1. The legal eagles do not quite know what to do with visuals. Lawyers will focus on your verbiage the way a chain saw focuses on a tree limb. But lawyers have not yet realized that they could possibly police images. As long as you're not plagiarizing an image or publishing something offensive or illegal, your lawyers probably won't try to edit them.
2. On the other hand, your target reader most likely does know what to do with a visual. He'll check it out first and foremost and it may be the "hook" that gets him to read. So these are powerful tools that do not really get scrutinized by the kind of people who are trying to save the world from marketing.
3. Visuals can carry a pretty hefty emotional charge. It is often difficult in medical texts to get that much emotional power into text … but you can do it with a picture.
4. You can test images, just like you can test text.

Right now, there is such a rush to make all medical materials as bland as possible that I wonder if healthcare professionals are all asleep right now. If you want to stand out, grab some visceral visuals … even if it's just a diagram of a new molecule … and infuse your written text with power.

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This results in cheeseburger marketing.

The reason I call it cheeseburger marketing is that, like cheeseburgers themselves, cheeseburger marketing is fun, tasty, filling, and absolutely no good for you. After not much time, cheeseburgers make you fat and sick.

Here is how to tell if you're doing cheeseburger MarCom:

1. Creative choices as to formats, colors, media, images, photography are driven by personal choices and individual opinions rather than real reasoning. This puts personal taste ahead of what makes sense for your message.

2. Messaging is egocentric. You can tell you're egocentric when you want the first line of your brochure (about a product) to be the company's mission statement. You can tell you're egocentric when every line of the brochure starts out, "We at the Acme Anvil Company …." You can tell you're egocentric when nothing in the brochure has any emotional impact on the target reader.

3. Decisions in MarCom are made whimsically, haphazardly, more with an eye to what is fun than what is useful.

4. Nobody plans. MarCom has no crisis plan, no PR plan, no strategic plan, no publication plan. Add to this no archiving of documents, no formalized procedures.

5. Nobody measures. Now this is an area where I have a lot of opinions, because some types of marketing are very easy to measure, some types are almost impossible to measure, and a lot falls in-between. So even an expert team really can never measure MarCom results to the degree that they should be measured. Everybody falls short. But in a cheeseburger MarCom department, nobody even tries to measure. This means that successes get overlooked and failures get repeated.

6. MarCom projects are based on what feels right or seems like fun, rather than what works at selling product or even what the field wants and uses.

7. Vendors are selected by who takes the staff to the best lunches and hands out the most wonderful holiday gifts. Vendors who provide good service are ignored in favor of those who come bearing gifts.

8. MarCom staff remain vigil in their quest to be uneducated about their company, their products, their technologies, and new media. Not knowing things is regarded as a badge of honor; people who understand the company's products are considered to be hapless geeks and best shunned.

9. MarCom isolates itself from other departments. MarCom players do not know other departments or issues in the company. Most MarCom members spend their time sharpening their sarcasm skills rather than their people skills.

All of these traits compare to people who would rather sit around and eat cheeseburgers and fries instead of eating healthful food and exercising. It's the mindset that favors fun and excess over discipline and health.

If you have a flabby MarCom team, you may also have a flabby Marketing team. The keys to good health follow:

1. Develop a solid understanding of what your company does, what it sells, and who else sells similar stuff.

2. Get to know your customers and your field personnel. Spend an hour or so and listen to their stories. Process this information to the point that you know what keeps your customers awake at night. (That's crucial to good marketing … knowing hot buttons.)

3. Insist that MarCom people stay up to date with new technology in their field, including social media, Internet, electronic documents and so on.

4. Make MarCom people interact with lots of other people, including scary people like engineers and software guys and gals. If your MarCom people refuse this or are panicked, you have a bunch of cheeseburgers.

5. Measure, measure, measure. Even if you do it wrong, even if your results are dubious, even if you don't know what you're doing, keep trying and keep counting.

6. Take corrective actions. Measure so you know what doesn't work and stop doing it. Measure so you know what does work: do that more.

