When work commences on a pharmaceutical social media proposal, the immediate inclination is to jam the plan chock full of everything that can be done.  You want your creativity to shine through and the potential of social media to be clear.  To achieve this goal every crazy idea that crosses your mind finds its way into the plan.

Considering what can be done is important.  It provides you with a benchmark for future program ideas and allows for the type of big-picture thinking that is needed to move social media forward.  But a word of caution: focus first on what can realistically be done.

It has become abundantly clear to me the more I talk to companies interested in moving forward in social media that an all or nothing approach will more often end in the “nothing” part of the equation.  These types of proposals scare of pharma marketers that are still surveying the scene.  Rather than excitement the result is trepidation.

Instead of throwing out Facebook, Twitter, YouTube, LinkedIn, mobile apps, augmented reality, Foursquare and any other social media idea you can dream up—why not go back to the basics?  Start with listening by a well thought out social media monitoring program.  During the course of this program, you will get a feel for what your community is lacking, what your opportunity to add value might be and what the rules for engagement are.  This is invaluable information as you dive deeper into social media.  A good social media monitoring program will tell you where to focus and what to contribute.

As I’ve advocated for in the past, there is a case to be made for social media in stages and on a budget.  It allows the building blocks to be put in place before going full steam ahead.  Taking on everything at once is akin to throwing the roof on a house before the frame is up—it’s bound to come crashing down.

The “big” ideas should not be ignored nor should they be left out of plans entirely.  But aren’t we better served focusing on what can realistically be done before focusing all our energy on what can be done in a perfect world? Because I have news for you, it ain’t a perfect world out there.

Brief Programming Note: Apologies for the slow going on posting here as of late.  Between a work, real life and a vacation, it’s been difficult to carve out the time to write.  But alas, things look to be freeing up so I’ll be back at it more regularly.  I know; music to your ears.

Have you heard? A few pharmaceutical companies (and one oil company) have recently stepped into a healthy dose of crisis situations.  As is always the case, the response to those crises has been sliced, diced and pureed in every way imaginable.  The majority of industry pundits have been dissatisfied with the response of pharmaceutical companies in crisis situations and have pointed to their social media presence as proof of failed strategy.

I’m here to tell you it is not that simple.

In the midst of a crisis communications situation, there is a list 15 city blocks long of what a pharmaceutical company can’t say.  This is never more true than in the public eye of social media.  On the flip side, the list of things a pharma company can say when embroiled in a crisis is small enough to fit in your wallet.  So, all those calling for full transparency using social media are naïve.  I certainly would not suggest that a company should withhold pertinent information or intentionally deceive the public—but they simply cannot provide full transparency.  Why?  In many instances it’s illegal pending FDA review.  There is also a litany of legal considerations that put the squeeze on communications during a crisis. For example, no legal team at a pharmaceutical company would ever allow a public apology before all the facts have been sorted out.  In a legal sense, a public apology admits fault.  Fault implies responsibility and responsibility brings lawsuits.  It might seem callous, but that’s the reality.

Given the grim picture I have just painted, is there any hope for a pharmaceutical company dealing with a crisis.  Should they even be considering social media as a platform for handling a crisis and protecting their reputation?

While there is a long list of what you are not able to say during a crisis, you should be prepared to quickly say whatever is within bounds.  It sounds simple but too many companies get caught with their pants down under the assumption that a crisis won’t hit their companies.  A few well-respected brands would beg to differ.  You should enter a social media engagement expecting a crisis.  If you don’t expect a crisis then shame on you.  Knowing that a crisis situation may occur, you can then intelligently guess the areas where one is likely to arise.  Product recalls, disgruntled shareholders and adverse events seem likely to tip off a firestorm.  What are you doing to prepare for these circumstances?

Again, this is not about transparency for the sake of transparency.  A pharmaceutical company should not be taking to social media channels discussing specific adverse events.  But, it should be prepared to let the patient population know that they have been heard, the dialogue is open and they take the situation very seriously.  Pharmaceutical companies should also be prepared to offer additional resources.  Most pharmaceutical companies have case managers in their patient advocacy program—they should be at the ready during a crisis.  Top management should be visible and active.

