Wishes for America at 300

 

We’re done celebrating America at 250. Now comes the question: What should we be able to celebrate when America turns 300?

In my new piece for The Hartford Courant, I argue that the next great civic advances should prioritize three goals:

• Protect political equality
• Treat education as civic infrastructure
• Ensure affordable, accessible healthcare

These are the next reasonable steps. By our 300th, we should be judged on whether Americans can participate fully and fairly in the life of the country.

The Dissonance in Pharma DTC Erodes Credibility — and Limits Its Potential

The future of DTC should foster understanding, trust, and improve clinical conversations.

Prescription-drug commercials have been a recognizable part of American TV for nearly 30 years. Their production values have kept up with the rest of the advertising world, and in the costliest broadcast spaces, they now look almost identical to ads for consumer tech, cars, and sports betting. As The New York Times reported, spending on direct-to-consumer drug advertising is rising again, driven by competition in high-profile therapeutic areas – a reminder that DTC advertising is not fading but growing in scope and influence.

I have been writing about DTC pharmaceutical ads for nearly 20 years, and the dissonance – cavorting cartoon characters or people climbing mountains while vital information is voiced over – has remained remarkably consistent. Patients and clinicians often start the clinical conversation inside a narrative that the advertising has already shaped.

DTC advertising is the biggest untapped resource for public health education in the country. The concern isn't about the presence of risk information; it's whether the overall experience helps people understand what those risks mean and how they should affect treatment choices.

An ad for Vanda Pharmaceuticals’ antipsychotic Fanapt highlights this disconnect: a calm voice lists stroke risk, cardiac complications and sudden death while smiling, anime-style characters move through bright, cheerful scenes. The disclosure follows regulations but trivializes the seriousness of the condition and distracts from the importance of the adverse-event information.

Regulators have started to recognize the gap between mere compliance and actual understanding. The FDA’s letter to Novo Nordisk about a TV commercial for oral Wegovy criticized how the ad implied broader emotional and lifestyle benefits than the evidence supports. In another letter concerning a commercial for argenx’s Vyvgart Hytrulo, the agency noted that “attention-grabbing visuals, frequent scene changes and background music” might hinder understanding of the major risk statement. That language matters because it acknowledges that production techniques influence how risk is perceived. However, it stops short of addressing the core creative decision in most branded campaigns – whether the story enhances the safety message or competes with it.

Direct-to-consumer advertising grew rapidly after the FDA relaxed its broadcast guidance in 1997 and finalized the approach in 1999. Drug names became part of everyday conversation. Awareness increased, but public trust in the industry did not follow the same trajectory. The American Medical Association’s 2015 call for a ban on DTC advertising reflected ongoing concerns that brand narratives can influence the clinical encounter before a diagnosis is made. Physicians interviewed by The Times this week described spending valuable visit time recalibrating expectations created by advertising – explaining why a widely promoted therapy may not be suitable or why its risks and benefits are more complicated than the commercial suggests. That debate is unfolding at a time when trust in health institutions remains fragile.

The conversation still tends to frame DTC as a choice between maintaining the current model and eliminating it. But this overlooks a bigger issue. The pharmaceutical industry now controls some of the most influential health-communication platforms in the country – including television, streaming, social media, search, and digital video. How this multi-channel infrastructure is used has huge implications for how patients understand their health.

That reach is most visible during the Super Bowl. In 2024, Pfizer chose not to promote a specific therapy but to “celebrate science” on its 175th anniversary. Instead, the message was muddled and abstract. Pfizer missed an opportunity – not because its creative execution was weak, but because the platform’s power far exceeded the depth of what it chose to say.

That same media moment has also shown what a different objective looks like. Novartis’ Super Bowl LX screening initiatives and Bayer’s heart-health risk campaign used the industry’s most expensive media real estate to encourage early detection and informed action. They are not simply creative templates for branded advertising; the regulatory environment is different. They demonstrate that when education takes priority, storytelling shifts – and viewers leave with knowledge rather than just an impression.

Branded advertising operates within stricter regulatory constraints, but it still makes choices about tone, pacing, and imagery. These choices determine whether safety information is incorporated into the story or hidden beneath it. The issue is not about fair balance. It's whether the surrounding narrative trivializes the disease and distracts from the risks that should influence treatment decisions.

In many product campaigns, the narrative reassures, while the safety information warns. The viewer receives two emotional signals at the same time and must reconcile them. This split may work well for recall, but it weakens the credibility on which long-term brand success now depends.

Eliminating DTC would remove a source of awareness that has encouraged patients to seek care earlier and discuss stigmatized conditions with their physicians. The opportunity is to use it more effectively. A better approach would replace distraction with decision support – focusing on the moments when a patient and clinician weigh options, reassess progress, and adjust the course if a therapy is not suitable. In this model, safety information is not an interruption; it becomes part of the narrative.

This isn't a call for longer risk language or more data on the screen. It's a call for creative alignment. When tone, imagery, and narrative support the medical reality instead of competing with it, the advertising sets the stage for the clinical conversation rather than pre-empting it.

That shift has business implications. The industry has long argued that informed patients achieve better outcomes. In a crowded and scrutinized market, credibility remains one of the few durable advantages for brands. Creative work that distracts from risk might boost short-term recall, but creative approaches that aid decision-making builds trust with patients, clinicians, and regulators.

Direct-to-consumer advertising has become a permanent feature of American culture. Its future credibility will rely more on whether it bridges the gap between marketing and medicine than on disclosure adherence. In a medium where a 30-second story can reach tens of millions, aligning the message with medical truth is no longer optional; it is essential for understanding.

Scientific Snobbery and Other Acts of Institutional Malpractice

Arthur Caplan’s important new EMBO Reports essay, “How stupid has science been?” serves as a powerful reminder that for decades, much of the scientific community viewed public communication as a career liability – the Sagan Effect, because many regarded the famed astronomer with disdain for trying to explain science in simple, relatable terms.