7. Weed out the culture of "I like green." Train everyone you can that personal preferences and tastes do not matter in the creation of marketing materials. You do what the customer wants, which you determine by what works. See #6. Create a world where it is possible for a marketing director to HATE the color orange but use it effectively in marketing materials.

8. Force MarCom people to think through different areas–to look at competitive ads or review websites from other companies. Encourage them to build "swipe files," cool stuff they have seen in other uses that might be re-purposed for your marketingt.

9. Don't allow MarCom to be the idiot department. Most execs tend to regard MarCom people as dispensable clowns who can draw pictures and make up stuff. That's not because executives are dumb, it is because MarCom does not do its own branding and upgrade its image. Let MarCom market itself.

You see cheeseburger marketing in medicine every single day–egocentric messages, pretty but meaningless pictures, and badly designed pieces that cost the company hundreds of thousands of dollars because teams of non-designers met for endless hours deciding on such crucial issues as line weight and fonts.
 

Even good companies can have cheeseburger marketing. So put down the cholesterol-heavy, artery-clogging fun foods and go grab an salad and hit the gym. You need to show discipline, courage, intelligence, and a lot of savvy … in your MarCom efforts. You wouldn't have much respect for a person who ate cheeseburgers all the time, talked only about himself and his pleasures, and became a big, fat slob. Your customers won't like MarCom efforts from a self-indulgent, self-referential, and self-pleasing bunch of marketers.

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The taggers get extra credit in their circles for placing any of their handiwork in areas that are difficult to access. A good example of this are those taggers who place graffiti on overpasses or in high-security areas.

Content providers or people who, like me, write for money mainly for corporate clients, can also get extra credit for writing materials that reach readers who are difficult to reach.  It’s a common request I get from many of my clients: We want to reach doctors, but they get so much mail already. We want to reach hospital administrators, but they are hard to access. We want to talk to our patients, but we just don’t know how to get their attention.

So a skillful tagger gets his writing in a danger zone and a skillful content provider figures out ways to access people that are difficult to access.

How can you write something that will capture attention of a difficult-to-interest group? That is a topic that could fill a book, but here are a few pointers.

1. You have to write something that your target audience will care about. If you’re trying to capture the attention of a group for something that interests you but not them, you’re doomed to fail. You have to know your target audience and figure out (a) what they are desperate to know, find out, or learn and (b) how they generally like to get their information. That’s a job for research, not your intuition or best guess.

2. You have to offer real content which in most cases is going to mean real answers, real solutions, and real products. If you deliver fluff to your audience, they’ll be mad at you. It’s actually more productive not to reach an audience than reach an audience only to annoy it.

3. You have to be willing to get outside of your comfort zone. If you could reach these guys doing the kinds of things you usually do (working in your comfort zone), you wouldn’t have this problem. Clearly, you’re going to have to try something new. This may mean new media (video, audio, online content) and new vehicles (YouTube, Twitter). It may mean going back to old-school stuff (an offline newsletter, a classified ad). It may be a hybrid (try a classified ad that offers a free report they can get by calling an 800 number or going to a website).

4. You can’t give up. Rome was not built in a day. Those who reach tough-to-reach audiences do so because they tried lots of different things and were willing to give themselves permission to fail. Permission to fail means having some money and time that you are willing to risk as you try to achieve your goal. Just learn from your mistakes along the way.

5. Find ways (before you start) to measure your success. This may be a clicker on a website or a coupon or some kind of direct response. Work with your marketing guys to figure out a way to measure results and determine in advance what might be considered successful. Then track your numbers.

6. Encourage your writers to learn, learn, learn. Groups that are hard to reach are hard to reach because they do not find much useful in the usual places. This means that the usual approach to writing is going to turn them off. In most cases, this writing is not useful to them because the writers do not offer useful, valuable, practical, realistic information. The way to achieve success is to offer information that will help these people; give them information that they not only want, give them the stuff they are desperate to know. This means that writers have to do lots of research. Don’t keep your writer in a cubicle and expect them to address a difficult audience effectively. Let me them out to roam and learn the nuances of the market.