There is a common misconception when it comes to crisis communications—that if done correctly, it is capable of solving the problem.  Regardless of how well you handle the crisis from a communications perspective, it still happened.  Crisis communications is not about fixing the problem, it’s about putting forward the human dynamic of a company—and there is no better way to do that than with social media.

So you’ve made the decision to jumpstart your social media efforts.  Good for you.  You’ve surveyed the scene, understand the relevant communities that have formed and pounded out a pile of useful content to share.  But then it suddenly dawns on you: “social media is hard work, I can’t do this alone—what should my internal team look like.”

Good question.  One of the most frequent questions I get is centered on how to structure an internal social media team for success.  For pharmaceutical and biotech companies, structuring a social media team involves a few wrinkles due to regulatory and legal restrictions.  The above is certainly a dramatization of the conversation that occurs, but it’s not that far from what most companies experience.  There is often an “internal champion” that fights the good fight, wins approval and then deals with the resource problem later.  It’s a survival instinct.  These internal champions realize that they are often fighting an uphill battle—one that will only become steeper with additional moving parts.

Admittedly, I am an agency guy.  By definition, I am part of the external team (a part that, as you might expect, I think is an integral cog in the wheel).  That being said, I think I’ve developed a broad enough view of the landscape to observe the “ideal scenario” and the “real-world scenario.”

If there is a so-called definitive piece of work on this topic, it comes from Jeremiah Owyang at the Altimeter Group.  Jeremiah places internal social media teams into three buckets: the tire, the tower and the hub and spoke.  Essentially, Jeremiah believes that social media teams either form on the fringes of a company (the tire), centrally located in isolation (the tower) or with a central source that facilitates efforts to relevant departments in a company (hub and spoke).  Jeremiah’s conclusion is that the hub and spoke is the ideal scenario for structuring an internal social media team.

My own anecdotal evidence supports that theory.  A hub and spoke model for social media teams allows for a more cohesive strategy that cuts across departments.  It also provides ample opportunity for a variety of customer touchpoints to get involved in social media.  As I have reiterated endlessly, social media should not occur in isolation and the hub and spoke model is one mechanism to prevent that from occurring.  It would like something like this:

That’s the ideal scenario, but is it feasible in the real-world? Yes and no.  Consider a pharmaceutical company embarking on a social media engagement strategy.  It would be great if that company were able to involve all key stakeholders right out of the gate.  But the reality is: many will be in “prove it to me mode” first.  As such, in a practical sense, the most likely (not best, but probably most efficient) way to start a social media engagement is in the tower model.  Generally speaking, that central command will be in corporate communications.  Corporate communications, by its nature, sits at the center of an organization and is in a unique position to get access to content.  This provides a bit more control, establishes a mission control and sets the benchmark and template for success for those “prove it to me” people.  The added benefit of having the tower located in corporate communications is that it can be easily transitioned into the hub of a better defined hub and spoke model.

Social media is in many ways still a developing medium.  Because of that, people are so laser-focused on the execution piece they neglect the resources needed to make that execution possible.  Social media takes time.  It takes resources and it takes commitment.  But you don’t have to tackle it all at once.  Start with the tower and you’ll find your way to the hub and spoke.

Social media focused on regulatory concerns only does not line up

Those of you that have read this blog more than once know that I have been beating the Return on Health (ROH) mantra lately when it comes to pharmaceutical social media.  The thought is that far too many social media programs start by considering how they will extract value and not how they can add value.

That’s a misaligned process.  Instead, marketers need to start by focusing on the patient with an eye toward how their interactions will enable access to more information and better health outcomes.  That’s the value you bring to the able as a pharma marketer.  That doesn’t mean you ignore your ultimate goal of building a brand that drives more revenue.  But instead of starting off with that at the forefront, you rely on a marketing principle that fosters long-term and authentic engagement.  It’s a significant shift in thinking but one that is critical if social media ever hopes to gain widespread adoption by pharmaceutical companies.

