Why Donald Trump Would Get an F (in my class)

The Donald is Not The Researcher

This article is not about politics; it's about veracity and logic. (Yes, it's sad that these words together - politics with veracity and logic - should seem so oxymoronic.)

One of the courses I teach at NYU is Research Process & Methodology for students in the M.S. program in Public Relations and Corporate Communication. An objective is to help them prepare a comprehensive proposal for their thesis projects. After they complete their degree, a few may go further into the research realm. But I'm satisfied if they leave with the tools and confidence to be competent purchasers and evaluators of research.

We're nearly at the end of the semester, and I like to remind students of the original objectives and discuss whether or not we have reached them. That's when Mr. Trump popped into my head. With his rise in the political polls tied to his investigation into the president's birthplace, just what kind of purchaser and evaluator of research is he?

As a purchaser, he hired "people" who were deployed to Hawaii to determine if a birth certificate (the "certificate of live birth" in that state) existed or was altered. On one occasion after another, he told the world, "You're not going to believe what I'm hearing" and "I'm hearing that it's missing." 

I wonder if his research team will get paid now that the state has released copies of the certificate from the official bound volume of documents at the president's request.

As an evaluator, he ignored previously released certified documents, hospital birth announcements, and a mountain of facts from the government of Hawaii and investigators from the news media. As of this writing, he still has not given his blessing to the "long form" certificate of live birth that he sought so doggedly these last few weeks.

Of course, I couldn't have fired Mr. Trump if he were in my class. However, based on his performance and disregard for the research process and ethics, he would have received an F.

With his F, though, he's still one clever guy. As the citizenship issue dies down (but kept alive at some level, I'm sure), Trump is ramping up the next crusade - the president's grades and whether he truly earned his way into Columbia and Harvard. By finding new platforms to question the credibility and legitimacy of the president, he remains in the spotlight - whether it's for political gain or TV ratings. If there were a class on self-promotion, he'd get an A.

Between blog posts, you can follow me @pauloestreicher.

How "Camelot Wisdom" Can Address Our Political and Budget Woes

Politicians Should Take Some Lessons from King Arthur's Leadership and Communication Style

The failure we see in the statehouses and in Congress starts with an inability to listen and understand. It was clear to King Arthur that having the ability to comprehend other people, their circumstances, and their environments was not only nice and good, but important in other ways, too. He learned that one could achieve a huge competitive advantage. What better way to know your adversaries? And who do people want to vote for, fight for, or work for? Most often it’s the person who takes an interest in them, recognizes their motivation, and feels their pains and successes.






Just about everyone clamors for some understanding. But this cuts both ways: we want to be understood by others, and others want us to understand them. Yet, we may be losing our collective capacity to understand on an emotional level as some recent studies have shown. Perhaps this is one reason why the “my way or the highway” method of negotiation has become so popular. The belief of many politicians that even a 50 percent-plus-one victory gives them some sort of clear and unassailable mandate is another reason why we can’t move past gridlock. We can’t take a step forward when the first position is to dig-in-your-heals.

This was similar to how Arthur behaved initially in his mission to unite England at a time of competing kings and threats from abroad. Might for Right was his grand strategy: he invented the Round Table to channel the energy of the knights away from fighting toward the enforcement of a new order. Over time, however, it turned out to be a failed policy. In T.H. White’s The Once and Future King, Arthur said to Lancelot, “…when the kings are bullies who believe in force, the people are bullies too.” He had the sense to see the flaws and began the process of moving, “groping,” toward a newer, better foundation: Equal Justice.

We’d all like to get things right the first time and politicians are no different. Though it’s certainly the most desirous way of operating, it’s hardly the most common. Sometimes the imperfect thing is the only thing to do. Whatever axiom you want to use—half a loaf is better than none or Voltaire’s “The perfect is the enemy of the good”—incrementalism is hard to accept but equally hard to forswear.