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Step one involves talking to them. I know many marketing people who take a perverse pride in never, even stepping foot outside the marketing department (or cafeteria). These guys realize that other areas of the company are populated by people who like math better than music and do not always have good social skills. But you can’t have good marketing success unless you get to know these people. Visit their departments; ask to sit in on relevant meetings that are run by “their side”; make every effort to call or sit down with a scientist whenever you need something explained.

Step two involves patience. You won’t get everything you need in the first sound bite of information. That’s why you need to do your best to create a relationship with these colleagues; you need some “name recognition.” They need to know who you are, what you do, and why you keep asking them all of these weird questions. Give your relationship some time. This is particularly vital since many engineering and scientific types live in the world of patents and proprietary knowledge. This makes them super-secretive by profession, and they’re usually already shy by nature. It can be tough to get one of these guys to share any information, so your best bet is making sure they at least know who you are and that you’re one of the “good guys.”

Step three: explain marketing to them. As much as Kaplan-Meier curves or polymer molecules or hermetic seals are a mystery to you, marketing is a black art to them. The best way to convince a scientist that marketing is good is to create a strong immediate link to sales, which is a world of numbers. Show the scientist sales figures and point to specific marketing endeavors that helped bring those numbers up. You may win an ally if you can persuade a scientist that talking to you will help the company translate his knowledge into sales.

Step four may involve instilling some controls, with which you may be uncomfortable. Most scientists are deeply distrustful individuals (scientist and skeptic just kind of go together, don’t they?) and they no doubt imagine you’re trying to hoodwink them. It can be useful for your relationship to include a scientist in a review of marketing materials, to show him or her interim drafts of materials, or to allow other access to “materials-in-progress.” You may not like this and it may be against your boss’s better judgment, but if you can swing it, it can really work. It helps the scientist see that you’re not out to con him.

Step five is the one you thought should have been first: research. You need to do some homework before you talk to scientific types. Now don’t go haywire. You’re not going to out-engineer the engineer. You just need to know what they’re working on and how they do things.

Last but not least, in step six, ask questions. Think of yourself as a reporter trying to dig out a story from a mad scientist. When in doubt, ask, “How does this work?” And if the scientist comes back at you with jargon, come back with more questions. “What does that mean?” You can even enlist his or her help: “How can we explain this kind of technology best to a physician?” or “What does a patient need to know about how this new device works?”

The weird thing is that scientists and clinical experts and all of these other people are mostly very interesting individuals. They’re usually a lot of fun and can greatly add to your expertise and help your marketing productions. The only thing is: you have to cultivate the relationship. In all the years I ever worked in marketing in medical device companies, I never saw any of these guys linger around marketing. You’re going to have to go to them.

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One of the most important responsibilities of the marketing department is to equip the sales rep for this 10 seconds.  In a lot of ways, medical marketing departments are like the companies that make bullet-proof vests for law enforcement officers or soldiers. It is not our job to fight the fight or go into battle, but it is our job to give the valiant hero who does go face-to-face with the opponent every conceivable chance of success.

So what do you do to equip your sales reps to turn those golden 10 seconds into success? Here are 10 things that you should be doing to help your sales reps in those precious 10 seconds.

1. EDUCATE THE REP. Most companies want to educate physicians, some reach out to educate fellows, a few want to educate patients … but who thinks to train the sales reps? Every new product, every launch, every new change in your industry should be a cry to get training materials out to your rep. The quickest way to shoot yourself in the foot is to call this “Mandatory Training” and make it be a bunch of boring online stuff with a quiz. Reps, like the rest of us, hate efforts to school them. So create launch and news materials for the rep that play on emotions (like his desire to earn, his desire to present a hot new product, his desire to counter objections to his product line). Depending on your field force, you may want to do periodic live meetings, webinars, as well as rep-facing brochures. A membership site built for your reps can be a great idea, particularly if you keep it well-stocked with tips that really help the rep earn more money. Most people don’t mind listening to lessons if they can see an immediate and tangible benefit.

