Science is well named. Deriving from the Latin word ‘scientia’, meaning knowledge, science is the most reliable method of learning about the world ever devised1. Despite this, and as amply demonstrated by the response of some less informed commentators to the Covid-19 pandemic, understanding of what science is and does among the public and their representatives is often poor. This is an important societal issue for, as UNESCO points out, public and government understanding of and engagement with science are essential if people are to make informed personal and professional choices about how to deal with current and future challenges2. Improved education and more effective communication are invariably seen as the keys to solving this problem but if they are to succeed, the science itself must be brought to life; liberated from dry facts, obfuscating jargon and unintelligible data.
It is widely accepted that to engage people and change their behaviour you must first capture their attention and then make them care3. Scientists at a similar level of expertise and in the same or working in related disciplines have no problem communicating among themselves. However, the method they use – typically exchanging and reviewing facts and evidence – can be ill suited to motivating non-scientists. This has a particular relevance to healthcare communication.
A life and death issue in healthcare
Effective communication within a healthcare setting is vital. Failure at any stage in the process can lead to death or an impaired quality of life. Patients must be able to convey information about their condition to healthcare professionals, who need to understand and interpret this information correctly. Health professionals then need to communicate effectively with patients about diagnoses and treatments. Compromising any of these stages will lead to ineffective healthcare delivery4. However, the process is not straightforward. Doctors may tend to lapse into technical talk using medical shorthand or clinical details, which is the complete opposite of what patients want and need5. Some medical professionals might also lack the empathetic skills that enable them to understand the feelings and psychological experiences of patients when receiving information, especially when it relates to difficult or complex health conditions.
Much of the content of communication in healthcare is based on a scientific understanding of diseases and their management. However, although there are specialists who are scientists by training and instinct, this is not true of many healthcare practitioners. Scientists have been described as people who constantly question things, develop falsifiable hypotheses and collect data from well-designed experiments; whereas it has been suggested that doctors tend to follow familiar patterns and rules, often improvising as they go. In the past, the way many work and think has been likened to the improvisation of jazz musicians6, which is why practicing medicine has sometimes seen as much of an art as it is a science.7 However, it would be fair to say that this has changed in recent years, with the practice of medicine becoming increasingly evidence based.
The science underpinning the analysis of diseases and identification of medicines originates with researchers. These people most definitely are scientists and pass down their knowledge to doctors and others through scientific papers, learned articles, symposia and a host of other means, often mediated by opinion leading doctors or other professionals. The communication tends to focus on empirical data and evidence in the time-honoured manner. Occasionally a ‘gifted’ presenter might be able to add light or colour, but in most cases the information is dry and unengaging. Facts are conveyed but the science isn’t brought to life. 8
The challenge for pharma of bringing science to life
Pharmaceutical marketers have long recognised the importance of bringing science to life – using stories, metaphors or visual concepts – especially when equipping their sales reps with a compelling presentation. However, three factors make bringing science to life more important than ever before
- The complexity of new drugs
- The empowering of patients
- The move into a virtual/digital world
Drug and medical science is becoming ever more complex and specialised. Studies have shown that medical knowledge is expected to double every 73 days9. David Sackler, a father of evidence based medicine, famously said ‘Half of what you learn in medical school will be shown to be dead wrong or out of date within five years of your graduation.’10 The increasing complexity underlines the already recognised importance of ongoing medical education and explains the accelerating trend towards more and more specialisation.
At the same time, expectations among HCPs and patients have continued to rise. Patients are more informed or (depending on the source) misinformed about the condition from which they are suffering and the treatments that are available. They have also been encouraged to take a more active role in their health11 , for example, many are using health and fitness trackers to help manage their own lifestyles. Some GPs have started encouraging patients to invest in pulse oximeters to monitor their oxygen saturation (SpO2) levels, which is seen as a key indicator of worsening Covid symptoms. As a result, patient empowerment and patient centricity have become mantras in both healthcare systems and pharmaceutical marketing.12 However, even though the concepts are broadly accepted, there remains uncertainty about how organisations can become more patient centric and doubts about whether financial goals can be achieved compared with a more traditional, product-centric model.13
Increasingly, science needs to be brought to life in the digital world. Technologies such as apps, portals, websites, gaming platforms, embedded sensors and wearables have opened up opportunities but also present challenges, such as data security and the credibility and quality of information.14 They demand new skills from healthcare professionals; dealing with patients using telemedicine or virtual consultations is not the same as traditional face-to face-consultation15 – for example, generations of doctors have been trained to read the body language of patients walking into their surgeries, which many consider as important as what is actually said during a consultation. Replicating this within a virtual environment is clearly a challenge.