Like the uncertainty felt by corporations and interest groups of today, Arthur created a conundrum for the class of nobles in his attempt to change civilization. They weren’t sure if he represented a threat to their positions and wealth or an opportunity to enhance them. And like all threats and opportunities, he had to deal with the rational as well as the emotional sides of the issue. Protecting self-interest, maintaining tradition, helping your fellow man, and doing what’s best for the greatest number of people all had to be balanced. Arthur had the right intention with the wrong method and he knew it. He admitted his mistake. That’s the first step in re-railing a strategy: identify the strengths and weaknesses—what should be kept, modified or jettisoned. Acting in the best tradition of the modern innovator and entrepreneur, Arthur took a risk. He went forward with a plan, though there were imperfections 
and gaps in understanding all of the potential issues.


The ability to sustain an effort is frequently underappreciated. Because incremental advances are hard to discern, we often see anxious leaders swapping out one set of strategies and tactics for a new set too soon; they don’t allow enough time for their plans to mature. With enough patience (and the appropriate resources), we know that all the baby steps can add up to become a completed marathon. Rarely do we see or accomplish all or nothing; compromise and incremental success may not seem satisfying, but it’s the way most things operate and succeed. The two steps forward/one step back process frustrated and even depressed King Arthur but making progress and leaving improvements behind is what’s important.





There are, of course, times when one can (or must) reach the finish line in one bold move. But this “Camelot wisdom” should remind our leaders that the Holy Grail they seek isn’t at the end of this day or the next week but after a long journey of give and take.

You can read more in Camelot, Inc. Leadership and Management Lessons from King Arthur and the Round Table, www.camelotinc.com.

Between blog posts, you can follow me @pauloestreicher.

Endorsements for Camelot, Inc.

Camelot, Inc. provides a most thoughtful framework for thinking through some of today's biggest business leadership challenges. It’s a thoroughly enjoyable read.

Brian T. Gladden, Senior Vice President and CFO, Dell Computer and former President, GE Plastics

The dos and don'ts in Camelot, Inc. highlight the enduring characteristics of protecting and building personal and corporate reputation. Oestreicher has found a compelling way to teach us as much what to do as what not to do.

John Doorley, Academic Director, graduate program in Public Relations and Corporate Communication, New York University and co-author of Reputation Management

Oestreicher’s book goes well beyond the depiction of King Arthur and his court. The complicated relationships between leader and managers, the balance between personal and work lives, and the conflict between idealism and pragmatism are as much a part of today’s business world as they were in medieval England.

Richard Edelman, President and CEO, Edelman

Camelot, Inc. is a remarkable ‘mining’ of lessons from the Arthurian legends. Oestreicher has found timeless prescriptions for achieving excellence in leadership.

L. Patrick Gage, Ph.D., enGage Biotech Consulting, former president, Genetics Institute and Wyeth Research

As a child, my introduction to human drama in literature was through the tales of King Arthur and the Knights of the Roundtable. Truly everything you need to know about human values is found in these tales. Paul Oestreicher recognizes that these tales hold timeless lessons for leaders as he brings the reader inside the Roundtable.

Greg Simon, Senior Vice President, Worldwide Policy, Pfizer and former chief domestic policy advisor to Vice President Al Gore

Camelot, Inc. gets to the heart of the mentoring role in growing and sustaining enterprises—both large and small. In our increasingly “virtual” business and social environment, Paul Oestreicher shows how critical mentoring is to passing along core values to the next generation of leaders.

Victor R. Budnick, Managing Director, Ironwood Capital and Lead Venture Mentor, Yale Enterprise Institute

You can see more information about the book and order at www.camelotinc.com.

Camelot, Inc.: Leadership and Management Insights from King Arthur and the Roundtable

An Excerpt from the Introduction

What lessons about management and leadership can an ancient king and court bring to us in the 21st century? Can the trials and tribulations of people so removed from us in time and custom truly be relevant in modern corporations, organizations, or governments?

If one thinks of texts and stories even more ancient than those of King Arthur, the answer is obvious. People continue to draw important meaning from the stone tablets, scrolls, and books of the past. Indeed, there are many for whom ancient ways and teachings enhance their well-being and guide their daily lives. The Roman emperor and philosopher Marcus Aurelius wrote (before the time of Arthur, in the second century), “If you have seen the present then you have seen everything—as it has been since the beginning, as it will be forever.”

