply liked ideas. In all honesty, as a bullish graduate I would have preferred Nike over Pfizer, but the world changes, and so do we. Today I choose to have a significant impact on society, over a cool one.

Paul Polman, CEO of Unilever, says: The business benefits from ethical practices are not soft ones about reputation or image. They are hard measures of growth and margin improvement. Wherever you look, it’s a no-brainer.

I agree 100%. Havas Lynx aims to help patients, their families and HCPs to improve outcomes, whilst also driving the commercial success of our clients. We call it #HelpfulChange, and whilst it sounds improbable and unrealistic, it has been the central strategy behind our success. It aligns with the increasing trend for Pharma companies to out behave the competition & benefit through their enhanced brand equity. Unfortunately the more conservative in our industry wait for others to fail & win by default. Doing nothing, but doing nothing wrong, they would argue. These people fear their brand, and lack the courage their power affords them to improve society. Those that embrace this power, those that choose to make a difference, and show courage in their actions, will succeed in today & tomorrow’s social world – they’ll have a brand with meaning.

Johnson & Johnson have invested in Care4Today, through Janssen Healthcare Innovations. Like many others, they believe innovation can improve outcomes. However, unlike the majority, they have invested significant time & resource to bring forward that day. They will both make a difference, and secure a competitive advantage.

AstraZeneca invested in a critical testing infrastructure for non-small cell lung cancer. Monthly tests increased from 18 to 452 over the course of the campaign. Patients were more accurately diagnosed, treatments more accurately prescribed.

Novartis support Skin To Live In and, despite the regulatory challenges, aspire for it to be the most progressive campaign in healthcare communications, supporting the community & building brand equity – a fair trade.

These are just a few examples from our portfolio, beyond Havas Lynx there are numerous other superb cases of brands doing good and making money. It is the future of our industry, one that will be shaped by passion & courage.

Hand shake croped

Content is King, so they say…

Participate in something greater, by David Hunt

“Content is King” is a great expression; catchy, weighty, easy. It’s also misleading, absent of substance, and wrong on many levels. As of January 2014, the Internet has 861,379,0001 websites, or if you prefer Google has indexed 200 Terabytes of data2 which is just 0.004% of the total Internet. Either way, there is no shortage of content. There is however an appetite for relevant, topical, bespoke content delivered as part of an expert brand strategy – the social world requires brain not brawn.

Content is a form of advertisement, albeit positioned as a more sophisticated strategy. The objective remains to elicit an emotion that drives an action. However, despite this universal truth, the world has changed. It is more connected, more social, and ultimately more judgemental. It is no longer enough to tell stories; we need to craft a collaborative narrative. Being instant lacks longevity and durability. Producing content without emotion and relevance dilutes and devalues brands. Today, more than ever, the market requires insight, imagination and innovation. Our Havas colleagues in Australia produced what I consider to be the best social campaign in healthcare: The world’s most powerful arm.

Great agencies are more, not less, critical to the brand building process. So too is a genuine brand. We can no longer manufacture our image, we can no longer limit the format of our customer interactions, we are exposed, open, and unintentionally honest. A strong authentic brand personality is essential. It must represent the values of a business and be aligned to the personality of their customers. Fonts, colours and high-gloss photographs, pale-away versus behaviour and conduct. Social success today relies more than ever on the principles of brand development.

The scale of the Internet is infinite, standing out from the crowd is harder than ever, unless of course you join the crowd. Become more than just an isolated part. Participate in something greater. Unite your community through a shared ambition. Do more. Social success is inextricably linked to the power of the collective to make a difference; it requires more than a content production line.

shutterstock_103225520

  1. http://www.techmadeeasy.co.uk/2014/01/18/many-websites-january-2014/
  2. http://www.websitemagazine.com/content/blogs/posts/archive/2014/07/22/do-you-know-how-big-the-internet-really-is-infographic.aspx


‘Never do you see as much hope and ambition as on the 1st of January’

Does pharma need to reshape traditional borders and practices in recognition of universal digital behaviours? Can this be the catalyst to improve outcomes across the globe? What role can HAVAS LYNX play to unlock this opportunity? What are our ambitions for 2015?

The Global Opportunity, by David Hunt

In the fifteen years since I started out in healthcare communications, I’ve noted that typically when a company seeks to shake things up they appoint a new e-commerce manager, set-up a small innovation hub, or change a few job descriptions. Yet in those same fifteen years, I’ve gone from making calls on my phone to living my life through it. Our attitudes and habits have changed drastically and we know that our industry needs to better reflect this. But do we know how?

Do we need to run things differently?
Social media and wearable technologies offer great opportunities to pharma, but tech alone won’t transform pharma, just as the latest Garmin watch won’t propel weekend joggers to Olympic glory. We need to look at our processes. In my opinion, we are quick to leap into lengthy rollout processes, when we should be quicker to dive into prototyping.