That shift in thinking is needed across the board and includes things like our fixation with adverse events and off-label usage.  I am as guilty as the next guy when it comes to spending an inordinate amount of time thinking about how to handle these very important issues in pharmaceutical marketing.  And we should continue to give careful consideration to where they fit into a social engagement strategy.  Dismissing AEs and off-label usage discussion as non issues demonstrates a clear lack of perspective.  These topics remain at the forefront of every pharmaceutical legal, compliance and regulatory department, and thus should remain a part of our conversation.

But we shouldn’t limit our discussion to solely focus on how to navigate the issues of adverse events and off-label usage in social media.  Why?  Because focusing the conversation in this area relegates the patient to the sidelines.  How many patients know what an adverse event is and even realize they are discussing off-label uses for a particular drug?  I would venture to guess is it a very small minority.  These types of issues, though important, are really geared at how a company can limit its liability with regulatory bodies.  It’s a necessary step and a conversation that needs to occur, but perhaps not at “stage one.”

The better approach would be to work from the patient out.  As pharmaceutical marketers, first ask yourself if there is a concrete reason for you to be engaged in social media.  If the answer is no—stop there.  Go no further.  Starting off the discussion focused on adverse events and off-label usage reverse engineers the process.  It starts with a company-centric point of view and eventually finds its way to the patient.

Successful engagements will start with the patient in mind and incorporate regulatory planning only if the first criterion is met.

Do you have a strategy to fit into the community?

As has become painstakingly obvious, the standard of communicating in the business world has changed dramatically over the last few decades.  First it was the advent of email and most recently the rise of what we’ll call “the digital communications era”—namely the ability to reach anybody, anytime, on any device.  Text messages, Twitter and Facebook have accelerated this dynamic and fed our appetite for smaller and smaller bits of content.

The ripple effects of this change are widespread.  Of course, the positive perspective is that work output is increased, productivity enhanced and the decision-making process accelerated.  In addition, as we have chronicled here, social media opens up an entire new toolkit for the marketer.  This is particularly true in the world of pharmaceutical marketing where customers are becoming increasingly wary of what they viewed to be nefarious efforts of pharma companies.  They craved a more authentic interaction with companies that would disband the ads that seem to strike fear more than they provide useful information.  Insert social media.  Social media allows pharmaceutical companies to introduce a different dynamic to its marketing programs—one built on trust and transparency.  In that sense, social media and micro content is a boon.  However, it’s not all good.

There is a fundamental disconnect between the types of communication facilitated by social media and strategic marketing plans.  The very nature of social media may be tempting marketers to put strategy on the backburner.  When you boil it down, a person’s interaction on a social network is ad hoc.  It’s not a planned, measured and calculated interaction.  This is a dynamic that many marketers have yet to solve.  How do you conform to the community norms of authenticity and put a strategic plan in place?

Unfortunately, too often marketers have opted for the wrong answer; either throwing strategy to the wind or going too far in the other direction and planning every interaction.  The flaw in both approaches should be obvious.  If a pharma marketer plans every single interaction he intends to have on social media his conversations will no doubt be manufactured.  His very presence will be loaded with ulterior motives.  However, if a marketer surveys the landscape and concludes that strategy and focus are not needed she too will fail.  Strategizing every interaction may not be needed, but having a reason for being there is imperative.  Rather than focusing on tactical plans to the minutest detail, pharma marketers should focus on decision-making frameworks that guide interactions in social media circles.  Empower the faces of your social media presence to act with confidence.

In the old days in business, the standard form of communicating a message to a large group of people was writing a memo.  Those memos were well-crafted, thought-out documents.  They had to be.  You couldn’t afford to be ambiguous in your message or marching orders—the medium did not allow it.  Social media does allow for ambiguity and poorly defined communication.

Perhaps it’s time we took a page out of the 1980 playbook and apply it to social media.