So it is with the stories of King Arthur. Life’s lessons during the time of Camelot and the Round Table remain relevant because, at the core, they are about the human relationships that connect us, divide us, and drive us forward (or backward) in our various dealings—personal, business, or otherwise. Looking at the past, we can gain the accumulated wisdom from so many people, conflicts, and circumstances. Those enduring qualities and complexities of human nature, told and retold in story, song, and scripture, have given us guidance and assurance in the past and will continue to do so in the future.

In Camelot, Inc. we glean management and leadership insights from Arthur’s evolution from the awkward and out-of-place squire derisively called the Wart to impatient student to compassionate king to tired ruler. We’ll start at a time when Arthur found a mentor (rather, when the mentor found him) and observe how he learned, how he developed his leadership philosophy and his vehicle for communications, what it took to excel, how he created a vision and mission, and then how a failure to confront issues led to his decline.

It’s not just that these royal life-cycle transitions so closely track the rise and fall of modern managers and leaders. Arthur will help us to deal with some of today’s most pressing leadership issues: knowledge retention, developing coherent plans and proposals, building internal and external advocacy, communicating and negotiating, team building, maintaining ethical standards, innovating, ensuring flexibility, moving from vision to execution, and succession planning.

Much of what we hear and what we come to accept as fact or truth has been termed “conventional wisdom.” Here, we have Camelot Wisdom. Camelot, Inc. will not be a history lesson, but I will use history to illustrate the dos and don’ts critical to our success as learners and leaders.

Camelot, Inc., Praeger Publishers. Available February 15, 2011. Please visit www.camelotinc.com for more information.

Cats and Dogs - It's Raining Opinion

A Bad Survey Results in Bad Reporting

Today, The New York Times published "Among Weathercasters, Doubt on Warming," a story based on a new survey from George Mason University that concludes there are "tensions between two groups that might be expected to agree on the issue [climate change]: climate scientists and meteorologists, especially those who serve as television weather forecasters."

In brief, only about half of the 571 TV weathercasters surveyed believed global warming has occurred, fewer than a third thought it was "caused mostly by human activity" and more than a quarter agree with the statement that "global warming is a scam." Here are some important under-appreciated facts:

Climate scientists and meteorologists are like cats and dogs, apples and oranges. College degrees versus graduate training and research. Predicting the weather tomorrow versus studying decades of data.

Not all TV meteorologists are created equally. Half don't have degrees in meteorology -- they simply report the weather. Sadly they are often the de facto local science expert because 94 percent of TV stations don't have a full time science reporter. Thus, misinformation and junk science can be easily perpetuated.

Politics forms the backdrop, not the science. I hate this but, as I've said before, the facts sometimes don't matter (Do the Facts Matter? Of Course They Do, Of Course They Don't). There's 130 years worth of information to conclude that CO2, driven up by human activity, is linked to climate change. Unfortunately, those now famous emails from a British group that allegedly tried to suppress some climate data have given climate change deniers a new reason to cast suspicion and doubt on the collective work of the field. It is also notable (and not reported in the NYT story) that 37.9 percent of the survey respondents identified themselves as somewhat or very conservative, 35.1 as moderate, and 27.3 as somewhat or very liberal (1.6 didn't know).

I really don't care where one stands on the political question -- my friends stretch across the spectrum -- as long as there is an open mind and a respect for the facts. But it would interesting to see how the survey might have changed if 1) political leanings were neutralized and 2) sorted by true expertise in the field/years of education. The bottom line is that The New York Times may be making a mountain out of a mole hill by elevating the visibility of a flawed survey.

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.

End of Year News and Announcements

A New Book in the Works
This is my 50th entry and it’s the first one with something about me. I thoroughly enjoy commenting on news and trends, and offering up a new idea here and there. And, it’s gratifying to track how and where this is all being viewed. People from over 50 countries have visited

C-O-I-N-S.

However, some of you have noticed that the blog articles and published pieces in the trades have appeared less frequently in the last month. I have an explanation.

