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.

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.

A Message About Messages

This article also appears in Medical Marketing & Media.

Dr. Marijn Dekkers, CEO of Bayer, feels underappreciated. He has some good reason. At Bayer’s Spring Financial News Conference (on Feb. 28^th), he said, "Almost every day, newspapers publish something about cancer – statistics, the best doctors, the best hospitals, the best treatments." Yet, they don’t discuss, "the molecule, the invention or the scientist behind the invention without which the doctors, hospitals and treatments could not help patients."

People go into a hospital, they interact with health care providers but what they see mostly from the pharmaceutical industry is a little, unimpressive looking pill. This isn’t new. Low trust and reputation scores have been a fact of life for decades now. The anger over high prices and low transparency has not been offset by improved health outcomes or the positive impact on jobs and the economy. Dr. Dekkers said, "I feel that this lack of appreciation for our ideas and innovations has to change." 

More credit ought to be given to the investments and inventions made by the biopharmaceutical sector – no question. But placing responsibility on the media for a perceived lack of fairness seems misplaced. The health care industry is attempting to meet the needs of its customers and so is the news media. In most cases, they’re selling a story with a point of view because that’s what the market is telling them to do. And they’re constrained further by the revolution in social media. There are fewer and fewer “real” journalists, professionals with credentials who have an understanding of the issues and the science. How many health and science sections in major daily newspapers have survived? Can you get beyond one hand? 

Today’s reality is health care is covered largely in the business sections and the industry feeds right into it. The first two-thirds of Dr. Dekkers’ talk was focused on his company’s impressive financial results. It was, after all, a financial news conference. But if getting a fair shake by the press was of such concern, perhaps he should have allowed his CFO, who was the next speaker anyway, to discuss all the numbers.

Next time, Dr. Dekkers may wish to lead off with and stick to some of his briefly mentioned closing messages – Bayer’s commitments to sustainability, ethics, access, value and serving the needs of the patient community. As messengers, as leaders, the tone should be set using the words, images and emotions that best communicate the industry’s contributions, not just the spreadsheets and stock charts. Tell the audiences what’s in it for them.

But there’s still a big missing piece to this communication puzzle. Dr. Dekkers pointed out, “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.” Indeed, the industry’s stakeholders must have a higher level of health and science literacy. 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. A massive, sustained education effort is needed to help turn the ship of disbelief and discontent.

Of course, a more knowledgeable public will not guarantee an enhanced corporate reputation. It must be earned. It will take time and the self-inflicted wounds – the reputation-killing missteps and misdeeds – need to stop or at least be minimized. Our job as strategic communicators is to help find common ground and common language, increase mutual understanding and secure the win-wins we know are out there.

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

Science Denial Part 2: A Threat to Children, Education and Competitiveness

The New York Times published a special Education Issue last week, “Learning What Works” in STEM (science, technology, engineering and math) education. The articles, collectively, set out an array of recommendations from top experts. They include:

• Increase attention to ideation and creativity
• Make teaching more immersive
• Increase teacher training and teacher pay
• Develop and distribute better instructional materials
• Encourage mentoring by outside experts or college/graduate students
• Provide the history and the context for science
• Dedicate time to applying ideas and practical invention
• Raise curriculum and testing standards

These are all good and important. So, let's go! There are many priorities out there but STEM education must be in the highest classification. We know from the scores obtained by the 2009 Program for International Student Assessment that 15-year-old students in the U.S. perform about average in reading. Average isn’t great but, when it comes to the math and science scores, it’s practically outstanding. Out of 34 countries, the U.S. ranked 17th in science and 25th in math. (The 2012 results will be released at the end of this year.)

But there are barriers to success even within the science teaching community. Dr. Eugenie Scott, executive director of the National Center for Science Education, said that roughly 20 percent to 25 percent of the nation’s biology teachers don’t believe in evolution and subscribe to creationist views. Teaching evolution and/or climate change in schools has been hotly debated by legislatures and school boards in states including Arizona, Colorado, Kansas, Kentucky, Indiana, Louisiana, Missouri, Montana, Oklahoma, Pennsylvania and Texas. These boards should embrace and promote, not disparage and reject, the facts.

