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Building relationships

Comms specialist, John Clare, contends that pharma's public relations is in need of some PR help

various words spelled out and crossing over like a word gameA full 25 years ago, I was a TV reporter in London when HIV/AIDS was the big story. I interviewed a professor who said: "If you're diagnosed today with HIV, choose the wood for your coffin." Today, if two men aged 35 received diagnoses, one with HIV, the other with diabetes, the one with HIV would have every chance of living longer than the other.

That change, as well as the development of successful treatments for common cancers, multiple sclerosis, asthma and many other conditions, has been driven by the pharmaceutical industry working with doctors, researchers and patients. It's absolutely right that we communicate that, clearly and accurately.

This summer, I was at a wedding in rural England. On my table was a serving colonel in the British Army. When I told him that my business advises pharmaceutical companies on communications, he said to the group, without fear of contradiction, "Of course you know that drug companies could cure cancer tomorrow, but they make more money by keeping people alive a little longer and charging a fortune for the drugs."

I was stunned that somebody so intelligent and educated could hold such a view. His opinions may be extreme, but he's not alone in his suspicion of the industry.

At the annual World Conference on Science Journalism (WCSJ), held in London this summer, one session asked: Is the growing influence of PR on science journalism in the public interest? I was on the panel at the invitation of the Healthcare Communications Association (HCA), alongside others including industry critic Ben Goldacre.

At the start of the WCSJ discussion, the chairman asked the 200-odd people attending this same question. Their response was no, with a 99 per cent majority.

So it's not just the pharmaceutical industry that needs to improve its reputation, it's the way PR operates within it. Ironically, pharma PR needs some good PR.

Misunderstanding
The motion discussed by the panel is indicative of how the pharma industry and its PR practitioners are not just misunderstood, but resented. This is partly owing to the traditional tension between journalists and PR practitioners. Many journalists still regard PR people as failed journalists and envy their salaries and corporate packages. In turn, many PR people regard journalists as hostile, cynical and frightening. Science writers (as opposed to health writers on the UK national press) usually come from a science background and are suspicious of all non-scientists who try to interpret their work.

Journalists have long memories and many of them are living in the past. They believe that PR involves lavish entertainment and that our relationships with doctors are based on freebie trips to five-star hotels in exotic destinations. They don't realise (maybe because we haven't told them) that such practices have been outlawed today.   

An impression we need to correct is the idea that PR = spin. The words 'PR professional' and 'spin doctor' are interchangeable in the public and journalistic minds. The reputation of political bruisers like Alastair Campbell and Peter Mandelson, with their threats, temper tantrums and apparent power over journalists, has rubbed off on the rest of the profession. 

So when a journalist receives a call from a healthcare PR firm, suspicions rise, defences are activated and what Ernest Hemingway called the 'bullshit detector' is set to its most sensitive level. 

The reality is different, as any communications professional who has had fruitful relationships with journalists will tell you. Of course, all PR people aim to portray their clients in the most favourable light, but the good ones will exercise their own judgement, challenge the client's thinking and tailor the story to the audience before they pick up the phone. The good story pitch (when backed by the facts) is a godsend to a busy reporter. It's been that way for decades, since Christiaan Barnard carried out the first heart transplant, or Louise Brown became the first test tube baby. Was any harm done? Or did the public excitement generated by the PR teams accelerate the science in all these areas to the benefit of the patient?

Growing influence?
My belief is that there is no "growing influence" of PR in science journalism, but rather there is a growing awareness of it, accompanied by the growing suspicion outlined here. 

But there is another important factor behind the panel's motion, which also shows why public relations needs some PR help. Implicit in the wording is the idea that PR is in some way underhand. Only today on Twitter, I picked up a piece by a 'former PR man' headed 'how PR works'. In it, the writer claimed: "One of the most surprising things I discovered during my brief business career was the existence of the PR industry, lurking like a huge, quiet submarine beneath the news." He then 'exposed' a series of allegedly underhand or sly tactics commonly employed in the public relations field. 

As I said in my WCSJ presentation, silly, bad and completely wrong things have occasionally been done in the name of pharma PR. But the communications industry is not alone in making mistakes. Professor Deborah Blum, a plenary speaker at the conference, wrote in a recent issue of Nature: "Science is just like any other enterprise. It's human. It's flawed. It's filled with politics and ego."

The same is true of PR, pharmaceuticals and even journalism. But in my experience, people in pharma communications do their best to publicise the benefits and risks of medicines realistically and ethically. Many scientific writers are now joining PR and medical communications agencies. Once again this year, I was on the judging panel for the Communiqué Young Achiever of the Year. The calibre of those people was as high as ever and if the future of pharma PR is in their hands, it's in rude health. All have science degrees, a strong social conscience and a clear view of right and wrong. 

Making it better
So what can be done? First, identify and acknowledge the real problems. These are:
• A lack of trust between many journalists and the industry, which includes its communications specialists and marketers 
• A misconception about what pharma companies can do and say
• An out-dated view of the industry and its practices.  

What would a PR campaign on behalf of 'pharma PR' comprise? Like any good campaign, it would have clear objectives, which would be smart. I suggest they should be:
Objective one: Help journalists to understand the new pharma world, where all activities are conducted under tough codes and close scrutiny. 
Tactic: Acknowledge that mistakes have been made in the past, but demonstrate that the world has changed. 
Objective two: Show how appropriate PR benefits (not harms) the patient. 
Tactic:  Use examples such as:
• Medical research has saved the lives of a quarter of a million children aged one to 14 in the UK in the last 50 years
• Diseases which used to kill or cause serious harm are now rare, thanks to immunisation. These include diptheria, mumps, measles, tetanus and whooping cough.

Be bold in highlighting the potential harm caused by anti-industry campaigns, such as the one against the MMR vaccine.
The HCA has recently been developing position statements on key activities that are sometimes misunderstood and criticised. That's a great start. 
The campaign would also have a range of good spokespeople, ready to respond quickly and knowledgeably to criticism. Thanks to social networking, everyone with a laptop and an axe to grind is an opinion former. I see drugs, devices and vaccines criticised on a daily basis. There are complications about pharmaceutical companies responding directly to patients, but these need to be overcome quickly.

Openness
Senior people in the pharmaceutical industry have already started a trend to openness and ABPI president, Chris Brinsmead, has put it at the top of his agenda with his VITA campaign (Value, Innovation, Trust, Access).

We must follow their lead.

A recent survey of MPs provides cause for optimism. A total of 49 per cent of members of parliament described their feelings towards the industry as "mainly favourable", while the views of 18 per cent were "very" favourable. This contradicts the feeling of many insiders that the industry is under siege from a range of opponents, not just pressure groups and the media.

Viewpoint
We need to engage with our critics and put across our point of view.

Ben Goldacre sells T-shirts, mouse mats and similar products on his website. One is a baby's bib with the slogan, 'MMR is safe'. We need to tell journalists and other critics that we wouldn't be allowed to say that.

Ben's T-shirts carry the slogan: 'Actually, I think you'll find it's a bit more complicated than that'. This might not be a bad slogan for our own campaign.

The Author
John Clare is the founder and chief executive of LionsDen Communications, a healthcare specialist communications training company. He has been advising pharmaceutical, vaccine and biotech companies on communication, media and crisis strategy since 1992. In 2006 he received the Communiqué Judges Award for Outstanding Healthcare Communications. He was a journalist for almost 20 years, and held a variety of senior jobs in print and broadcast, including at ITN and the Daily Mail. He is a founder member of the Healthcare Communications Association.

2nd November 2009

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