That cultural snobbery mattered. It left many citizens unprepared to evaluate claims and ceded ground over to the ill-informed, propagandists, and those seeking to manipulate others. Snobbery created a vacuum, but if we only focus on scientists’ failures, we’ll miss the larger structural forces now fueling mistrust and politicization – forces that must be addressed directly if we want science (and our health and global competitiveness) to recover.

Start with the partisan divide in trust. Pew Research Center finds confidence in scientists remains higher among Democrats than Republicans, and the gap widened during and after the pandemic. The pattern shows that party identity influences whether evidence is trusted – regardless of facts or how skillfully scientists explain it.

It’s worth remembering that science wasn’t always a partisan issue. America’s main science agencies were created through mid-century consensus, not by culture-war reactions. The CDC began in 1946 as a malaria-control effort that evolved into the foundation of the nation’s public health system; the NSF was established in 1950 when President Truman created it for “research driven by curiosity and discovery”; the NIH’s history dates back to the 1887 Hygienic Laboratory.

But now, active political interventions have been layered onto the federal science apparatus. Recently, the White House fired CDC Director Susan Monarez weeks after she took office, prompting senior resignations and raising alarms about political control of public health decisions. The administration also proposed slashing NIH’s budget by roughly 40 percent (about $18 billion). Even if Congress moderates these proposals, they signal that federal science has become a partisan battleground.

Performance and integrity are vital for building trust. Americans remember serious ethical and governance failures—like the inhumanity of the Tuskegee syphilis study and the retracted, heavily debunked Wakefield paper linking vaccines to autism—because they shattered the expectation that science self-corrects quickly and transparently.

Finally, our news and information ecosystem supercharges falsehoods. A study of millions of tweets published in Science showed that false news spreads “farther, faster, deeper” than truth – mainly because people share novelty and outrage, and platforms amplify it. That’s a systemic issue; clearer language from scientists helps but can’t, on its own, beat virality.

The trust dividend is pragmatic, not poetic. When evidence prevails, patients receive faster diagnoses and fewer risky detours; businesses scale sooner because regulators trust transparent methods; schools update curricula without culture-war spectacles; and cities act on air and water data before crises metastasize. That’s why the antidote to politicized science isn’t just speeches but a system: clear standards, timely corrections, and public dashboards showing how evidence guides decisions. Consistently doing this doesn’t just reduce tension—it boosts the nation’s ability to solve problems. Communication matters, yes, but performance plus transparency are what turn skeptics into stakeholders.

Certainly, talented public communicators like Neil deGrasse Tyson, Brian Cox, Michio Kaku, Hank Green, and Jessica Knurick, along with training hubs like Stony Brook University’s Alan Alda Center, have entered the scene. Helpful, but far from enough. These efforts must multiply a thousand, even a million times, reaching every part of the country.

So, yes: some snobbery initially created a vacuum. But now, polarization, policy shocks, long-term under-investment, governance failures, and algorithmic virality cause most of the damage. It’s a monumental problem, and we cannot wait for Congress to take meaningful action.

1. Scientists: make communication a core, even mandatory, part of your role, not just a side activity. Back in 2006, I urged scientists and doctors in Nature Biotech to make science more understandable and accessible to the public. It’s not about dumbing things down; it's about making them simple and relevant. If your research is funded by the public, explaining and justifying it is a service. Include a clear, plain-language summary on every paper and preprint; hold regular public Q&A sessions with schools, libraries, and faith groups; and include communication achievements in promotion and tenure dossiers.

2. Media: stop presenting “both sides” equally; emphasize the strength of evidence. False equivalence turns well-established science into a debate show. Use proportional balance: give more coverage to claims supported by strong evidence and less to fringe assertions unless the story specifically addresses misinformation. As I’ve argued elsewhere in “False Equivalencies: The Danger of Treating All Information Equally,” giving equal time to unequal sides misleads intentionally.

3. Schools: focus on teaching how to think rather than just memorizing facts. We don’t need every student to become a scientist, but every citizen should be able to recognize evidence, uncertainty, and tradeoffs. Make the scientific method a regular part of education from middle school onward, pairing it with statistics, probabilistic reasoning, and media/digital literacy. Balance STEM with the humanities so students can grasp ethics, history, and policy contexts.

4. Politicians: be the local leaders science needs. Establish a standing science advisory group in your office composed of accomplished professionals from nearby universities and health systems. Hold regular evidence briefings on issues important to your constituents (e.g., climate change, mental health, vaccine guidance, opioids, air, water, and soil safety). When guidance shifts, announce it openly and explain why. Leadership isn’t about having all the answers; it’s about showing your process.

The current politicization is (hopefully) temporary, not unavoidable. We can reverse it, but only if we address and invest in all the root causes—not just the easiest or least controversial ones. We must be brave and determined before we become sicker, poorer, and even more vulnerable.

What Pfizer’s Super Bowl Ad Should Have Been

There’s been a lot of discussion around Pfizer’s decision to spend an estimated $14–21 million on its “Here’s to Science” Super Bowl ad. I’d like to boil it down to two questions: Why did they do it? Did it accomplish their objective?

For the question of ‘why,’ STAT News reported, “The ad comes as the pharmaceutical company celebrates its 175th anniversary and looks to promote a dynamic, optimistic message about Pfizer’s future to the general public, investors, and the company’s own employees.”

Pfizer spokesperson Faith Salamon said the goal was to “celebrate science in a fun, engaging and uplifting way.”

Unfortunately, The New York Times didn’t buy it. In their review of Super Bowl ads, the NYT placed Pfizer in the category entitled, “The Flagrant Missteps: Famous people and millions of dollars that together can’t quite amount to mediocrity.”

Flagrant sounds too intentional. This is a case of missed opportunity (except for the soundtrack — who doesn’t love Queen’s “Don’t Stop Me Now”?).

I had an array of reactions, but these were the key moments:

Most horrifying: A corpse comes alive, with his arm dissected from shoulder to fingertips — depicted in Rembrandt’s The Anatomy Lesson of Dr. Nicolaes Tulp — looking like he wants to get off the table.