A part of it is the time devoted to reading papers and grading final exams for the Research Process & Methodology course I teach at NYU’s M.S. program in Public Relations and Corporate Communications. I had another great group of students who left, I hope, as more aware users, evaluators and purchasers of research. They will help to further elevate the field, and bring a more rigorous approach to communications planning and measurement.

The other reason, I am very pleased to announce, is that most of my writing energies will be placed toward completing a book on leadership and management. Camelot, Inc. will be published by Praeger and has a planned release in late 2010/early 2011.

I will still comment occasionally here and on Twitter, be involved with NYU and be available to take on consulting assignments in corporate and marketing communications, and issues and crisis preparedness.

I wish you a happy and healthy holiday, and a wonderful year ahead. I’ll look forward to staying in touch.

Paul

Afghanistan Speech Plan

Notes for the President
Tomorrow evening, President Obama will address the nation from the US Military Academy at West Point. After three months of deliberating with his “war cabinet,” the President will outline his decision, which is presumed to include sending 30 – 35 thousand additional troops to Afghanistan. Word has been leaking for weeks (from sources including the military) about the proposed strategy, and the sides for and against it are already well developed.

We know that President Obama can deliver a great speech, but I thought I would offer up a few ideas on how to make communicate this crucial communication with maximal effectiveness. Here is what his address should contain:

The Background. It’s laudable that the President has adopted a stance of (at least attempting to) not dwell on the past. The answers are ahead of us, not behind. Yet, it’s important to explain why we are where we are. Not to be condescending, but the President should even consider using a map. Show the region, show the threats, show the opportunities. I know he’s been dinged for being “professorial,” but my view is that it’s a good thing. We have a President, a Commander-in-Chief, smart enough to give these important lessons to the public.

The Goal. Some have challenged the President to accept the military’s recommendations and move on. It’s a simplistic plea. A military strategy must support public policy goals. The question of why we are there and what we must accomplish in the name of national security must be answered first, clearly and plainly. Only after the planned outcomes have been stated can we decide on which strategies (military, diplomatic or both) are appropriate.

The Decision Process. As a corollary to the points above, it’s worth mentioning how this decision was reached. There has been criticism of the three months it has taken to debate the request for more troops. In the previous administration, many decisions came quickly, from the gut. Now, we have a more analytical, deliberative and inclusive decision making process. It needs to be explained. Moreover, the role of the military must be clarified – our civilian government should never be just a rubber stamp.

The Options. After hearing about how the information was gathered and analyzed, we should receive an overview (not the details) of the options the President had to grapple with before settling on his final decision. What were the pluses and minuses, and the potential consequences?

The Path Forward and Back. After laying out the options, make the case for the decision. What does it mean of us, for the people of Afghanistan, for the balance of power in the region? What are the consequences of increased involvement, when will we know when we’ve achieved our goals and how do we leave without causing more harm than good? And, what responsibilities will the world community shoulder? Can we count on a fairer distribution of the burden?

Acknowledge Other Worries. We all know of the disastrous experience the Russians had in Afghanistan. We know the parallels to Viet Nam are many. The President must address the concerns over another potentially bloody quagmire and how his strategy has the best chance of success. In addition, he should acknowledge the costs (human and financial), and the possible impact on the economy and on our security. He should also make the case that the seriousness of other issues – financial reform, jobs, healthcare, energy, climate change – means we must tackle our problems simultaneously, not sequentially.

Conclude with a Rallying Point. At the end, the President needs to seal the deal. That is, obtain the support of the majority of the American public. He needs to convince us that it’s time to get behind his decision and, most important, the brave men and women tasked with carrying it out. And, following the speech, surrogates from all sectors of society should be mobilized to reinforce the President’s message.

The content of the President’s speech must be spot-on but so must the tone. He must be perceived as truthful, authentic, realistic and reassuring. I’ll be tuning in at 8 o’clock tomorrow night to watch some history.

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Between blog posts, you can follow me on Twitter.