Students receive at least some science as part of a required curriculum. But what happens when they arrive at home? Are the lessons in science class reinforced or refuted? In a 2012 poll by Gallup only 15% of U.S. citizens believe humans evolved without any intervention from God. Thirty-two percent said God guided the evolutionary process and 46% said God created humans in their present form. (Seven percent had no opinion.)

And what do the students hear from those in power? Rather than lead the country through and away from false and flawed ideas, a number of our elected leaders are cheerfully, bombastically, pulling the country backward. In Congress, the House Science Committee hardly holds to its title. Rep. Paul Broun (GA) fumed, “All that stuff I was taught about evolution and embryology and the Big Bang Theory, all that is lies straight from the pit of Hell.” Former Science Committee member Todd Akin (MO) famously opposed abortion for rape victims, in part, because “if it’s a legitimate rape, the female body has ways to try to shut that whole thing down.” Rep. Dana Rohrabacker (CA) said recently, “Global warming is a total fraud” and dismissed global warming as a plot to institute a “global government.” His suggestion that “dinosaur flatulence” could explain historic climate change patterns was also notable. Rep. James Sensebrenner (WI) similarly amped up the conspiracy theorists when he said climate change theory was a “massive international scientific fraud.” Rep. Ralph Hall (TX) also charged that climate change is the product of a global conspiracy of scientists and told the National Journal in 2011 that he didn’t believe in a human influence on global warming because “I don’t think we can control what God controls.”

This competition between God and science is a false construct and distracts us from the issues. In his book, The Language of God: A Scientist Presents Evidence for Belief (2006), Dr. Francis Collins, director the National Institutes of Health, wrote, “the principles of faith are, in fact, complementary with the principles of science.” He went on, “there is no conflict in being a rigorous scientist and a person who believes in a God who takes personal interest in each one of us. Science’s domain is to explore nature. God’s domain is in the spiritual world, a realm not possible to explore with the tools and language of science.” Not believing in a “personal God,” Albert Einstein, nonetheless said, "Science without religion is lame. Religion without science is blind."

The task of increasing our STEM preparedness goes well beyond the confines of schools. It’s immensely complex, opposing interests are deeply entrenched, and will take much longer and cost much more than most people realize. It’s not a problem that can be addressed by a five or ten year plan. It will take a generational blueprint that needs to be comprehensive, cohesive and well capitalized in order to see a return on the investment.

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

Science Denial, the U.S. and Us

This article also appears in odwyerpr.com.

Before a Call to Action, We Need Insights and a Plan

Professor Adam Frank at the University of Rochester rang a warning bell about the dangers of science denial in an important op-ed (Welcome to the Age of Denial) in The New York Times last week. He stated the sad fact that, “it is politically effective, and socially acceptable, to deny scientific fact.” Science denial is becoming more entrenched and culturally correct.

This juggernaut of illogic is like a cancer that has metastasized. He noted that, “climate deniers, taking pages from the creationists’ PR playbook, have manufactured doubt about fundamental issues in climate science that were decided scientifically decades ago. And anti-vaccine campaigners brandish a few long-discredited studies to make unproven claims about links between autism and vaccination.”

How do we fight this? Dr. Frank called on the scientific community to channel Carl Sagan, the late astronomer, author and science personality, and do more communicating (and for the general public to be more active, too). The Equation blog from the Union of Concerned Scientists echoed this “call to action.”

Yes, scientists must learn how to engage and how to communicate. I know there are some efforts underway at institutions such as the National Academy of Sciences and Stony Brook University’s Alan Alda Center for Communicating Science but, no matter what, there are critical steps that must come first. We need to ask questions and use the resulting information to generate the insights necessary to develop and implement a plan.