Most confusing: The inclusion of a tartigrade (“little water bear,” an eight-legged creature about one millimeter long) swimming across the screen.

Most inspiring: The positive message sent by highlighting four women scientists, one of color.

Most overreaching: It seems the ad makers knew most of the public couldn’t differentiate between famous scientists or science disciplines, so they threw some recognizable names out there. The relevance was questionable since half of the science luminaries depicted were mathematicians and physicists, yet Pfizer is a healthcare company.

Most jarring: The words “Here’s to the next fight” come across the screen but don’t connect to anything seen previously. The next words are “LetsOutdoCancer.com” followed by some video of a little girl being applauded for what must have been successfully completing treatment. (A lovely moment, to be sure.)

The Let’s Outdo Cancer website details Pfizer’s research pipeline and product portfolio. There’s also important information on how to participate in a cancer clinical trial and a partnership with the American Cancer Society to “improve health outcomes in medically underrepresented communities across the United States.”

There is no doubt that we’re benefiting from the discoveries made by Pfizer and their partners. We’re living better, healthier lives. There’s a ton of good information on the site but it doesn’t have much to do with “Here’s to Science.”

A one-off effort like a Super Bowl ad can help achieve specific objectives but, in my experience, plans need follow-through and messages require repetition. I don’t know their actual plan, of course. I’m not an insider. But if Pfizer seeks to promote a positive message and increase engagement with stakeholders, I have a suggestion. They have an enormous opportunity to create a more receptive public if they work towards increasing trust in science.

Engaging a wide array of audiences on the value of science is critically important to elevate trust. Dr. Marijn Dekkers, former CEO of Bayer and former Chairman of Unilever, pointed out at a financial conference several years back that “even the most outstanding ideas and scientific breakthroughs have no chance if people do not accept, appreciate and support them. All too often, people are afraid of — or uneasy about — new ideas, inventions, processes or products.”

The public acceptance of innovation is clearly at risk according to the 2024 Edelman Trust Barometer, an annual trust and credibility survey. It found that respondents believe innovation is poorly managed by nearly a two-to-one margin. And while technology as a whole is trusted by 76 percent, gene-based medicine is only at 50 percent. (It gets worse. GMO foods are trusted only by 32 percent.)

The issue goes far beyond industry interests. Poor science literacy can eat at the core of our democracy. Professor Jon D. Miller, now at the University of Michigan, warned us nearly 20 years ago that “people’s inability to understand basic scientific concepts undermines their ability to take part in the democratic process.” He continued that for many issues affecting society, “if you don’t know a little science [it’s] hard to follow these debates. A lot of journalism [will] not make sense to you.”

So, here we are. The current state is that science and scientists are under attack. Facts are being denied and misinformation proliferates. Critical thinking is being abandoned. Education is underfunded. Science is politicized and weaponized. It must stop.

It’s not a problem that can be addressed by a one-year budget cycle or even a five or ten-year plan. It will take a generational blueprint that needs to be comprehensive, coordinated, and well capitalized to see a return on the investment.

Getting the message out is only one side of the coin, though. Ensuring the message is received requires the same sort of effort. The Super Bowl ad should have been the kick-off of an ongoing effort to engage, inform, and educate the public about science and scientific principles. But it’s not too late. We need conveners. Partners need to be assembled and resources gathered. Objectives must be determined and milestones assigned.

Let’s get started.

Between posts I invite you to follow me on Threads @pauloestreicher.

Stopping Ourselves from Mattering Less

Oh boy, was I wrong. “Who needs these humanities requirements?” I asked as a college student. I was going to be a scientist and wanted to place my attention on (what I thought was) my ultimate goal. 

Sure, I learned to appreciate the genius of Shakespeare and enjoyed the scrum in my political science classes. But I loaded up on the hard not the social sciences. I bought the promise that technology had the answers to everything. One couldn’t be a whole person without a rock solid background in math, chemistry, physics, biology.

Whole person, huh? I said I was wrong, right? I’m not sure I can say it enough. I’ve come to hate mutual exclusivity and false equivalencies and yet, there I was. It took me years to figure out (with no small contribution from my wife) that interesting people, valuable people, are a package. We should have an appreciation – a facility, even – with a multitude of subjects spanning STEM subjects to the liberal arts.

We need to know enough about both the humanities and science to be capable citizens. With the politicization of so many topics – vaccines, evolution, climate change, stem cells – a more roundly educated public is essential. 

We need to expect and demand more of our leaders, too. I wonder how many of them read books like David McCullough’s 1776 or John Adams that chronicled how the founding fathers built a nation on progressive values; Peter Watson’s Ideas with two million years worth of language, thought, and invention; Constantine’s Sword by James Carroll on the evolution of faith and systematized prejudice; Stephen Hawking’s A Brief History of Time to make your head ache when contemplating the enormity of our universe, or Abe by David Reynolds to show us how personal evolution and compromise gave rise to one of our greatest presidents.

Social media and cable news echo chambers have made it all too easy to receive what the algorithms are trained to feed us. We suffer from inertia, from a lack of curiosity, from what used to be the common practice of debating the issues (and not the facts). If the facts don’t fit the person’s worldview or “frame,” as the cognitive linguist George Lakoff termed it, the facts bounce off like bullets shot at Superman’s chest. Your opponent deflects all the data, swears on what they believe to be true, while you get blue in the face.

But now comes the latest assault on holistic education. The New York Times recently reported that West Virginia’s “flagship school will no longer teach world languages or creative writing — a sign, its president says, of the future at many public universities.” What the WVU administration is calling a “transformation,” others are calling a “blood bath.” It’s frightening to think this could be the beginning of a very dangerous spiral.

The questions of how to educate, what to teach, and with what money are not new. But this is different. We’re looking at institutional changes that could take years, generations to repair. If we’re not careful, if we don’t invest in expansive, accessible education, we will be less able to govern, less capable of informed, civil discourse, and less capable of maintaining our competitiveness on the world stage. The hollowing out of education, and the under-budgeting and the reversal of opportunity are as grave a threat as any facing our country.