2. OFFER A VARIETY OF TOOLS. Many companies like to promote their products with certain specific vehicles: a selling sheet, a trifold or “slim jim,” a big full-color brochure, a folder stuffed with journal reprints, or whatever. However, if your sales force is larger than one guy or gal, you are likely going to need different types of materials. Some sales reps work well with a pocket card; others need a glossy brochure; somebody else will make her own folder with an assortment of “leave behind” materials; and a third will want to bring in a laptop with a short presentation. Instead of trying to make everybody do the exact sames sales presentation, recognize that good reps play to their strengths and will do better with one tool than another. Offer a big basket of tools for reps to choose from.

3. BE COHERENT. Make sure your online messaging matches the marketing collateral your sales reps show doctors. As easy as that sounds, it’s a common shortfall. The reason is that many companies produce web content separately from marketing materials (sometimes in different departments!) and those people may not talk to each other. Also make sure all of this matches your messages at scientific sessions and advertising.

4. INCLUDE TECH SERVICES. Docs talk to reps because reps have an annoying way of getting their foot int he door. But docs talk to your Tech Services team because they want information, have a problem, need advice, or just do not understand something. But Marketing is notorious for not talking with Tech Services. Tech Services should get launch kits, be aware in advance of marketing messages, and see every piece of marketing material and product labeling that a physician customer could conceivably see. This assures that a doctor who talks with Tech Services is going to get at least reasonably close to the same message from Tech Services as from the sales rep.

5. GET REP INPUT ON MARKETING MATERIALS. I have worked in Marketing long enough to know that many sales reps are difficult, opinionated, obnoxious individuals. While some reps do need anger-management training or charm school, companies are increasingly putting their foot down to tyrannical outbursts by sales reps (and hallelujah for that). Despite the occasional wild-eyed rogue of a sales rep, a good marketing person will also find reps with insight and ideas about marketing materials. Keep your mind open when reps propose these things. Every now and then you’ll get a winner.

6. WHEN IN DOUBT, COUNT. One of the best ways to see what marketing pieces work and what ones don’t, get a tally from your literature storehouse. Everybody may love your award-winning brochure, but if reps do not order them, it probably was not worth the money. On the other hand, if you can’t keep humble spec sheets in stock, that is clearly an effective selling piece.

7. MAKE IT EASY FOR THE DOCTOR TO GET MORE INFO. There was a time when reps liked to build a firewall around “their” doctor and keep the whole world, including the rest of the company, out. That does not benefit the company or the doctor,  who may need more information when the rep is not available. Put stuff online. Collect email addresses. A lot of companies do not allow doctors to order materials, but why not? Why not publish a small catalog of proof sources, brochures, DVDs, training materials, and other items that a doc can order directly from the company?

8. ENTER BEARING PATIENT MATERIALS. Most doctors do not do as good a job at patient education as they would like and–truth be told–this nags at many of them. A smart company will help fill in this gap by developing the kind of patient materials a doctor would be most likely to want to share with patients, whether by placing them in the waiting room (popular these days) or handing them out to specific patients. Reps who offer these materials usually have something the doctor genuinely wants. I would imagine that a great patient campaign supporting a new product launch would find some resonance among physician-customers.

9. PROOF SOURCES ROCK. This may seem counter-intuitive, but one of the strongest marketing pieces in your arsenal is not the slickest. Proof sources are very compelling to physicians and they do not even need to be slick or presented in some snazzy folder to be effective. Doctors do not expect you to show up with a peer-reviewed article that endorses your product. What they might enjoy is having you present them targeted, focused articles on the conditions your product treats or something related. It’s a kind of combination testimonial plus “soft sell.” You’re not marketing … you’re informing the doctor and the reason you’re informing the doctor is that you work in that same field, in that you represent a company that treats that very condition.