In my last post, I attempted to make the case that pharma social media is nothing new—just a form of relationship marketing using a different channel.  In essence, sales reps have been making a living for decades based mostly on their ability to cultivate relationships.  Those relationships are developed based on an exchange of value—the docs get access to information (and sometimes incentives) and the reps get a hefty commission.  Without some sort of exchange of value, no relationship can function.  In that sense, sales reps and social media programs are not all that different.  Right?

Sort of.  While the basic tenants of building a relationship are the same, one key difference does exist—the definition of value.  In the more traditional form of relationship building, value can be defined a number of different ways.  Value can be access to information.  Value can be key clinical trial data.  Value can be providing access to a drug that widens a doctor’s treatment options.  Those are all good things.  But the problem is: value in this world can also be defined by expensive lunches, putting doctors on payroll and fancy country clubs.  This type of value should not dictate the subscribing patterns of doctors.  And while there are a lot of great sales reps out there that provide a very admirable and needed service, there are also those that fight tooth and nail for every sale by resorting to whatever it takes.  This type of relationship building is still predicated on an exchange of value.

Social media is vastly different in this regard.  Value is not defined by pharma companies and doctors, value is defined by the patients—the community.  In social media, the idea of value is redefined from past relationship marketing efforts.  Because patients are intimately concerned with their health, they have the right to define value in their own communities.  This is why pharma companies need to focus on Return on Health (ROH) as a key guiding principle of social media.  It allows them to focus their efforts where it counts—on the patient.  Of course, just like any relationship, there is always the possibility that it can be exploited.  The same types of motivations that drive sales reps could certainly drive marketers to cross ethical boundaries in social media.  But the difference is—the social media community won’t allow it to happen.  It can’t happen for an extended period of time in social media circles because pharmaceutical companies do not dictate value.  While sales reps function in the friendly confines of a doctor’s office, social media takes place in front of a giant spotlight.  The patient has decided what value they are seeking and if pharma companies fail to oblige they will be ostracized.

That leaves pharmaceutical companies and the agencies advising them with a choice: get in by understanding the value the patient has dictated or get out.

Relationship marketing is really nothing new in the world of pharmaceutical companies.  For decades, the industry has relied on the ability of its sales reps to form lasting relationships that pay off in the form of increased prescriptions.  Say what you will about how the reps cultivated those relationships, but the fact is, they were able to tailor their information delivery to what doctors were seeking.

In recent years, the pharmaceutical industry has sought to regulate how those relationships are formed by cutting back on tchotchkes, expensive lunches and other ethically questionable practices that influence prescription writing.  Just today, the news circulated that New York Governor, David Patterson, was seeking to eliminate the practice of providing gifts to doctors after an office visit.  In some ways, this mirrors the voluntary code of ethics adopted by Big Pharma a little over a year ago.  However, others argue that the new limitations that Governor Patterson seeks to impose are too rigid and eliminate the ability of the sales rep to deliver his key value—education.  It’s an interesting conundrum: how do you allow the free flow of information to ensure access to the best sources available while at the same time curtailing the types of seedy relationships that place undue pressure on doctors?

Before you answer, ask yourself an additional question: is this problem all that different from what pharmaceutical marketers face when entering the world of social media?  To be an active participant in social networks, the key skill you need to possess is the ability to form relationships.  For a pharma company, the biggest value they can provide patients and doctors online is information.  In much the same way that sales reps face regulations on their relationship-building practices, pharma marketers will inevitably be faced with the same ethical questions.  But you knew that already. That is the primary reason why the FDA has started to pay attention and is certainly the reason why many pharma companies are skittish about launching a social media initiative.  The more pressing question is: how do you establish boundaries that govern a pharmaceutical company’s ability to provide information without crossing regulatory guidelines?  Can impending guidance from the FDA actually make it more difficult for pharma companies to get information it the hands of patients as a result of strict regulations?

