Sticky or stuck?

Source: Pharma Focus
Written by: Emma D'Arcy

How the industry can overcome its reservations of social networking and forge new more open online relations with doctors.

The 60's philosopher and communications guru Marshall McLuhan said, "the medium is the message" and certainly the current buzz around social media could lead you to conclude this new medium will soon overshadow all other media.

The pharma industry is currently conspicuously absent from online conversations about health and medicines. Web 2.0 and social networking have seen new sites and interactive discussions spring up everywhere on the web, but few pharma companies have a voice.

Except for a few companies (Pfizer 'eavesdropping' into www.sermo.com, GSK 'corporate-talking' through its 'More than Medicine' blog and several companies using Twitter for corporate and employee communications) the industry is lagging in the endeavour to truly innovate its interactions with the medical community, particularly via social media.

Can social media improve relations with physicians?

The term 'social media' under the umbrella of web 2.0 technologies originated as customer support, using surveys, polls, focus groups, online forums and discussion groups to garner feedback on products. Today's social media tools (blogs, networks, wikis, podcasts, RSS and now tweets) all contribute to the user-generated opinion and peer-to-peer online conversations.

Social networks are communities in which individuals are connected through values, working relationships, ideas and friendships. To enter into such online conversations, companies must engage in genuine information exchange rather than data-dump, so that both parties benefit from the relationship. Accordingly, as trust builds through active listening and sharing, loyalty develops which leads to a more lasting and meaningful relationship. This is known as 'stickyness' in web 2.0 vernacular.

For the pharmaceutical industry this offers a remarkable chance to interact with physicians and patients.

Against a tirade of allegations about undue influence, unnecessary spending and inappropriate relationships with its customers, industry can start to use more on the power of social networking and social media to align more transparently with these groups. However, this paradigm-shift in communication is an alarming conceptual challenge to pharmaceutical companies who, as the most heavily-governed industry, have always had to be careful about accuracy of the dissemination of information about their products, pipelines and objectives.

The value that social media offers to companies, and the opportunity to revolutionise and elevate physician-industry interactions to an equal, collaborative footing could be lost if industry cannot see past its own fears and stigmas surrounding web/health/physician 2.0. Whichever term you prefer - the majority of industry is stuck in the read-only internet.

Overcoming inhibitions

To capitalise on social networking industry must overcome its inhibitions about social media, which are rooted in a fear of litigation, and an environment that lacks formal guidance and protocol. So far, the self-governing trade associations have been evasive about the governance of social media, hence companies opt to not engage in the new media.

From a communications and PR perspective, the desire to dismiss social media is understandable because it is forcing a fundamental shift in mindset. The industry still has to be persuaded that moving from formal, periodic, outbound 'broadcasts' to real-time and direct 'participation' is not science-fiction but medical-science fact. Less secrecy about your product, people and company is compelling and humanising - it offers the chance to end the 'pharma is the big bad wolf' story.

Given that there are approximately 260,000 doctors on Sermo and more than 120,000 physicians using docnetworking.co.uk, it is evident that stakeholders are willing to engage in this way using this medium. If industry's voice remains notably absent, however, it is likely that scepticism will surface. Industry will be chastised for deliberately choosing not to participate. If incorrect information is posted about a product for example and a choice is made to ignore it or not correct it, the interpretation (fair or unfair) may be perceived to be the moral equivalent of not coming to the aid of a person in trouble. It is in industry's best interest to register that social media is more than a passing-trend; it is the principle way in which physicians and patients want to communicate already. Like it or loathe it, the Facebook/Twitter/Bebo generation are super multi-taskers who consume 20 hours worth of multi-media streams in only a seven hour real-time every day. And this choice of interaction is not limited to teenagers, nor is it the lonely pursuit of the stereotyped computer-geek; the most recent Manhattan Research survey of US trends revealed that 'those with a voice online tend to be older, with much professional experience and something to say.'

Social media calls for experimental participation

There are already a plethora of blogs and physician-physician and patient networks that have appeared to radically alter the patient-physician-pharma communication triangle. The absence of the industry in these online conversations is remarkable. There are at least five times more patient-originated social media sites than there are ones prepared by or directly for industry. Also unusual is the lack of a 'place' for the industry to engage directly with the medical community with equality; although there are several sites for healthcare professionals.

Online marketing has clear potential in simple business terms, too. The ROI from traditional marketing channels is declining and the colossal spend on doctor-detailing via the sales force is no longer acceptable to patients or to the public. Relationships with doctors, however, will remain pharma's main conduit for dissemination of product data and companies would be wise to participate directly and pioneer the value in social networking opportunities.