According to McKinsey, even before the Covid-19 pandemic accelerated the change towards the new world of marketing, the success rate of new product launches was low – 40% failed to make their two-year forecasts16. Several factors may account for this including tougher access barriers, increased pricing pressures, stronger competition, heightened expectations from customers and maybe insufficient understanding of customer needs. Achieving successful launches is going to be even tougher in the future because of the shift from traditional, face-to-face interactions between pharmaceutical reps and HCPs to the use of digital channels. A survey in Europe carried out in September 2020 showed that, on average, the number of face-to-face interactions was 70% lower than before the pandemic17. Although levels of access varied by country and showed an increase compared to a similar survey in May there is little to suggest that the shift to digital will not become permanent. Making the most of alternatives such as video interviews or email will require the learning of new skills and a better understanding of the audience’s interests and needs, ideally on an individual basis. An interesting comment, highlighting the need for new skills, was made during a recent webinar, ‘sales reps who have never sold virtually, are being led by people who have never sold virtually and being trained by people that have never sold virtually.’18
We can also expect a growing shift from outbound or push marketing, where the product is promoted directly to the customer, to inbound or pull marketing, where the customer (through a combination of education and inspiration) is encouraged to seek out further information for themselves.19 In this model of communication the role of the rep will evolve, although their customer knowledge and insights will continue to be important in ensuring that the right information and services are provided to their customers in the right form at the right time. It seems likely that their role in bringing science to life will therefore continue to be significant but will be considerably more challenging. It has been suggested that they will become ‘the sales orchestrator’, a role which has been described as a multiskilled conduit, receiving, interpreting and feeding back information as well as engaging HCPs intelligently20.
The ability to bring science to life is of massive importance to society at large, legislators, the media, healthcare systems and all industries involved in the effective communication of scientific messages. The growing complexity of drug and medical science and greater interest and involvement of patients in their own care has made this even more challenging. If the current pandemic has taught us one thing, it is that, whilst we are able to make amazing scientific advances, there is a huge amount still to be done in communicating science effectively, particularly to non-scientists. Statistical data needs to be understood, misinformation and suspicion needs to be countered, hearts and minds need to be won. This should change and change quickly. People at all levels must be enabled to embrace and care about science. In short, for the wellbeing of us all, science needs to be brought to life.
- Naomi Oreskes. Why trust science? Princeton University Press, 2019
- Science for society, UNESCO, 2020
- Joubert Marina et al. Storytelling: The Soul of science communication. Journal of Science Communication, Vol 18, 2019
- Haran Ratma. The importance of effective communication in a healthcare setting. Harvard Public Health Review, 2019:23
- Kathy Roy Gaughran. Healthcare Storytelling – The best marketing magic and how to do it. Healthcare Success, 2019
- Smith Richard. Doctors are not scientists. BMJ, 2004;328
- Francis Gavin. Medicine: Art or science? The Lancet, Vol 395, 2020
- Ward Angela. The art of storytelling in clinical data communication-what can we learn from Batman and Joker. Pharmaphorum,2018
- Densen Peter. Challenges and opportunities facing medical education. Trans Am Clin Climatol Assoc,2011
- Medicine under the magnifying glass.The Explainable Start-up. 2018
- Furst Drew. How to deal with growing complexity of clinical care” when you don’t know what you don’t know”. Elsevier, 2019
- Fernandes Nagore. Developing product and patient centric services. Pharmafield, 2019
- Phillips George and Elliot John. The path to patient centricity. IPSOS The Aurora Project, 2018
- Bucchi Massimiano. Facing the challenges of science communication2.0: quality, credibility and expertise. EFSA Journal, Vol 17, 2019
- Moa Andre. 5 Pharma Trends for 2021. Disruption and transformation in the Covid era. Tribeca Knowledge,2020
- M’lika Arafat et al. Ready for launch: Reshaping pharma’s strategy in the next normal. McKinsey & Company, 2020
- EU Physician experiences, expectations and perspectives on Pharma engagement. McKinsey Covid 19 Survey, 2020
- Stone Andrew.Blended and augmented: Reimagining the role of the rep.Reuters Events Pharma, 2020
- 19Lawson Chris. The advantages (and disadvantages) of inbound marketing in the Life Sciences. Orientation Marketing, 2019
- 5 changes you need to make now: AcceleratingHCP engagement post-crisis. Reuters Event Pharma in partnership with Ashfield, 2020