There is no easy answer.  On the one hand, as a social media advocate, I believe that the primary value a pharmaceutical company can provide is information.  Impending regulation that prohibits the company’s ability to do that may ultimately harm the patient in the long run.  On the flip side, I also realize the importance of governing this industry given what is at stake and by no means would advocate a wild west atmosphere of lawlessness.

Yet still I struggle, how far is too far when it comes to restrictions on pharmaceutical companies?  In the offline world, there are hordes of honest, hard-working sales reps that feel they are providing a service in the form of information.  Regulations such as those proposed by Governor Patterson make it far more difficult to provide that service.  Online, we strive to provide that same service while at the same time thumbing our nose at the tactics of sales reps.  Where is the line between providing information and breaking an ethical code of conduct?  In some cases, the line is not always clear.

We often trumpet the arrival of social media as the newest tool in a marketer’s bag of tricks.  But it’s merely an extension of what has been taking place for decades at pharmaceutical companies—building relationships based on providing value to the target audience.

I have my own thoughts on why social media is different from the relationship marketing of years past, but would be curious to hear your feedback in the meantime.  I’ll post my ideas tomorrow on why social media is a new form of relationship marketing and how the ethically questionable tactics—regardless of guidance—will be rooted out.

Working in the agency world is a little bit like the dating scene—if you are around it long enough, you are bound to get your heart broken (or wallet as the case may be) once or twice.

It’s no secret that agencies are let go for a variety of reasons that range from the completely justifiable to the head scratchers.  The average retention rate of clients in the PR business is something in the neighborhood of 12-16 months depending on which reports you choose to believe (I am happy to report SHIFT’s is much longer!).  With such a revolving door, one must wonder: what drives a pharmaceutical company to fire its social media agency?

There is no definitive list of reasons that leads to an agency getting the boot.  It can be a result of missed metrics, poor strategy outlines, faulty execution, budget constraints, etc…And while the list is long, I’d venture to guess that there are two primary buckets that cause a pharma company to fire its social media agency—false promises made by the agency and unreasonable expectations of the pharmaceutical company (sometimes one causes the other).  We’ll take these one at a time.

False Promises Made by the Agency

I touched on this one a bit in yesterday’s post.  Too often, agencies walk into a pitch eager to win business and selling whatever they think the company at the other side of the table wants to buy.  They do this without regard for whether or not they believe they can deliver on those lofty promises.  Why?  They don’t care.  The goal is to win the business and earn a quick buck—not create sustained value.  This breeds the thinking that social media is a silver bullet.  With people out there selling it as such, it is no wonder that some marketers think that social media has the ability to mask existing problems.  It does not.  Because agencies are selling false hope, when they can’t deliver on that hope, they get the axe—justifiably.

A good social media agency will outline challenging goals, but not make promises of a brand remake over night.  A good agency will highlight the risks of engaging in social media and have a plan in place to mitigate those risks and deal with them when they arise.  Most importantly, a good social media agency will say “no”.  They won’t be afraid to tell you if your strategy is off base, or if your line of thinking will fall down when engaging with a community online.  If your social media agency is afraid to tell you “no” I can almost assure you the program will fail.  False promises are a quick way to the unemployment line and only makes the job of legitimate agencies that much more difficult.

Unreasonable Expectations of the Pharmaceutical Company

The message I have been trumpeting recently, along with others, is that social media does not shovel problems under the rug—it rips the rug off the floor.  If a company walks into a social media engagement thinking that it can distance itself from product problems or damaging messaging it is sorely mistaken.  The more likely result is the social media community will expose that problem quicker than you ever thought was possible.  And not only will it be exposed, it will run rampant until you step up and offer a solution.  The thing people often forget about social media is that it acts as one giant neighborhood watch.  Phonies are uncovered, bad products are rooted out and shifty salesmen are pinpointed.  It’s not a comfortable place to be if you have skeletons in the closet.

Unfortunately, some pharmaceutical companies are willing to throw caution to the wind and hope social media can work miracles.  When those miracles fail to materialize, the social media takes the fall.  Sure, it is the job of the agency to steer the client in the right direction and set appropriate expectations, but sometimes it is not enough.  In those cases, the pharma company is bound to fail because it simply demands too much.