Such enlightenment is hard to find, however. Traditional medical education communication companies (MECC) are keen to help their pharmaceutical clients map their journey to this promise of 'open relationship nirvana' through social media applications (and specialist digital groups are trying to work with MECCs to become visible to pharma), but more often than not their creativity gets quashed by the fear of industry to wade into unchartered territory. Richard Evans, managing director of DarwinGrey says: "The pharmaceutical industry is slower to use social media compared with other sectors because of part-perceived and part-real regulatory hurdles and the operational complexities of where exactly a social media strategy should be managed and with which external agency experts. A mix of corporate affairs, legal, regulatory and eStrategy expertise will drive the adoption of social media internally because ultimately it will be the company's reputation that is open to dissection.

"As such, when social media credentials and capabilities are discussed, we are never surprised that while clients are familiar with the concepts the freedom to pursue far reaching plans is often not yet in place - but it is changing."

David Moore, vice-president eMedFusion, KnowledgePoint360, provides another insight into why his agency's pharma clients can seem shy to engage. He suggests there is scepticism surrounding the translation from a personal origin to a professional application of the approach: "The stigma of this being associated with an adolescent Facebook/pop music superficiality is difficult to shake off [and] that social media are in-vogue but lack depth which is completely alien to the clinical-trial/data-demand culture that pharma are required to operate in".

This echoes one of the common criticisms levelled at social media - inaccuracy - which accompanies general concern about a sense of 'loss of control' of content in online conversations. The simple counterpoint to this is one of participation and proven statesman-like behaviour - with social media there are potentially millions of voluntary contributors, editors and fact-checkers who are compelled to substantiate, ratify and corroborate.

And online communities do not tolerate miscreant attempts to destroy, hijack or pollute the e-environment in which they invest such personal capital. Hence the manifest 'stickyness' of loyalty through a trusted experience. Wikipedia for example, is the benchmark of this segue from random opinion to respectable information around citizen journalism - it has been validated to be as accurate as Encyclopedia Britannica with four times the volume of information. Content is continuously submitted and scrutinised by a global cadre of experts who are committed to conserving its value. While this may seem spontaneous, it is actually a highly-ordered mechanism with the ability to self-regulate and correct rapidly.

For those who lament that social media may signal extinction of the peer-review process, the opposite is the reality: social media represents the chance to see the process evolve by assigning 'the wisdom of the crowds' approach. Clearly the opportunities must be explored, investigated and fine-tuned, but as Len Starnes, head of European e-Business at Bayer Schering stated in 2007, "Connecting in more interactive ways can be incredibly powerful. Enabling individuals is what's its all about and that's something we haven't had before. It's really about getting individuals to participate."

Pharma needs third parties to inspire confident engagement

Ironically, the pharma industry, which accommodates such prestigious pioneers of medical science, needs to experiment more with social media and harness the potential benefits for users and the industry. Malcolm Allison at Actelion Pharmaceuticals summarises the approach by most companies, explaining that, "We are still working out how to get involved and most efforts we have seen so far have been clumsy. We are observing the utility of social media to increase transparency of interactions with stakeholders - trying to guage if it is possible or viable to get more use out of these media without our involvement or the contribution becoming distorted."

Despite this caution, industry recognises much can be achieved with social media. Malcolm echoes many of his peers in industry when he notes: "Although we are exploring slowly - and there is no policy in place yet, we are able to use information gleaned from social postings, to lead discussions and develop closer working relationships with physicians. [It] does give us insights into the disease community, especially when we venture into new areas. It can jumpstart our understanding, and provide hooks to elaborate on in discussion. It can also help us to frame questions, and more rapidly gain the confidence of KOLs."

The voice of such pioneers is finally gathering momentum and companies are starting to believe that the hurdles of using social media can be overcome by working with third parties who are leading social media projects such as www.myphid.com - a professional networking hub established to promote and encourage interactions of merit between industry and healthcare professionals.

I co-founded myPHID to activate collective and personal clinical and commercial aspirations - to act as both provoker and mediator so that community members are able to talk transparently about medicine not marketing, align with peers, share goals and passions about medical science and make a difference to how relationships in healthcare are established, perceived and valued.

As an experiment in the value of social media, myPHID (scheduled to launch its interactive phase in September 2009) is already proving that industry can harness these tools to claw back the credibility it deserves for the way it wants to improve relations with physicians on an equal footing.

Evidently, we are witnessing a shift from traditional forms of information-sharing within the profession and business of medical science. Social media hold the potential to change interactions from being one-on-one relationship to a multi-faceted network with multiple layers of interactivity. These new avenues provide the opportunity for industry to break down the distrust that shrouds their current modes of activities.

If pharma can be persuaded to be sticky with social media rather than stuck in their outdated practices with physicians, there is scope to behave better and with corporate confidence about such important collaborations.

Emma D'Arcy is founder and leader of scientific insights at MyPHID: emmad@myphid.com A one-day conference on pharma-clinician relationships, ACTIVATE 09, will be held on 8 September. Visit: www.activate09.co.uk for more information.