Play To Cure: Genes in Space is an app created by Cancer Research UK, whereby users identify critical faults in real gene data by zapping asteroids and collecting space dust. This visionary combination of gamification and crowd sourcing for clinical benefit is the result of of rapid prototyping. Over the course of a two-day game jam, teams of developers, scientists and academics conceptualised and experimented to produce 12 prototypes. The most promising idea was taken forward, developed and released. Even after the release, developers took advantage of the virtues of digital to make further updates.

Shouldn’t pharma be this iterative and agile, and learn through experimentation?

For further information, please review our white paper on Wearables and for more information on Gamification please see our presentation on slideshare.

Is it time to redraw the map?
Some time ago, we carved up the world into vast market regions (EMEA, Asia-Pac., etc.) and we’ve stuck by these distinctions ever since. Why? Last year, 45% of Scottish people said they didn’t feel adequately represented even within the British Isles. Yet where geography and culture still divide, technology unites (in behavior, not beliefs); the average internet user in Germany spends the same amount of time online as the average user in Kenya.

Do we need to find new criteria by which to map our markets? Could technological uptake or HCP preferences be more incisive distinctions? Why should different therapy areas or different companies define markets in the same way? There are questions to be asked, most important of all: could a smarter choice of market distinctions offer a competitive advantage?

For further information, please read our white paper on the Global Opportunity

Can we fit into our users’ world?
The taxi I took on New Year’s Day was an Uber, a company non-existent ten years ago and now reputedly worth $40 billion. What makes Uber great? I use Uber because it’s quick and convenient. I have friends who take comfort in the safety it offers, others who love the ease of payment and splitting fairs via the app. Like many of the decade’s most successful digital start-ups (Airbnb, Dropbox, etc.), Uber offers a neatly packaged, universal service that fulfills a range of users’ needs.

Our lives are filled with such brands – we pick and choose the ones we like and build our own digital ecosystem with them. These ecosystems are an intrinsic part of our lives and pharma must learn to fit within them. The biggest consumer brands have managed it, pharma should be no different. We have the insight, commitment and expertise to make a difference.

Rather than offer all-in-one solutions, how can we integrate with the brands already established in people’s ecosystems?

For further information, please review our presentation that introduces our thoughts on Personal Ecosystems.

Can we deliver holistic improvements that drive better outcomes?
What one thing are patients, payers and professionals the world over looking for? Better patient outcomes. However, this doesn’t necessarily require better treatments. A range of factors contribute to patient wellbeing – adherence, lifestyle, mentality – and a combination of incremental improvements in such areas can make a huge difference overall. Digital is undoubtedly a tremendous vehicle for encouraging behavior that delivers these improvements. Dr. B.J. Fogg provides extensive academic evidence, but for more immediate proof we may look at Fitbit – it doesn’t make runners better, but it encourages habits that make runners better – and it is just the start.

What small improvements can pharma instigate to dramatically promote the success of a treatment?

Should we re-evaluate how we prioritise markets?
In any industry, it’s typical to focus on the markets that represent the biggest commercial benefit. However, I believe there’s a broader criterion pharma should consider. Consumer brands such as TOMS and Patagonia are built upon their strong social conscience. Could pharma engender such values in its approach to the global market, and look to promote a greater equality in treatment around the world? Driving positive outcomes in low-income markets would have an incredible impact on vulnerable populations, whilst providing a compelling, ethical positioning.

It might be ambitious, but could we expand the global medical debate beyond science to include morality and social responsibility?

Our resolution for 2015 is to find a few answers, and fulfil our potential to make a real difference. We’re excited to work with partners that share our values, beliefs and ambitions.

For more information please see a recent key note talk on the topic, or read our latest white paper.

Narrative Education

Dr Nick Broughton is Medical Director of HAVAS LYNX Medical and has a strong interest in the ethics of business and compliance. Nick tries to explore the good and not so good in an industry he cares about. Below he writes about narrative education.

Narrative education: The power of storytelling, the importance of the individual and the start of a radical shift in pharma, by Dr Nick Broughton.

Telling stories
Telling stories

Boston 2013 and a bunch of agency types collect in a rather cramped and faintly dismal hotel function room for an afternoon of whatever it was the meeting agenda said. Into this arena of postprandial apathy steps Dr Rita Charon foremost exponent of narrative medicine and it appears she has forgotten her slides. Nothing appears on the screen behind her save for an artistic abstract featuring, as I recall, purple lines and black rectangles.

With nothing on the screen to stimulate the senses, a confused audience turns its attention to the quietly spoken senior gentlewoman occupying stage front. The lady is talking, clearly though not loudly, and with little, if anything, that could be described as so vigorous as a gesticulation. All I could think (given the piscatorial attention span of the average agency executive) was that I hoped the gags were good. There were no gags.