So, a “call to action” directed where, with what information, in what form? Before anything is done, we must understand the causes, motivations and forces at work. What are the religious, political and corporate interests, and what are their strategies and tactics? And, we must know our target audiences, and their issues and concerns. What’s the right language, the most compelling examples, what will it take to be persuasive? We know it’s not just about the facts – otherwise, everyone would accept global warming and evolution, no one would smoke, kids would get vaccinated and all motorcyclists would wear helmets. Scientists (and marketing and communications professionals) need to marry specific, emotionally-based messages with the factual.

The news media, of course, have a huge role to play. In misguided attempts to achieve fair balance (or, cynically, sometimes achieve the outcomes they wish), the media feeds into false equivalency – providing equal coverage to opposing views when, in reality, one side dramatically outweighs the other. An example was brought into the sunshine on the pages of The Wall Street Journal. It published a letter last year, “No Need to Panic About Global Warming (January 27, 2012), that said, “There's no compelling scientific argument for drastic action to 'decarbonize' the world's economy.” The editor noted the letter “has been signed by the 16 scientists listed at the end of the article.” I checked those names. Of the 16, there was only one climate researcher and one atmospheric scientist. 

Indeed, a few days later, another letter was published entitled, “Check With Climate Scientists for Views on Climate.” The 38 climate, environmental and atmospherics experts who signed the letter admonished, “Do you consult your dentist about your heart condition?” They went on: “While accomplished in their own fields, most of these authors have no expertise in climate science. Research shows that more than 97% of scientists actively publishing in the field agree that climate change is real and human caused. It would be an act of recklessness for any political leader to disregard the weight of evidence and ignore the enormous risks that climate change clearly poses.”

This isn’t just about promoting the truth or science getting its fair share. 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.” The Union of Concerned Scientists’ Center for Science and Democracy points out that “Many of the nation’s founding fathers were citizen scientists,” including Benjamin Franklin, Thomas Jefferson, John Adams, James Madison and George Washington. “John Adams, for instance, spoke of the “science of government.” In a debate with Benjamin Franklin in 1776, Adams invoked the principle of mechanical equilibrium to argue on behalf of his conception for our government’s system of checks and balances—designed, at least in part, to ensure policies based on verified, trustworthy evidence."

We've had one ”wake-up call" after another on the issue of science denial. But it's complex -- there isn't just one thing we should do. To start, though, we must review and revere our history, and use those founding principles again. The nation began with questioning dogma, exploring options, celebrating invention and spreading information. That brought us a long way and it can bring us further still.

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

Angelina Jolie's Fearless but Flawed Message

This article also appears in Medical Marketing & Media.

 A good chunk of humanity is talking about Angelina Jolie’s double mastectomy today. She penned a remarkable Op-Ed in The New York Times about her decision to have preventive surgery and breast reconstruction following the results of a genetic test. The variant of her BRCA1 gene gives her an 87% risk of breast cancer and 50% risk of ovarian cancer. (Clearly, she’ll need to confront the latter issue at some point and I wish her the very best.)

I join the millions who are happy to read that Ms. Jolie is making a fast recovery. Her story is another reminder of the need for education and outreach, and brave decisions. And, she points out the crucial issues of access, cost and preventive health care (though the discussion is one much broader than breast cancer). As sad and terrifying as her experience must be, however, she's fortunate to have deep emotional and financial support. It’s a stark reminder of health care haves and have-nots.

Unfortunately, her nod to "wonderful holistic doctors working on alternatives" is less helpful. Steve Jobs was famously regretful of his choice to pursue alternative therapies. He wished - too late - that "conventional" (science/evidence-based) therapies had started earlier. Instead, he tried dietary supplements, juices and acupuncture for nine months while his cancer spread. I’d hate to see Ms. Jolie provide a platform to physicians like Christiane Northrup, who has used Tarot cards to diagnose illness, or celebrities like Suzanne Somers, who apply, ingest and inject unapproved products in an attempt to stay young, and Jenny McCarthy, who uses the very unfortunate story of her son to create fear and confusion around vaccines.