The Pharma Pricing Dilemma

How to Rebalance the Picture
There’s front page outrage in today’s The New York Times. The pharmaceutical industry is roasted again in “Drug Makers Raise Prices in Face of Health Care Reform.” How much of the criticism is deserved, and how much is a result of poor communications or inadequate reporting?

The article cited several studies that link big increases in drug costs to legislative efforts – like bumping up carpet prices just before the big sale, or the rush to raise interest rates and fees before credit card reforms become law. The most recent study was conducted for the AARP by Stephen Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. It concluded that drug prices increased approximately nine percent in the face of an overall decline in the Consumer Price Index of 1.3 percent. He told the Times, “When we have major legislation anticipated, we see a run-up in price increases.”

Not so, said Merck spokesman Ron Rogers. “Price adjustments for our products have no connection to health care reform.” But Joseph Newhouse, a Harvard health economist, said he found a similar pattern of stiff increases after Congress added drug benefits to Medicare in 2006. He said, “They [the industry] try to maximize their profits.”

No kidding. Of course the industry, any industry, wants to maximize their profits. Indeed, there’s an obligation to employees and shareholders. The problem is one of perception. What is smart business that helps to guarantee the long term success of the enterprise, what is abuse or greed, and what is corporate desperation?

The other side of this story is not told particularly well, and it’s hard to determine if it’s the lack of space accorded the pharmaceutical industry by the Times, the lack of a compelling message by the industry or both. The article states that “Drug makers say they have valid business reasons for the price increases” but then fails to explore it further.

Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America (PhRMA), does manage to get a shot in by criticizing the study methodology and its sponsor. “In AARP’s skewed view of the world, medicines are always looked at as a cost and never seen as a savings – even though medicines often reduce unnecessary hospitalization, help avoid costly medical procedures and increase productivity through better prevention and management of chronic diseases,” he said.

Yes, good points, but readers are still left with questions and concerns. And, what about the cost of failure – the part of the price increases that are necessitated by the sheer difficulty of bringing new, differentiated medicines to the market? The reality is that, without the ability to replace innovative products lost to generic competition, outsized price increases will continue to play an outsized role in pharmaceutical profitability.

So, what needs to be done in order to achieve some balance, some greater understanding of the complexities in healthcare costs?

Provide proof. The industry must deliver concise, compelling and understandable information. Any spokesperson should be able to recite at least three pieces of evidence to support their position. And, if you believe the methodology of the offending study is flawed, develop your own bullet proof information.

Utilize credible supporters. The extreme pricing contention was delivered by two academics, a consumer group and an industry analyst. The industry’s position was staked out by the pharmaceutical trade association. It’s clear where most readers will place their trust.

Strike the right tone. Lashing out may be tempting but it could have the effect of creating sympathy for your adversary. And, in this case, the object of PhRMA’s annoyance – the AARP – represents millions of the industry’s customers.

Think about the timing. It may be that, as Catherine Arnold of Credit Suisse said, “If you’re going to take price increases, here and now might be the place to do that, because the next year and the year after that might be tough.” But, if these price increases cancel out some of the savings promised by the industry during negotiations over health insurance reform, don’t be surprised if some legislators attempt to exact new concessions with renewed determination.
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Between blog posts, you can follow me on Twitter.

The Twitter Tail Wagging the Corporate Dog

This article also appears in odwyerpr.com.

Social Media Are the Means, Not the EndsWhile scanning through a long list of Twitter posts the other day, I saw a link to TechCrunch, a blog “dedicated to obsessively profiling and reviewing new Internet products and companies.” An entry by MG Siegler, “Comcast: Twitter Has Changed The Culture Of Our Company,” caught my attention.

Sure, technology can help drive cultural change. Think of the tools of war over the centuries or what the automobile has meant to society. The examples are endless. But the culture of a company?

Yes, according to Comcast CEO Brian Roberts. In response to a question about the role Twitter was playing with the cable communications giant at the Web 2.0 Summit in San Francisco, he said “It has changed the culture of our company.” He backed that up by saying that Comcast uses Twitter to scan for complaints and engage with customers.