Author of Camelot, Inc.: Leadership and Management Insights from King Arthur and the Round Table.

Between posts, I invite you to follow me on Threads.

No Easy Fix: Opinion and Belief vs. Facts and Truth

We’ve all experienced the feeling. Our hopes get raised and then... splat. No payoff. No satisfaction. 

I got excited when I saw the title of Adam Grant’s recent article, “The Science of Reasoning With Unreasonable People,” published in The New York Times. Could “motivational interviewing” help win over people who choose beliefs, faith, and opinions over facts? What wonderful news! We need a breakthrough when it comes to persuading people to accept the facts around a host of science-based issues including climate change and vaccine safety. 

Alas, it was not to be. In one example detailed in the article, an intensive effort managed to get an anti-vaxxer from negative to, well, a tiny bit less negative. At the end of his piece, there was a tinge of resignation. Grant wrote, “All I can do is try to understand their thinking and ask if they’re open to some rethinking. The rest is up to them.”

All I can do? There has to be more, right? 

It turns out that motivational interviewing might have a limited role in addressing the vaccine hesitancy of some new mothers. A study cited in the article demonstrated a seven percent (statistically significant) increase in vaccination coverage in a subset of infants. While a good outcome, the authors recognized a number of study design limitations. And in actual practice, there’s a huge amount of ground to gain.

The chasm between hard data and belief exists because facts don’t matter to a big chunk of the population. We’ve known this for years. If facts were all it took, we’d be done: People wouldn’t smoke cigarettes, abuse drugs, be racist, or refuse to wear motorcycle or bicycle helmets. If the facts don’t fit the person’s worldview or “frame,” as the cognitive linguist George Lakoff terms it, the facts bounce off like bullets shot at Superman’s chest. Your challenger deflects all the information while you get blue in the face.

So, it’s clear that information and insight by themselves don’t produce change. It’s the desire to change and seeing the value in change that drives us forward. 

One desire killer is inertia. We’ve heard the excuse: “That’s the way we’ve always done things.” There may be no consequences: “Who’s going to notice, who’s going to care?” We may feel powerless: “I don’t have the resources, I don’t have the access.”

A second drag on change is simple ignorance and, on this issue, I’m having déjà vu. I wrote about “Swine Flu's Teachable Moment” nearly a dozen years ago: “It was disturbing to read about a growing public health threat in "Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases" in this week's New England Journal of Medicine (Omer et al.). The bottom line is that there is a critical need for new education and policy efforts to protect children (sometimes from their own parents) and the general public.”

Dr. Marijn Dekkers, former CEO of Bayer and former Chairman of Unilever, pointed out at financial conference several years back, “Even the most outstanding ideas and scientific breakthroughs have no chance if people do not accept, appreciate and support them. All too often, people are afraid of – or uneasy about – new ideas, inventions, processes or products.” Dropping information – even crucial or compelling data – onto the heads of an unprepared public, or expecting a response to another “call to action,” is unproductive and unrealistic.

We’re in this situation partly because our science literacy is abysmal. The United States ranks 18th out of 78 countries, according to the most recent analysis by the National Center for Education Statistics. China, Estonia, Japan, Korea, Canada, Poland, Slovenia, UK, Netherlands, and Germany are among those ahead of us.

And it’s an even bigger issue than the public health or economic competitiveness. Poor science literacy can eat at the core of our democracy. Professor Jon D. Miller (now at the University of Michigan) told The New York Times in 2005 that “…people’s inability to understand basic scientific concepts undermines their ability to take part in the democratic process.” He continued that for so many issues affecting society, "if you don't know a little science [it’s] hard to follow these debates. A lot of journalism [will] not make sense to you."

It’s not a problem that can be addressed by a one-year budget cycle or even a five or ten-year plan. It will take a generational blueprint that needs to be comprehensive, coordinated, and well capitalized in order to see a return on the investment. Let’s get started.

Between posts, I invite you to follow me @pauoestreicher.

Who Can Win the Battle for Truth?

This article also appears in Medium.

We’re fighting over the truth in the news media, at home, at work, and in the halls of Congress. And the battle carries over to our institutions of higher education with sides taken over free speech and academic freedom.

President John F. Kennedy said, “The goal of education is the advancement of knowledge and the dissemination of truth.” So, it seems appropriate that Cornell University recently held a symposium entitled, “Universities and the Search for Truth.”¹

Why does this all seem more urgent today? Humans have always been truth-challenged. Ancient conquerors frequently rewrote history. The Bible is filled with stories of deception. Some countries, institutions and industries exist on the clever use of propaganda.

The truth is the amount of what we call information is expanding wildly, and spread in more ways and with greater consequences than ever before. The rise of the internet and consumer-generated content, pressures on professional journalism, and our reliance on social media channels and their complex algorithms all influence what we see, hear, believe and share.

Add these modern issues to Friedrich Nietzsche’s declaration that “There are no facts, only interpretations” and we have a gray, goopy and potentially grave mess. Echoing the reality of truth’s plasticity, Professor David Shalloway at the symposium said, “Data can be true or false, but knowledge is usually only an approximation.” And Professor Holly Prigerson voiced a similar view: “Truth is not an absolute thing. It’s not binary, and it’s on a continuum.”

Our judicial system recognizes our inclination to manipulate the facts into a self-satisfying truth when we’re asked to “tell the truth, the whole truth and nothing but the truth.” As much as the words matter, though, Professor Sarah Murray said, “Language itself doesn’t ensure the truth or reliability of information. It’s how we use language and communication and who’s using the language that are judgments about that.” Most people understand this – the messenger can increase or decrease the credibility of the message.