Of course, people die even though they had the best of what science could offer. Cancer is a terrible, complicated array of diseases. And it's true that some people get better while on alternative therapies. Is there something to it? Quite possibly. We know that many modern medicines are derived from natural substances. But the cures you often hear about could be the result of other factors including poor initial diagnoses.

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 health care provider. This all makes the public an easy target for purveyors of alternative medicines and bogus devices.

So, while some push for greater access to health care, a parallel effort must be made to fund research and education. 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 need a massive, sustained effort to enhance health and science literacy.

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.

Remarks to the 12th Southern Connecticut Invitational Science & Engineering Fair

It was my great pleasure to be a part of the 12^th Annual Southern Connecticut Invitational Science and Engineering Fair on Saturday, this time as president of the sponsoring foundation. I made a few remarks to the students, teachers, judges, volunteers, mentors and parents before introducing our terrific keynote speaker, Dr. Dan Riskin. Dan is an award-winning evolutionary biologist known for his work with bats. He’s also the co-host of Daily Planet for Discovery Canada, and the host of Animal Planet’s Monsters Inside Me.

Here’s some of what I said to the students:

There is so much to be gained from your participation here. It goes well beyond the competition – there are life lessons here, too.

The great sportswriter, Grantland Rice, said, “It’s not whether you win or lose, it’s how you play the game.” True enough. In our case, though, it’s not whether you win or lose, it’s what you’ve learned. I hope all the research and preparation for your projects propel you higher and farther in science or engineering. But even if that’s not your final destination, there’s much to be gained from the process.

Aside science and health, one of my interests is researching the stories of King Arthur and Camelot. I’ve found that there are a number of important lessons in leadership, management and communication to be learned from those medieval stories. And, believe it or not, important lessons on the scientific method.

I want to share just three quotes from T.H. White, who wrote five terrific books on the King. Merlin said to a young Arthur, “Learn why the world wags and what wags it.” The message here is to observe, question, probe and explore. We need to use these techniques in science and engineering but they’re equally important in any school subject or at work or in figuring out relationships.

We think of Merlin as a magician, the archetypal sorcerer, the starting material for Albus Dumbledore in the wonderful Harry Potter series. But he was Arthur’s teacher and mentor, and thought of himself as a scientist. He said, “The only thing worth doing for the race [for all people] is to increase its stock of ideas.” That’s it, isn’t it? We need to keep thinking – and thinking habitually – because that’s the way we solve problems both big and small. We need to turn issues and problems around, look for other perspectives and other options. We can learn on our own and we can learn from each other. We can reuse or reformulate old ideas or create new ones. It all depends on the need.

Finally, when Arthur was an old man and about to face his final battle, he was depressed that his vision for a peaceful and united England was unraveling. He asked Merlin if he was a failure. Merlin snapped back, “Certainly not. [Using the Knights of the Round Table to enforce a new civil code] was an experiment and experiments lead to new ones.”

I can tell you that during my days in the laboratory a great deal of what I learned was what not to do! Unfortunately, in science it seems that there are more dead ends than through roads. But as many of you are finding out, what may look like a wrong turn is by no means a wasted effort. It might be frustrating at times but we need to take what we’ve learned, turn it over, examine it, make good use of the insight and push forward. No one can promise a smooth path but I can promise that it will be a rewarding one.

Thank you for participating this year, and congratulations on your wonderful projects and impressive achievements! 

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.

Gaining Higher Ground by First Finding the Low

Treating the Cause, Not the Symptoms, of Pharmaceutical Industry Reputation

When confronted with a problem or an issue, we look for the root cause, the scene of the crime, Patient Zero. In the case of healthcare industry reputation, however, it seems that executives and consultants have a hard time finding that lowest common denominator. Though the pharmaceutical industry has suffered from behavioral, communication and performance missteps that have lowered reputation, it is low health literacy among consumers and the decline of science journalism that are fundamental to this problem.

Many millions have been spent on advertising campaigns to communicate the value of medicines and the cost of product R&D. Attempts have been made to showcase the role of industry research in modern medical breakthroughs. Disease awareness campaigns have been launched to help people better respond to symptomatic cues and get help. A conciliatory face has been unmasked as concessions on discounts and rebates were recently made during negotiations on healthcare reform.