OK, maybe Mr. Roberts got caught up in the moment. After all, he was at a social media conference. And, it’s great that Comcast is using new tools (Facebook and other networks were mentioned) to address issues around customer service. However, this does not a culture make.

Tools support the strategy (and, thus, the objective), not the other way around. The tools of war support the policies of government. The automobile supports our mobility. You get the idea. Comcast delivers communications products and services. Its culture should be wrapped up in service delivery and excellence whether Twitter exists or not.

So, if Twitter really did change the culture at Comcast – all of a sudden becoming a company focused on customers and what they want – I wouldn’t be crowing about it. I’m guessing, but what may have happened was that seeing thousands of Twitter-fueled complaints was Comcast’s wake-up call. Twitter makes it easy to sound-off – much easier than having to find a telephone number to call, listen to the prompts, press 1, listen to some more prompts, press 4, and so on. Seeing this groundswell may have acted like a cyber-mirror and forced them to look at themselves, and reflect on who their customers are and how they conduct their business.

Web 2.0 offers us wonderful tools. We’re nowhere near realizing their potential or knowing how they will evolve. What should be known (and written in stone), though, is what our companies, institutions or organizations stand for. The decision to adopt a particular technology should only be made if it helps us achieve that end.

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American Cancer Society vs. The New York Times

This article also appears in odwyerpr.com.

Feud Adds to Public Confusion Over Cancer Screening
As if there isn’t already enough conflicting information about cancer screening, a tiff between The New York Times and the American Cancer Society – two trusted sources of information – have the public scratching its collective head. It’s another example of how the current state-of-the-art in diagnostics, conflicting medical points of view, and the way in which healthcare news is communicated can cause people to either run to or away from their physician.

Veteran healthcare reporter Gina Kolata reported that the ACS “is quietly working on a message, to put on its Web site early next year, to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.” Dr. Len Lichtenfeld, Deputy Chief Medical Officer of the ACS, writing in his blog, counters that it’s not true. He wrote, “The American Cancer Society is not working on any stealth project to change commentary on our website to emphasize the shortcomings and risks of screening.”

With a tone of exasperation, Dr. Lichtenfeld went on to write, “And here is another news bulletin for the press and the rest of the media: developing and accurately promoting guidelines are complex processes that don’t lend themselves to sound bite messaging.” So true. Cancer is incredibly complex and the screening tools are far from perfect. Yet, it was Dr. Lichtenfeld’s boss, Dr. Otis Brawley, who was quoted in the Times article. He said, “We don’t want people to panic, but I’m admitting that American medicine has overpromised when it comes to screening. The advantages of screening have been exaggerated.”

What’s really going on here?

1. We have a gender gap. Much of the controversy boils down to the fact that prostate screening is less effective than breast cancer screening. It’s a message not very many men want to hear.

2. Cancer diagnostics are not created equally. In addition to some screening tests having greater predictive powers than others, they do not differentiate between tumor types that may be more or less aggressive. This has a big impact on which cancers to treat or just to observe.

3. The ACS needs to harmonize its message. A third ACS executive, CEO Dr. John Seffrin, has now weighed in on this story. He said, “we have long acknowledged that cancer screening isn’t perfect. Sometimes cancers get overlooked. Sometimes cancers get misdiagnosed. Sometimes aggressive cancers can appear even after a clear screening test. It is important to acknowledge these limitations, understand them, discuss them with your doctor, and decide what is right for you.”

4. Physicians need to find the right language. The pros and cons, the risks and benefits, if and when to treat – they all must be discussed. It takes time, and it takes some skill to understand their patient and their ability to understand and deal with the facts.

5. The public needs improved health literacy. A corollary to number 4 above is that the public simply does not have a good enough grasp of the scientific concepts or the ability to assess the risks or benefits. If The New York Times and the American Cancer Society can’t agree or somehow misunderstand each other, then what hope should the average citizen have of making heads or tails of all the possible screening and treatment options?

Let’s hope we can get back on the same page and deliver timely, accurate and understandable information on what is literally life and death information.
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Between blog posts, you can follow me on Twitter.