While the literature carries many comparisons between strategic communication and war – offense and defense, knowing your opponent, hearts and minds, etc. – Professor Mor Naaman acknowledged his talk was particularly “dark” and “grim.” “Modern media technology is killing truth and knowledge,” he said. “Instead, our technology emphasizes only information and emotion.” He added that social media is a “well tuned and optimized machine that plays exactly” to our biologically, psychologically and evolutionarily wired sense of emotion, not truth or knowledge.

You can see how fear and anger are being used as platforms for persuasion but we can use this insight on emotion toward a more favorable purpose. The most effective, enduring way to communicate is to link fact and emotion through the use of examples, imagery and storytelling. And the language needs to be relevant; context is required. A famous wrongful death case involving drug side effects was lost well before the conclusion of all the testimony. “We didn’t know what the heck they were talking about,” a juror told The Wall Street Journal.²

Yet, a problem remains in how we receive information. We hear about algorithms making viewing choices for us – the creation of echo chambers. The algorithms are sometimes called filters but they are not. They curate but also isolate. They homogenize, not cross-fertilize.

The symposium panel offered some fixes: Educate students on the ethical, philosophical and social issues of technology; study how technology can create misinformation and biases; create new curricula, and focus new research on these issues. While important, they are long-term solutions and it’s unclear how the findings would be applied widely.

We need equal attention on smaller, shorter-term initiatives. So, let’s stipulate that the truth is subjective and focus instead on the starter material – the objective facts – since these are frequently denied or called into doubt. In addition to the earlier call for using relevant language in describing the facts and connecting these to resonant emotions, we should consider the following:

Push to end false equivalency and the conflation of opinion with fact. If 97 percent of climate scientists agree on human causes for climate change, we should not see one-on-one debates. News organizations and social media news feeds should present the available, accurate data but must differentiate between fact and opinion.

Overwhelm the bad with the good. More experts need to speak out and share the facts to help push inaccurate information down the internet search list. The Alan Alda Center for Communicating Science at Stony Brook University is one of a growing number of programs tackling how to communicate complex information in more understandable, relevant ways.

Get there first. False or misleading statements are terribly difficult to retract and, harder still, to erase from one’s memory. In a study of nearly 900 participants, researchers showed “the repetition of tentative news stories, even if they are subsequently disconfirmed, can assist in the creation of false memories in a substantial proportion of people.”³ The bottom line is that people may continue to rely on misinformation even when a subsequent retraction is made and remembered.

Use technology to advance real time fact checking. We can’t rely on a reporter’s memory or ability to interrupt a guest to check the facts. The idea for a “Truth Meter” was raised at the symposium and it was reported last week that two Penn State professors received a grant from the National Science Foundation to develop technology to identify and exclude “fake news” on digital platforms.⁴ If IBM's Watson computer can win at Jeopardy!, there's no reason that (nearly) real time fact checking couldn't be a reality. We should explore the potential for machines to sift through transcripts, proceedings and testimony; almanacs and atlases; laws, regulations and policy statements; credible survey data, and peer-reviewed research reports.

These efforts will be successful only if our institutions – and society at large – do more to promote and enforce honesty, and venerate intellectual exploration. I keep reading about our “hyper-connected world.” But in these connections we need hyper-vigilance for the facts. Perhaps then we’ll have an easier time searching for truth.

I invite you to follow me on Twitter @pauloestreicher.

1.     Cornell University. “Academic Symposium: Universities and the Search for Truth.” August 24, 2017. https://www.cornell.edu/video/academic-symposium-universities-search-for-truth.

2.     Tesoriero, H.W., et al., “Merck Loss Jolts Drug Giant, Industry,” The Wall Street Journal, August 22, 2005.

3.     Lewandowsky, S., et al., “Memory for Fact, Fiction, and Misinformation” (2005), Psychological Science, 16(3):190-195.

4.     Associated Press. “Penn State Professors Get Grant for ‘Fake News’ Detector.” August 31, 2017. https://apnews.com/e1b353e9e62f4e4096e419c13b061750/Professors-get-$300,000-grant-for-digital-fake-news-detector.

A Lesson on Staying Focused – With Thanks to a Terrific Teacher

My high school days are well back in the past but some memories remain fresh. Hearing of the passing of my AP US History teacher, David LaPonsee, moves me to relay one of them, even though the lesson learned came at the price of some personal embarrassment.

Dave was brilliant, with multiple degrees from prestigious institutions. He expected a lot from his students but they received much in return. There was a lot of memorization expected but he always created context. The discussions were usually intense and politically-charged.

Beyond academics, he was always available and happy to engage. I can remember spending many hours in Dave’s office discussing current events as well as our work together in student government.

The class was assigned a final paper, which could be on the topic of our choice. With a WWII Army pilot father, I chose to explore the development of the US military from the Depression through the World War. Essentially, the birth of the Superpower.

Even back then, I enjoyed research. The sources – and the tangents – grew rapidly; so many interesting lines of inquiry opened up. Unfortunately, it wasn’t long before I was spending more time exploring the rise of our geopolitical adversaries than I was on my stated topic. The pursuit of knowledge was illuminating but I failed to conduct a reality check. I lost focus.

I handed in my paper, proud of the time and effort that went into its development. When the graded papers where distributed, I looked for my reward. All I found was a note: “Excellent paper but what does this have to do with US history? Please see me.”

Gulp. I wanted to crawl under the desk. I felt so foolish and, worse, I embarrassed myself in front of one of my favorite teachers.

The time soon came to meet with Dave. I explained the trajectory of the writing and he was comforting. Then, he asked what grade I deserved. Wow.

It was years later, when I came to teach strategy, research and communications at NYU, that I’d tell this story semester after semester and convey the lessons of Carl von Clausewitz, the 19^th century Prussian General. Focus, he said, “necessitates strict economy.” As strategists, if we do something “here,” it means we’re consciously not doing other things “there.” That episode from my past also prompted me to check in with each student throughout the term to ensure they stayed on track. But it’s not just about focus; it’s the feedback along the way that gives people the information and confidence they need to succeed.