It does not appear, however, that the “kitchen sink” approach to corporate reputation management is working. According to the yearly Harris poll of public attitudes toward different industry sectors, pharmaceutical companies have roughly the same score as cable companies and automobile manufacturers. The “good job minus bad job” number was nine (with supermarkets leading at 86 and tobacco trailing at -32).¹ Last year the number was 15 (with supermarkets at 84 and tobacco companies at -43).²

In the annual Harris Interactive Reputation Quotient survey of the 60 most visible companies, however, the pharmaceutical sector posted its highest reputation scores in five years – up to 31 percent in 2008 from 26 percent in 2007.³ The optimist might say that the upswing in public sentiment is proof that the varied messages and good works of the industry are finally penetrating the gloom. Yet, the cynic might say that it’s all relative; the self-inflicted wounds of other industries make pharmaceuticals look good by comparison. For example, the financial services fell into the reputation cellar with the tobacco industry, both at 11 percent. The auto industry suffered the largest decline (22 percent) in the survey's history. And, remember, 31 percent good for pharma means 69 percent not good.

Wherever the numbers are, they need to be higher. Bolstering industry reputation means generating more trust among the stakeholders. We can go a long way in enhancing the relationship with key stakeholders by delivering on healthcare promises. That is, better outcomes for patients. Generating better outcomes is heavily dependent on appropriate utilization which, in turn, relies on better health judgment.

Better health judgment starts with consumers and the need for them to be more knowledgeable about healthcare. 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.

In response to these issues and obstacles, the healthcare industry should get behind a massive, sustained effort to enhance health and science literacy.

Of course, having a more knowledgeable public will not guarantee an enhanced corporate reputation. It must be earned. The self-inflicted wounds – the reputation-killing missteps and misdeeds – need to stop.

But, putting that critical issue aside, without an ability to evaluate the facts and evidence, the important health and science issues of the day – stem cells, healthcare reform, research funding, vaccine programs – will continue to be misconstrued and remain political footballs.

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 all makes the public an easy target for purveyors of alternative medicines and bogus devices.

This growing problem drew widespread attention when Newsweek put Oprah Winfrey on its cover with the title, “Crazy Talk: Oprah, Wacky Cures & You”.⁴ To be sure, Oprah has made tremendous contributions to her viewers and to noble causes across the world. But when she give a platform to physicians like Christiane Northrup who has used Tarot cards to diagnose illness, or celebrities like Suzanne Somers who apply, ingest and inject unapproved products in an attempt to stay young, viewers see an endorsement of potentially dangerous treatments and interventions.

Jenny McCarthy, another guest of the show, has used the very unfortunate story of her son to create fear and confusion around vaccines. Indeed, compared to parents of vaccinated children in the U.S., significantly more parents of unvaccinated children believe that vaccine efficacy and safety are low (58% vs. 17%, 60% vs. 15%). Also, significantly more parents of unvaccinated children believe their kids have a low susceptibility to diseases (58% vs. 15%).⁵

Following the Newsweek article and sharp condemnation by the mainstream medical community, Oprah released a statement saying “I trust viewers, and know that they are smart and discerning enough to seek out medical opinions to determine what may be best…” Trust isn’t the issue, however. It’s whether or not viewers have the ability to differentiate real science from junk science, medical myths from medical facts.

This inability to filter information holds true for the fastest growing sector of media – new or social media. Some commentators have heralded the arrival of “citizen journalists” to fill the void left by the dwindling professional corps. Sorry. Although bloggers help to generate much needed discussion, citizen journalism does not equal journalism. And, with the “viral” nature of the web, every anecdote, half-truth or falsehood has the potential to be perceived as fact, as real news.

Indeed, we need more pros to sift a growing mass of information. Professional health and science journalists must help to communicate the progress and the failures, and to differentiate the facts and evidence from the frauds and junk science. Unfortunately, we’ve seen surveys confirm what we already know about the state of health and science journalism over the past few months. It’s a shrinking, wounded profession. We know the symptoms – they’ve been well documented. Like the global economy, journalism needs a recovery plan.