10. PAPER, PAPER, PAPER. The world is going paperless so every good contrarian is going to realize now is the time to start producing more words-on-paper. Traditional print is so out now that it’s trendy. Most docs are bleary-eyed from reading everything online. While I am one of the big advocates for having things online, I recognize that there is power in the unexpected and traditional brochures and leave-behind pieces are almost novelty items. The best printed pieces today are those that use print to do things that online stuff cannot: think die-cuts, embossing, metallic inks, glued-in items, perforated pull-outs, and so on. These make great leave-behind, particularly for fellows and other young guys who may have never seen an expensive glossy high-end medical brochure.

Help your reps in their few seconds of face time so that they can drive the sales that drive the company.

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Most companies hire lots and lots of people with fancy degrees and pay them big salaries and let them sit around far away from the battle. Meanwhile, they pay other people with far less education very little money to deal more or less non-stop with the company’s customers.

So how hard would it be to train the folks who answer your phone? Or pay them a little better so that you got the very best people for the job? Well, most marketing people never ask that question, but they should.

Training the phone folks need not be all that hard. When these people are first hired, there should be a training program aimed at introducing them to your company, your products, your markets, and the sort of inquiries they are most likely to get by phone. They should get an organizational chart and a thorough understanding of what departments exist, what they do, and what kinds of questions or calls are likely to come for which groups.

You have to assume that the person you just hired to spend all day with your customers does not know your industry. This introductory training should be very basic and ramp up to cover the nuances. In other words, if your company makes ablation catheters for atrial fibrillation, you may have to go over the very basics of atrial fibrillation, explain what a catheter is, talk about what ablations are, and then move on from there.

But introductory training is just that–the beginning. Your phone people should get regular training “booster shots” by getting information about new products, new services, new departments, new hires, and the momentary issues that your company is dealing with.

Include your phone staff in your launch memos–you can even give them launch kits or maybe abbreviated mini-launch kits to help introduce them to new products and services. (I know some marketing types are thinking this is a big waste of time but remember, most of the phone people spend more time in one day chatting with your customers than you do–so why should you deny them information on your latest launch?)

Your phone people are the ones who are the “voice” of the company. You may think that your executives are the voice of the company, but it’s the phone people that most of your customers interact with. You want them to be informed and high-energy and enthusiastic. So how do you drum up enthusiasm? I think one good way is to include them in certain marketing meetings (particularly ones about big changes and rah-rah ones) and to be sure that they regularly get marketing goodies like the new T-shirts or coffee mugs or logo pens. Again, I know marketing types who would say this is a waste of time, but shouldn’t your front line people be happy to be at work and excited about your latest product?

I once worked at a company that had just launched a major product. We were testing our phone service at that time and when one of my shills called the main number and asked about the new product, the person answering the phone had never heard of it.

That was not her fault. Her job kept her in a cubicle off the main floor, far away from the marketing and other departments and nobody ever thought to give her information or include her even on email distributions. Furthermore, I would imagine that it was embarrassing and disconcerting to her not to know what was being asked and that made her answer seem curt and even hostile.

If you have marketing guys in your company who resist including phone people in the information loop, you need to start asking yourself: are those the right guys to be in marketing? It costs so little to take your phone front-line people from mediocre to outstanding–and why would you want to keep anybody (especially the guys and gals who answer your phone) in the dark about your company’s products?

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And the most magnificent thing about marketing is that it really has not changed much over the centuries. True, the technologies have changed and so has the lingo and the vehicles, but the basic principles stay the same.

Marketing is the art of getting people to pick you. This means you have to offer something that they want. Furthermore, your offering has to have the right price tag and conditions. To find the right offering, you need to know who you’re trying to get to pick you. Then you should make your offering convenient, friendly, and appealing.

Nobody is going to know about your offering unless you tell them. Marketing involves a lot of tell-tell-tell. There are many lawyer types running around now who would have you believe that any representation of your product in a positive light is some kind of breach of ethics. Your medical company needs to let people know what you have and not be afraid to make it sound appealing.