I’ll always be grateful for the time I had with Dave. His intellect and empathy will always be remembered. And I’m happy I’ve been able to pass along some of his lessons, which are now used by the hundreds of students I had the privilege to teach.

Between blog posts, I invite you to follow me on Twitter @pauloestreicher.

ExxonMobil Lifts the Veil on its CSR

This article first appeared in odwyerpr.com.

I caught notice of ExxonMobil’s “Let’s Solve This” TV ad campaign a few months ago. Its message is to “invest in teachers and inspire our students.” Indeed, ExxonMobil has been a supporter of science education for many years. After all, they need to stay competitive and find the best engineers, chemists and geologists.

The ads are terrific… and terrifying. In each iteration of the ad we’re told that, in a recent world ranking, the students in the United States scored 17^th in science and 25^th in math. It’s shameful.

But remember, we didn’t get nudged off the pinnacle; we can’t blame the countries that have overtaken us. This is a self-inflicted wound. We slid toward the bottom of the heap with creeping anti-intellectualism and cuts to education.

My admiration for ExxonMobil’s effort was spoiled, however, after reading an AP report on a speech delivered by the oil company’s CEO, Rex Tillerson, to the Council on Foreign Relations. Though Mr. Tillerson broke with some industry colleagues and recognized that burning fossil fuels is warming our planet, he said, “we’ll adapt. It’s an engineering problem and there will be an engineering solution.”

He downplayed risks to the environment and agriculture, the threat of rising sea levels and the potential for contamination from drilling (by hydraulic fracturing, or fracking) in oil shale formations. Quoting the AP report, he blamed “a public that is "illiterate" in science and math, a "lazy" press, and advocacy groups that "manufacture fear" for energy misconceptions.”

So, what is the oil industry’s biggest challenge? It’s not finding new sources of oil. It’s not a threat from wind or solar energy. Mr. Tillerson said it’s "taking an illiterate public and try to help them understand why we can manage these risks."

There you go; there’s the essence of the ExxonMobil CSR (corporate social responsibility) campaign. The Company’s logic is that a more scientifically literate public won’t believe climate scientists or environmental advocacy groups. They’ll question and challenge their data and they’ll come to accept the information provided by ExxonMobil.

It’s neither a surprise nor wrong that a corporation should seek some sort of gain from its CSR investment. I’ve been involved in plenty of socially responsible programming that reaped corporate benefits and am proud of the work. But the campaign in question raises cynicism to a new level.

One of the beneficiaries of ExxonMobil’s outreach is The National Math and Science Initiative (NMSI). They state that, “American students are falling behind in the essential subjects of math and science, putting our position in the global economy at risk. The mission of the National Math and Science Initiative is to help provide the ideas, inspiration, and resources to close the gap.”

We all recognize that our science and math rankings are competitiveness issues. But it goes beyond this – it’s also about our democracy. Jon D. Miller, director, Center for Biomedical Communications, Northwestern University Medical School told The New York Times in 2005 that “People’s inability to understand basic scientific concepts undermines their ability to take part in the democratic process.” With the politicization of so many topics – stem cells, gene therapy, vaccines, evolution, climate change – a better educated public is essential.

I hope that ExxonMobil continues to fund science literacy and STEM (Science, Technology, Engineering and Math) education programs, even though I’ve now alerted them that their ultimate goal is wishful thinking. It's a classic example of doing the right thing for the wrong reason. And, I hope the public doesn't view all CSR programs as nefarious plots. There’s too much good being done to have CSR get redefined as Cynical Social Responsibility.

Between blog posts, I invite you to follow me on Twitter @pauloestreicher.

A Game's Afoot

Attempting to Bolster Pharma Reputation Facebook Style

I saw an article in Medial Marketing & Media several weeks back entitled, “Boehringer's Pharma-ville could salve industry's bad reputation.” The article was about Syrum, an on-line game where the “objective is to save the world, one disease at a time.” According to their web site, “Syrum is a social game on Facebook which sees you take control of your very own pharmaceutical company. You’ll have to equip and use your laboratory to discover new drugs and bring them to market in order to increase global health.”

Great, but as we’re waiting for further updates, I’ve wondered who this was targeted to and if this was an effort to increase the industry’s reputation, a Facebook game that helps BI find a new audience, both or something else? Reading on, the article said the game could “help address the flagging reputation of the industry,” but John Pugh, BI’s head of on-line communications tried to clarify the intent and said, “The main objective is to create a kick-ass game… It's about pharma and fun."

Too bad. Is that all BI’s leadership wants to get out of this effort? I don’t have an argument with “kick-ass” (however that’s defined) but I wish the endeavor also included some real learning objectives. Engagement and goodwill are important, or course, but can something be taught? Can knowledge be used beyond the game experience? I'd love to hear more about what BI will be measuring.

It’s clear that we need better informed, more knowledgeable customers. How else can they value and trust what we do in research, development, approval and medical education? More knowledge leads to better outcomes. Better outcomes leads to better utilization. Better utilization leads to better satisfaction. Better satisfaction leads to more trust.

This doesn’t mean that we can’t or shouldn’t be creative. I’ve said it before: we should use our talents and resources to develop a massive, sustained effort to enhance health and science literacy. When it comes to managing one’s health or the health of one’s family, most people don’t have enough knowledge to evaluate a medical product claim or even formulate the right questions to ask a healthcare provider. This deficit makes the public an easy target for anti-vaccination nonsense, and purveyors of alternative medicines and bogus devices.

If reputation building is a secondary consideration for BI, I suggest a revaluation of objectives because the industry needs all the help it can get. After inching up to 31 percent in the 2008 Harris Interactive Reputation Quotient survey, the numbers fell back to 29 percent in the latest results. In comparison, the technology industry scored 72 percent. Essentially, the scores are mirror images – as many don’t like the pharmaceutical industry as like the technology industry. Pretty sad, indeed.