The Lesson?

The new marketing model increases accountability on both the vendor and client side.  The days of arm’s length relationships are coming to a screeching halt.  In order to truly succeed in social media, you better have a true partnership.  Afterall, if you can’t master that relationship, you can forget about the new ones you will be forming through social media.

It’s no secret that social media is the trend of the day in pharmaceutical marketing.  A combination of constant evangelism on the part of social media wingnuts (I mean advocates), an uptick in real-world examples from pharma companies and the FDA public hearing has vaulted social media into the limelight.  Since attaining such prominence, social media seems to have a stranglehold on the marketing discussion (or maybe it’s that whole echo chamber thing I posted about).  But the limelight can be so bright that it causes you to miss other things right before your eyes.

If you haven’t picked up on my thinly veiled metaphor just yet, social media is the bright light in this case.  In recent months, social media has been relegated to shiny object duty.  It’s the marketing tactic of the day being waived before pharma executives at every strategy session to increase patient engagement, raise brand awareness and break into new markets.  That’s a good thing.  The level of conversations that are occurring regarding social media is encouraging.  It indicates that pharmaceutical companies are slowly but surely buying into its potential.  But there is a fine line to walk between realistic potential and hype—we are getting dangerously close to the edge.

Social media enters into the hype zone when it causes otherwise level-headed marketers to write off alternative, viable marketing tactics.  And if they are not written off, they are certainly placed on the backburner.  As an aforementioned wingnut, I believe in the value of social media as much as the next guy.  But social media CANNOT exist in isolation.  It has to be conducted in the context of a larger marketing strategy that includes a broad range of tactics.  I’m a PR guy.  In fact, while I tout the benefits of social media on a regular basis, a large chunk of my work is dedicated to so-called traditional PR.  That’s right, writing press releases, reaching out to editors and forming relationships with the main-stream media.  Can you imagine?

(Warning, here comes a small commercial, bear with me, I think it is relevant).

At my agency, SHIFT Communications, we describe ourselves as a hybrid agency in the sense that we do both traditional PR and social media.  I think that’s crucial.  We do this not so we can sell both services, but because we firmly believe that social media, and traditional PR should happen in concert, not in isolation.

Social media is important.  It will only grow in importance as companies become better at engaging with relevant communities.  But remember, social media should not happen at the expense of the remaining parts of the marketing mix—even traditional PR.

Let’s get this out of the way: social media for pharmaceutical companies is hard work.  There I said it.

Far too many people suffer from the misconception that social media is simple and merely a question of value.  “How hard can Twitter really be—it’s only 140 characters?” “My daughter can master Facebook; surely I can make it work.”  Or worse still, “All I need to do is come up with a few good corporate messages and then proliferate social networks with them—think of how many people will see it!”

The latter statement is the one that keeps me up at night.  When engaging in social media, pharmaceutical marketers are faced with a choice—take the easy route or the longer, more difficult road.  As I mentioned in my previous post, the easy route in social media is tempting.  Instead of taking the time to form relationships, learn the landscape and provide meaningful commentary, pharmaceutical marketers can simply broadcast a canned message to the masses.  Of course, this isn’t really social media but that may not matter.

We’ve reached an important, dare I say, tipping point in social media for pharmaceutical companies.  We’ve moved passed the evangelism stage to a point where many pharmaceutical companies are actively weighing and pursuing some form of social media engagement.  As they do, will they be tempted by the lure of the easy route in search of quick hits?  Or will they take the methodical, strategic approach?

The answer to the question depends on how the social media marketer approaches the medium in the first place.  It is important to remember that social media is not a silver bullet.  It cannot cure all the ills of the checkered marketing past of pharmaceutical companies.  Social media is not a quick fix.  Relationships in the real world are hard work (just ask my wife who has to deal with me).  All relationships take commitments, dedications and honesty.

Social media is no different.  And like any meaningful relationship—when it works—boy is it rewarding.