Finally, marketing involves following up with your customers. Once a customer buys, he or she is a powerful force for your business. It’s much easier to make repeat sales than initial sales, so customers should be treated as VIPs. You should also follow up with service and support.

And that’s marketing old-school.

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COI in medical marketing refers to the fact–deemed an embarrassment at best and a transgression at worst–that people who publish on certain topics often tend to have an interest in that topic. And since medical people are all grown men and women with careers, that interest may be considered a vested one, that is, attached in some way, directly or indirectly, to remuneration if not outright gain and profit.

If editors and publishers feign surprise at the realization of COI, it’s an act. Writers and publishers have been “interested” in their topics ever since Johannes Gutenberg peeled the first pages off his movable type press in Mainz, Germany, back in the 16th century. Even old man Gutenberg had an interest in his work; he was a deeply religious man and intended to use his press to publish Bibles recently translated into his native German language by Martin Luther.

Today, medical people have complicated relationships with the companies that develop drugs, therapies, devices, and other products. The idea that all of these groups operate in a plastic bubble discreet from the influences of the others is ludicrous. It’s not doctors over here, medical inventors over there, drug companies in this corner, hospital administrators in that. These groups all work together. No drug company can develop a new drug without the help, no the active participation, of many physicians. And it is only natural that physicians involved in the creation of a new drug will want to talk about it, which is something most doctors only do with slide decks or by writing articles.

That’s a simple example, but the fact is that most journal articles are written because somebody cares about something and that “care” often involves some sort of business tie.

Those who warn about COI would propose a different example for medical communication. In this COI-free world, only those utterly disinterested in a topic would ever be allowed to publish on it.

The fact is that the disinterested are, well, disinterested. Academic doctors are pressured to teach, prescribe, practice, educate, train, and publish; there are not enough hours in the day to meet all of their responsibilities at high levels. Now add to that the chore that they ought to be publishing not on matters that interest them enough to work on, but they ought to publish about things they do not care about at all.

COI right now is handled mainly by disclosures. If Doctor A writes about a particular drug, he or she is obligate to share all relevant business or commercial associations. This method does not really work well because most academic physicians have a whole slew of commercial associations. It is hard to be a key opinion leader and not have spoken on behalf of this company or consulted over that or taken an honorarium for a project somewhere else. Let’s face it, the world’s foremost authority on a particular drug or therapy is going to have associations with the companies and industries involved in that drug or therapy. So the COI disclosures do not surprise industry insiders, but they do come as a dreadful surprise to the purists who thought that only disinterested third parties wrote medical articles.

I don’t think there are disinterested third parties who know enough to write an article.  By the time an author achieves enough expertise to write well to his or her peers on a complicated medical topic, he or she has got some associations with industry.

The fact is, the world of medical publications is already in crisis. According to JAMA, only about half of all NIH-funded studies ever get results published. Most doctors write far less than they ought to. There are many topics, insights, and ideas that are known to a handful of insiders but are not published because publishing medical articles takes a great deal of time. And with the added monkey wrench of acting like a person with industry ties is somehow unfit to publish on a medical topic of keen interest, doctors are increasingly less interested in dealing with the rigamarole to get ideas into print.

And that is the real conflict–that medical information that is useful and valuable does not get published because of this whole COI fiasco.

I mean think about it this way: let’s say a fiendish man set out to get rich. Would he get his M.D., invest heavily in a drug company, and then publish an article about a drug marketed by that company in the hopes that his article would push the stock sky-high? No. That is the dumbest get-rich-quick scheme ever. The fact is that medical articles may be persuasive proof sources among physicians but they aren’t passports to riches. An unscrupulous physisican might take money from a drug company in order to publish an article favorable to a particular drug, but there is not a lot of money in that “racket.” In fact, it is pretty hard to persuade an overbooked doctor to do things he ought to do–how difficult would it be to get a doctor to spend 20 or 30 of his hard-earned free time hours to publish an article for a drug company in return for a couple of thousand bucks?

The real danger of COI is that physicians are being actively dissuaded from doing what they ought to be doing, namely publishing on topics they know and care about.

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