Unfortunately, much of this reputational gloom is self-inflicted (price hikes, quality problems, data transparency, etc.) but other aspects are controlled by external factors (insurance coverage decisions, political agendas, alternative medicine claims, etc.). It’s complicated and it’s fluid. So, let’s control what we can control: behavior, ethics, standard operating procedures and, in this case, communication and education.

BI deserves credit for exploring the edutainment world. I signed up to receive updates on the Syrum web site and am eagerly await more news. However, I might be outside of their demographic because the cartoonish graphics and sound effects seem to trivialize the point. I hope upon its official launch that the substance, at least, is a little more realistic.

Between blog posts, you can follow me @pauloestreicher.

Informed Dissent

H1N1 Vaccine is Here With Too Few Takers

Parents want the best for their children – happiness, success and good health. But nearly two-thirds plan on delaying or denying vaccinations against the H1N1 flu to their kids. It’s more than ironic to me, especially when so many complain about the lack of access to preventative care in this country.

Two similar polls just came out – one from the Associated Press-GfK and the other from Consumer Reports – that demonstrate that only about half of the U.S. population will be vaccinated. It’s not big news, though. This sort of result has been the unfortunate norm.

Why haven’t the numbers improved? Why are people so wary? Why are there so many who actively oppose vaccination? Is this just a case of people not being adequately informed? And, is this the government’s fault? The report published by the AP said that “The survey raises questions about government efforts to stem illnesses already spreading widely across the country.” I’m not quite sure what this statement is based on but my view is that the public-private partnership that has made millions of doses available is an impressive achievement.

So, allow me to briefly address some of the suspicions and concerns:

Flu isn’t all that serious. Influenza and pneumonia are the eighth leading cause of death in the U.S. (over 56 thousand annually).

It may be safe but I worry about side effects. Everything we do carries a risk. One must weigh the risk of injection site swelling and pain against contracting the flu with its potentially serious sequelae.

The vaccine hasn’t been adequately tested. Again, nothing is fool-proof, nothing is risk-free. FDA’s requirements for safety and effectiveness, however, are demanding. Moreover, the methodology for manufacturing the H1N1 vaccine is no different from other flu vaccines – vaccines that have an excellent safety record.

Vaccines can cause autism and other diseases. We may never know with 100 percent certainty but every credible study and review thus far (the most recent having been conducted by the Institute of Medicine) has concluded that there is no causative link.

I don’t think I/my children will get the flu. Sure, you might get lucky but why count on this wishful thinking? It has already been reported in 37 states – a much more rapid spread than in previous years.

I don’t trust it if the government is behind it. Fine, have a healthy skepticism but please don’t take it too far. Don’t undermine your health or the health of your family by listening to the fringe opinions of people like Rush Limbaugh who recently said that “All of this is designed to get people to respond to government orders, not to do things or to do things. It is designed to expand the role and power of governments and schools, and the media, of course, just falls right in line here with amplifying the nature of the crisis.” It's too bad there's no vaccine for paranoia.

If there are such good responses to these concerns, why aren’t people listening? Why aren’t people better informed?

My sense is that people are listening. They listen to and are informed by people that make sense to them. The CDC and NIAID have been all over the news with compelling information. About half of the country will act on what they heard. The other half will not be convinced. The message from anyone employed by or connected to these sources will not be trusted.

This is a barrier that will probably take a long time to breach. The ongoing outreach and education must continue while new efforts must be established to address the reasons why health messages bounce off of so many. Politics and conspiracy theories aside, elevating the public’s health and science literacy may give everyone a common ground from which to make their healthcare choices.

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Between blog posts, you can follow me on Twitter.

Knowledge Base

Perspectives on the State of Research Readiness in Public Relations
The following was published in the March 2009 issue of PRSA’s Tactics:

I recently finished teaching the Research Process & Methodology course at NYU’s master’s program in Public Relations and Corporate Communications. Serving as an adjunct professor is a great outlet for the coaching and mentoring that I’ve missed since becoming a communications and business development consultant in 2006. But this particular experience left me a bit unsettled. It drove home the fact that research remains a weak link in the development, execution and evaluation of PR programs.

Becoming Involved
I was invited by my friend and the academic director of the NYU program, John Doorley, to guest lecture within the program and later teach the Strategic Communication course. Then came a request to teach Research Process & Methodology.

Here, however, I had some reservations. Like Strategic Communication, RP&M was mandatory, but this was a subject that most students dreaded. We were to cover qualitative research, including interviews and focus groups, and quantitative methods such as sample selection, questionnaire design and data collection and analysis. The objections were along the lines of, “We’re the creative people, not number crunchers. We’re supposed to be intuitive — that’s why people hire us!”

Even though I had the feeling of being dropped behind enemy lines, I was energized by the opportunity to convey the need for more rigor in PR programming. Now, more than ever, it is necessary to identify competitive, political and social issues; understand key audiences, their preferences and perceptions; differentiate companies and products, and demonstrate the value of communications on business objectives and measure outcomes.

Clients crave creativity but they don’t want guesswork. To be effective, we need information to drive insight. If PR professionals want to be strategic, then research is required to help make the best possible predictions about the potential intended and unintended outcomes in PR programming.

Getting Down to Business
Most of the students’ anxiety was assuaged soon after starting the first class. Setting unambiguous expectations and goals were key. I made it clear that I did not intend to transform them into statisticians or programmers. Instead, they would become more informed users and evaluators of research. To reach this endpoint, and to keep the students engaged for the six hours per week that we met, we worked to strike a balance between theory and application — a mix of book learning with in-class exercises.

In one class, we reviewed and evaluated a variety of award-winning PR case studies including corporate rebranding, the launch of new products and national events. They were eye-opening — even for me. If these were chosen to represent the best work of the industry, the pinnacle of public relations, then we — the profession — had some work to do. Why did those objectives look like a bunch of tactics? What did “we achieved a high level of buzz,” mean? Was the result at all meaningful to the business? One hundred million impressions is a big number, but did the message reach the intended audience?