Dr Charon told stories. Individual patient stories recounted with depth of feeling and detail no one had witnessed before and, unexpectedly, the audience was rapt. These weren’t case studies as beloved by clinicians (49 year old man with three year history of x, had lab results y so I gave treatment z) or patient pictures (photo of healthy looking smiley person with something chronic and life-shortening) as beloved by the more naïve end of the pharma marketing community. These were stories that put disease, healthcare and treatment in their proper place within the context of individual human lives: narrative medicine.

The point here is that it is impossible to understand the impact of an illness on an individual without understanding the individual’s story. The effect on a person of being diagnosed as HIV positive is quite different depending on their marital status, their age, their culture and, most significantly, a myriad of factors particular to them.  This is the ‘data’ you need in order to act for that individual; this is the patient story. The art of the good doctor is to understand the narrative so as to be able to understand the disease and target therapy appropriately. Good medicine is narrative medicine, but narrative medicine is also, I would propose, good education. Dr Charon in describing the narrative of a patient with a rare disease indelibly imprinted the memory of its signs, symptoms, treatment and outcome in the memories of one hundred people who, up to that time, had lived in happy ignorance of any such disease.

Yes, stories are powerful but it’s really a bit glib to leave it at that. Storytelling, story appreciation and story learning are hard wired into our brains. We humans consume and repeat stories rapaciously all across our lives. From gossip down the pub, to jokes, to news stories we frankly can’t get enough. We absorb stories to the extent that we can completely suspend reality in pursuit of story enjoyment. When you turn on Coronation Street you (probably) know it’s not real, it’s being displayed on a flat screen for one thing, it’s shot in a studio, the actors appear in the papers, but none of this interferes with your appreciation of the story. It gets more bizarre still – theatre goers watching Shrek (the stage version naturally) rapidly forget their own presence when sat in rows in front of the acting ranks to absorb a story about an eight foot ogre. The truth of the story does not impact their appreciation or indeed their memory of it, and that latter fact is the crux of the medical educational opportunity that good storytelling represents.

The obvious opportunity in storytelling is to educate about disease, treatment and outcomes through the prism of individual patient stories as evidenced by Dr Charon. Good case studies told well on the congress stage can get part way there as they recount the triumphs and tragedies of a diagnostic conundrum, but they lack the medically irrelevant human details they need to make them good stories. Good storytelling needs that characterisation to make you care about the outcome and a good plot to surprise and dismay you along the way. Us humans like a structure to our stories, a set-up, a series of crunch points, a climax, a resolution. If you are Quentin Tarantino you might get away with mucking with plot structure but lesser mortals shouldn’t bother.

A good patient narrative, in effect an anecdote, is a Trojan horse for knowledge that our brains are unlikely ever to be suspicious of, but we must avoid confusion with anecdotal evidence. Patient stories should represent tested evidence and medical fact or give pertinent lessons on the unusual and be clearly labelled as such. This missive is not a plea for Daily Mail medicine.

Of course, such thoughts could be seen as a bit drippy in the hard EBM world we live in today; narrative education as I’m describing here is hardly mainstream. What’s wrong with explaining medical matters in blocks of prose with umpteen graphs and a slug of stats? What do you mean you can’t remember it? Thing is though, underneath all the bluster your top KOL/external expert/therapy area expert (the names vary – the gist is the same) is just the same story loving beast as the rest of us even where medicine is concerned. Telling the tale of your new medicine’s development, the characters, the failures, the blinding insights and the dumb mistakes can be an intriguing cocktail if told well. It has the useful spin off that for many a HCP it provides the first realisation that there are one or two steps for pharma before selling a drug.

Training on storytelling recently I got into in-depth discussion of whether storytelling could ever impact on that most sacred of objects, the clinical paper. Do they have to be quite so dull and unmemorable? I know we all (well ‘piscatorians’ at least) read the abstract and only carry on if there is something positive but it still seems like a wasted opportunity.

Wouldn’t it be cool if you wanted to pick up a clinical paper for the pleasure of reading the story within it rather than as a necessary drudge to find the interesting bits? More seriously, when reading clinical papers is such hard work is it any wonder we naturally ignore those that hold only negativity and non-significance. There are patient consequences to positive bias as our friend Dr. Goldacre has recently been explaining, but unlike him I suspect the issue is grounded more in human disinterest in the uninteresting than pharma malevolence.

The structure of a story, its characters and plot is one thing, but above all a story needs a storyteller. Stephen Fry I suspect could read a train timetable and keep us fixated. Harry Potter would have passed unnoticed into oblivion if his many exploits were described in an SOP. Execution is critical and herein pharma has created its own demons by spending too long supporting too many mediocre medical story-tellers to speak on its behalf.

Times are a changing and, I suggest, it’s about time. Pharma is equipping itself and its medical teams for a radical shift that will involve it speaking more for itself about the medicines it develops, the research it does, the lives it improves and (yes) the profits it makes. The shift is barely underway and will be painfully slow, but as we break ground let’s not forget the whole flaming point of what we do when we speak for ourselves – the patient and their story.