PR in perspective

We all know the scenario - you are attending a dinner party when the inevitable question comes from the person sitting next to you: and what do you do? Rather unfortunately for an occupation of which we are intensely proud and in which we have such passionate belief, the fatal combination of 'pharmaceutical' and 'PR' can be the social equivalent of the 'air' kiss of death!

Facing facts, as communications professionals, we have been relatively non-communicative at a public level about the role and the value of healthcare PR. Against a general backdrop of growing public cynicism and media that is increasingly savvy, it is hardly shocking to find the dinner party test reveals mainly negative opinions and beliefs of both pharmaceuticals and PR (namely spin, profits before patients and lack of transparency).

While we see conflicting information regarding relative rankings in public perception and trust, it is certainly true to say that the value of the pharmaceutical industry is poorly understood by the general public and, when under fire, the industry is often very slow to respond, if indeed it responds at all.

Yet, as we celebrate the 10th anniversary of Communiqué, with healthcare PR now firmly established as a key lever for success within the pharma marketing mix, it seems ironic that the tool with the potential to make the biggest difference to the industry's reputation is perceived, arguably, as more part of the problem than the solution.

Coming Of Age

Of course, there is a strong argument that what we are talking about here is communications rather than PR. While PR within healthcare has a far broader remit than PR in other sectors and there is a compelling case for it being a unique discipline in its own right, at a practical level the majority of pharma companies ultimately still say they 'buy' PR.

In this regard, not much has changed over the past 10 years but the ongoing terminology issues belie a significant shift in the use and perceived value of healthcare PR: from tactical to far more strategic.

In contrast to the very first edition of Communiqué, where PR was described as 'one of the most difficult parts of the marketing mix', due mainly to a lack of profile and general understanding, feedback from senior communications and marketing people from across the industry reveals just how far healthcare
PR has come.

Ever more sophisticated techniques have generated considerable rewards. From market preparation to data announcements, product launches to mature brand re-invigoration, from global to local activities PR has played and continues to play its valuable role. The result is unanimous agreement that in today's environment, PR is a vital strategic tool.

It is perhaps unsurprising then to find, again in contrast with 10 years ago, that there is remarkable consistency among those same professionals in defining the role of healthcare PR now. Probably best summed up as ëto create a favourable environment in which to manage reputation and thereby optimise commercial success', this contemporary definition explains why PR now, in one shape or another, has a seat at the table. A decade ago, board-level discussion of brand PR activity would have been limited to extremes of consumer media coverage - positive and negative. Healthcare PR in 2007 is a far cry from just generating column inches.

In The Spotlight

However, just as PR techniques have been refined and their deployment has become more wide-ranging, so has the level of suspicion, questioning of true motivation and seemingly universal scrutiny of the pharmaceutical industry.

We are all too familiar with accusations of inappropriate practice and the perception that marketing activity, and specifically PR, is merely underhanded, Machiavellian manipulation of unsuspecting audiences which, in our case, are the particularly emotive groups of healthcare professionals and patients.

The industry response has been serious, significant and is well-documented. Transparency is the watchword of our time. As we write, the Healthcare Communications Association has just announced the launch of an important new initiative: the Good Practice Guide (GPG). Designed to ensure that the highest standards are maintained in healthcare communications, the GPG provides much needed clarification and practical guidance on areas specific to working with the media.

The GPG is undoubtedly a major step forward, but by its very nature it represents a 'bottom-up' approach to our discipline. Surely what is needed in parallel is a 'top-down' approach. Or, put another way, at a time when we are seeking to be transparent about the 'what we do', should we not also address the 'why'? After all, when negative reports of industry activity appear in the media, the details of the 'what' (traditional use of ghost writers or paying journalists to write stories) are damaging enough in the wrong context, but the assumed 'why' (inferred dishonesty and distortion of the facts) is altogether more damning.

However, it is also true to say that such conclusions are often reached in a vacuum created by the lack of disclosure of the real and perfectly legitimate agenda.

Clarity and consensus

Why do we do healthcare PR? Exactly what is the agenda? Traditionally, the 'why' has been described using a variety of key phrases including 'raise awareness' and 'increase the market', and the 'how' has often been defined as ëharnessing advocacy'. But are these examples accurate, appropriate and acceptable in today's environment?

Recent levels of intensified scrutiny on the industry's marketing practices and the refining of the ABPI Code have brought this issue sharply into focus, for example, how can PR objectives be defined so as to state the underlying brand objectives ethically in a way that is palatable to any and every potential stakeholder?

Under what circumstances - if any - can PR activities be linked directly to brand sales? It is safe to say there is still much confusion and variation in interpretation, but achieving clarity and consensus is one of the key challenges facing the future of healthcare PR.

There is an urgent need to overcome the prevailing discomfort in revealing commercial objectives and to be unapologetic in the process. Pharmaceutical firms are, after all, commercial entities and it is important to bear in mind that everyone has an agenda: a commercial agenda is not automatically a bad thing.

The principle mechanics behind the best and most effective PR activities involve identifying and building upon the common ground within the multiple agendas of all relevant stakeholders. Contrary to what is so often reported, doctors, patient groups and many representatives of the media tend not to do, or say, things they don't want to or don't believe in!

As such, healthcare PR has a vital role to play in enhancing the reputation of the industry by influencing the environment to the mutual benefit of all the stakeholders. For example, clinical management is enhanced, patient care improved, uptake of the most effective/clinically appropriate medicines or medical interventions is increased and NHS resources are consumed in a more cost effective manner.

Breaking The Silence

Senior communicators agree that we will need to be increasingly vocal about the huge value the industry brings in terms of improving health, and in the drive to cultivate widespread appreciation of this value and build greater trust there is a need to stand up and be counted. In today's environment, each company has a right and is indeed expected, to voice its own opinions and, therefore, PR is no longer just about 'harnessing advocacy'. Independent, expert opinion is as important as it always was, but it is about achieving the right balance of voice.

It may seem obvious, but it is also important to consider the agenda beyond the brand. A significant number of pharma companies have already started actively to address the urgent need to harmonise individual brand and overall corporate agendas. The reality of the media in the 21st Century means that it is no longer possible to operate in silos. More than ever before, consumers make decisions on brands based on corporate reputations and it is important to remember that all healthcare professionals are ultimately consumers too. A contentious point perhaps, but a largely reactive stance in the public arena will not be sustainable for much longer and when no comment invariably comes to mean guilty as charged, surely it is time to break the silence.

Looking Forward

What does all this mean for healthcare PR over the next 10 years? So long as it can be deployed unilaterally in an ethical and responsible manner, there is little doubt healthcare PR will remain a powerful and legitimate marketing tool.

It will continue to be essential in the drive to achieve congruence between those messages coming directly from the company itself and in parallel to those emanating from the all-important independent sources within the broader universe inhabited by the key audiences.

This congruence is critical to driving action and behavioural change. The increasingly complex environment in terms of the media, consumer behaviour, shifting sources of influence and NHS policy represents potentially as many opportunities as it
does threats.

The dinner party test may seem like a trivialisation, but it is the ultimate acid test. In order to pass it, we must be open, honest and unapologetic, proud even of our motives. Answering the 'why' and the 'how' with integrity, transparency and consistency is central to the continuing application and evolution of our discipline. We just need the common, accurate and appropriate vocabulary with which to have those conversations.

Perhaps it is now time to redefine healthcare PR.