This analysis helped make the research process more real, more accessible. By the end of the course, the role of research in public relations was duly elevated in the minds of the students. They didn’t leave with a list of formulas memorized, but they did leave knowing how to ask good questions and take their place at the table of strategic PR planning.

Taking the Next Step
While feeling rewarded by the response of the students and the opportunity to connect with some terrific guest experts, I was left with some concerns. After I reviewed the final projects — detailed proposals for their Capstone papers — and posted the grades, I wondered about the state of research training in PR agencies. How do these firms really value research? What expectations do they have of the staff? How is research taught in other programs outside NYU?

I decided to send a three-question survey to the top 25 agencies. I inquired if they had an in-house training program, which courses they offered and if any were mandatory. Only eight of 25 surveys were returned — perhaps these were the firms that were most proud of their programs.

However, the results were still revealing. As one would hope and expect, 100 percent of the respondents offered a variety of courses and workshops. All of the agencies had programs in the traditional areas of public relations: writing skills, presentation skills and media relations. Some offered training in issues/risk/crisis management, advocacy/third-party relations, conflict resolution and digital media.

On the other hand, only three of eight said some or all classes were mandatory. I found this to be both surprising and disturbing. Competitiveness, differentiation and excellence are all based on learning.

When it came to metrics and numbers, the story did not improve. Only half of those responding reported that they offered training in research methods and/or measurement. Respondents at 50 percent of these agencies offered courses on budgeting and/or forecasting. I wasn’t hugely surprised by these answers, as I’ve known for a long time that numbers and words don’t mix for many PR practitioners.

But it’s time to push old habits aside. Indeed, these tough economic times reinforce the importance of numbers. “Good enough” is out. Precision is in. Of course, creativity and fresh ideas are essential. But we need balance: The same urgency that is placed on learning, thinking and executing the soft side of public relations must also be placed on the hard.

Personalized Promise

Preparing For the Era of DNA-Guided Medicine

I have been involved with the field of personalized healthcare since helping to lobby for the Human Genome Project bill in the late 1980s. In 2000, it was great to see the first “working draft” of the genome get published ahead of schedule.

Like any new technology, however, there has been a lag in translating discovery into practical application. Although DNA-guided medicine – getting the right drug to the right patient in the right amount at the right time – is not moving into mainstream medicine as quickly as we would like, we can be optimistic that it will displace traditional trial-and-error approaches with increasing speed. In addition to the ongoing efforts in the diagnostic and biopharmaceutical industries, academia and government, a new piece of legislation should spur the development and adoption of personalized medicine.

The boost may come from The Genomics and Personalized Medicine Act, first introduced in 2006 as S. 3822 by then Senator Obama and now being expanded by Representative Patrick Kennedy in H.R. 6498. The bill acknowledges that promoting the shift toward personalized medicine “will require continued Federal leadership and agency collaboration, expansion and acceleration of genomics research, a capable genomics workforce, incentives to encourage development and collection of data on the analytic and clinical validity and clinical utility of genomic tests and therapies, and improved regulation over the quality of genetic tests, direct-to-consumer advertising of genetic tests, and use of personal genomic information.”

In addition, the bill directs the Director of the Centers for Disease Control and Prevention (CDC) to “expand efforts to educate and increase awareness of the general public about genomics and its applications to improve health, prevent disease and eliminate health disparities.” Yet, it seems that these efforts might be limited to the “ongoing collection of data on the awareness, knowledge and use of genetic tests through public health surveillance systems, and analysis of the impact of such tests on population health.”

I’m afraid that what might be collected is more about what we already know – public understanding of health and science, much less genomics, is low. (Really low. Of those surveyed by the National Science Foundation, about 10 percent knew what a molecule was, about 30 percent could define DNA and about half knew that it takes the earth one year to orbit the sun!) I’d like to see the legislation strengthened by including an initiative to identify gaps in public understanding which would then lead to new efforts in public education.

Why? It’s the only way to develop and sustain trust in the new technology. Despite assurances in the Genetic Information Nondiscrimination Act of 2008, people are wary about sharing their DNA. People need know what personalized medicine can and can’t deliver. Without some greater understanding and trust in the science – and the system of collecting and processing samples – we won’t see appropriate demand, we won’t see appropriate utilization and we won’t see enough people benefiting from the information that resides in their own bodies.

Give Me an S, Give Me a C, Give me an…

The Necessity of Science Literacy

How do modern day snake oil salesmen make millions selling over the counter weight loss pills, arthritis cures and memory enhancers? Why have so many research projects become political footballs? Why do we risk losing our competitive edge in science and engineering? Two reasons, I think. We’ve allowed science to be devalued – denigrated, even. And, because science doesn’t occupy its proper place in the hierarchy of our society, our capacity to separate the good from the bad – the junk science from quality science – is at a frightfully low level.

Remember the first court case involving the arthritis drug Vioxx(R)? The jury awarded $253 million to the plaintiff. It was reported that the case for Merck, the manufacturer, was lost well before the conclusion of all the testimony. “We didn’t know what the heck they were talking about,” a juror told The Wall Street Journal. (In an NPR interview, plantiff's attorney Mark Lanier noted that Merck learned from this expensive lesson and communicated successfully with subsequent juries "in an everyday way.")

This isn’t just some isolated event or some trivial issue. We’re all hurt by the generally poor public understanding of science and our uneven ability to communicate it. In a New York Times piece on science literacy, Jon D. Miller, director of the Center for Biomedical Communications at the Northwestern University Medical School said, “People’s inability to understand basic scientific concepts undermines their ability to take part in the democratic process.”

There are, of course, bright spots. I’m on the Board of the Southern Connecticut Science and Engineering Foundation and we’re gearing up again for the annual science fair that we sponsor. Over the last seven years, the fair has grown from half a dozen student participants to about 120. And more schools are joining in. Still, it hits me each year that we have to struggle to get local press coverage. How about showing the same pride for the student scientists as we do our student athletes?

By the way, our need for judges has grown also. So, if you’re in the neighborhood this February and would like to help inspire some terrific young scientists and engineers, let me know!