A recent editorial in the journal Nature recognized that “scientists can do little to stop this bloodletting” though they can at least “help ensure that reporting about science continues to be both informed and accurate.”⁶ In addition, it was suggested that “the scientific community should work with journalism schools and professional societies to ensure that journalism programmes include some grounding on what science is and how the process of experiment, review and publication actually works.”

In another piece in the same issue, Toby Murcott wrote that science journalists must be more engaged – more a part of the action. They can’t simply massage a press release for their particular readership. He compares science journalism to the clergy, “taking information from a source of authority” and translating it for the congregation.⁷ He contrasts this with political journalists who, with a knowledge base on par with those who they monitor and interview, engage in an active exchange.

Physicians have a role in this, too. With inaccurate details or story angles developed for shock value, patients can be spooked out of taking their medications or seeking medical attention. Indeed, “communicating” was the first word on the first page in the first article of the first issue (of 2009) of the New England Journal of Medicine.⁸ Susan Dentzer wrote that “Whether they realize it or not, journalists reporting on health care developments deliver public health messages that can influence the behavior of clinicians and patients.” Unfortunately, many journalists “consider themselves poorly trained to understand medical studies and statistics.”

Yes, the quality of reporting and the training of journalists must be bolstered. A survey released this year by the Association of Health Care Journalists and the Kaiser Family Foundation reported that 43 percent of respondents said training opportunities had declined.⁹

But addressing this one facet is not enough. Journalism is a business and, thus, a business case needs to be made in order to save (and expand) health and science journalism. The bottom line is that demand is low. Certainly, there’s no dearth of interesting material. It’s just a simple truth that a dreadfully large portion of the audience lacks the background and understanding to feel engaged in the subject areas. In a survey of more than 19,000 U.S. adults, only 11 percent where found to be "proficient" in their health literacy.¹⁰ This is where the recovery must begin.

The stakes are high and not just for the employment of journalists. Remember the first trial involving the anti-inflammatory drug Vioxx® in 2005? The jury awarded $253 million to the plaintiff. Why? The science went right over the heads of the jury. In an interview with The Wall Street Journal a juror said, “We didn’t know what the heck they were talking about.”¹¹ Jon D. Miller, director, Center for Biomedical Communications, Northwestern University Medical School told The New York Times that “People’s inability to understand basic scientific concepts undermines their ability to take part in the democratic process.”¹²

Industry support for a long-term effort targeted at raising health and science literacy could lead to an increased public understanding and appetite for health and science information, news outlets being repopulated with professional journalists to help carry information forward, and a higher and wider industry reputation. Let’s spread intellectual curiosity, and use the marketing and partnering expertise of the industry to achieve these essential goals.

1. The Harris Poll^®, August 18, 2009.
2. The Harris Poll^®, August 7, 2008.
3. Harris Interactive Reputation Quotient^TM (RQ) survey, June 23, 2008.
4. Kosova, Weston and Wingert, Pat. Newsweek, June 8, 2009, pp. 54-62.
5. Omer, Saad B. et al. Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases, New England Journal of Medicine 2009, vol. 360, no.19, pp. 1981-1988.
6. Nature, vol. 459, no. 7250, p. 1033.
7. Murcott, Toby. Science Journalism: Toppling the Priesthood, Nature, vol. 459, no. 7250, pp. 1054, 1055.
8. Dentzer, Susan. Communicating Medical News – Pitfalls of Health Care Journalism, New England Journal of Medicine, 2009, vol. 360 no. 15, pp.1477-1479.
9. Kaiser Family Foundation, The State of Health Journalism in the U.S., publication #7869, March 2009.
10. National Center for Education Statistics, The Health Literacy of America’s Adults, publication #2006483, September 2006.
11. The Wall Street Journal, p. A1, August 22, 2005.
12. The New York Times, p. F3, August 30, 2005.

Between blog posts, you can follow me @pauloestreicher.