Healthcare PR
Can healthcare PR be a crime?
by Joshua Schneck | September 24, 2013
Can healthcare PR be a crime? In the case of ex-InterMune CEO W. Scott Harkonen, the answer is yes – according to the U.S. government, a Federal jury and the Ninth Circuit Court of Appeals. David Brown writes in The Washington Post about how Harkonen was convicted for issuing a press release that, according to the U.S. government, willfully overstated the benefits of a drug made by his company.
InterMune is a public company focused on pulmonary and orphan fibrotic diseases. It markets a medicine for idiopathic pulmonary fibrosis (IPF) and is in product development and clinical trials on other drugs.
No Factual Errors
According to Brown’s article, there were no factual errors in the press release in question. It was the interpretation of the facts that was deemed criminal. This raises troubling questions for a Minneapolis healthcare PR firm like ours, and our clients. When does promoting a point of view become a crime?
From the Post article:
“If you applied this rule to scientists, a sizable proportion of them might be in jail today,” said Steven N. Goodman, a pediatrician and biostatistician at Stanford University who submitted a statement supporting Harkonen’s appeal. “The courts don’t quite realize the significance of what is in front of them or the furor that might erupt if this kooky precedent is allowed to stand.”
Ruling a word of caution to a Minneapolis healthcare PR firm
This ruling is a word of caution to a Minneapolis healthcare PR firm that works in healthcare PR and healthcare content marketing. Can healthcare PR be a crime? It can in some cases, but there is a free speech issue here that needs to be thought through carefully.
Ultimately, it gets down to what patients are entitled to know. They shouldn’t be deceived, obviously, but should they be prevented from knowing a company’s interpretation of research facts? I don’t claim to have the answer, but it’s a question worth asking.
Bringing clarity to medical device PR
by Joshua Schneck | September 23, 2013
Bringing clarity to medical device PR is a long standing goal of this Minneapolis healthcare PR firm.
MR Instruments is a producer of high-resonance MRI technology and developed the medical technology industry’s first 3T (Tesla) MRI coils for the most demanding MRI applications. The clarity of image MR Instruments helps produce for physicians was our inspiration for bringing clarity to MRI’s target audiences: MRI manufacturing companies, MRI users and buyers and key influencers.
MR Instruments hired Snow to increase visibility of this new technology and officially launch its flagship product at the RSNA Conference in Chicago. Snow Communications drew on its deep expertise and experience in medical device PR and medical device content marketing to bring about good results for MRI.
For more details, please see the case study.
Can you trust clinical practice guidelines?
by Joshua Schneck | September 18, 2013
Can you trust clinical practice guidelines? Thank you, Gary Schwitzer of HealthNewsReview.org for an excellent blog post on the BMJ (British Medical Journal) article about conflicts of interest on clinical practice panels. The BMJ article details some of the types of conflicts common on the clinical practice panels that issue treatment guidelines.
As a Minneapolis healthcare PR firm dedicated to promoting the transformation of healthcare to a patient-focused, outcomes-based model, we believe it is vitally important that engaged patients receive evidence-based, unbiased information.
For example, in the controversial area of PSA testing, the article notes that The American Urological Association’s best practice update in 2009 and its 2013 practice guidelines reflected potential conflicts of interest in the context of association sponsorship, committee chair conflicts and multiple panel member conflicts. The article contrasts this with the conflict-free status of the U S Preventive Services Task Force in 2012.
Who do you believe?
While the U.S. Preventive Services Task Force found harm from routine PSA testing and no evidence of net benefit, the American Urological Association 2009 guidelines promoted routine PSA testing. In 2013, the Association revised its guidelines to reflect a more conservative approach to PSA testing.
As noted elsewhere, studies have found troubling patterns of conflicts of interest in practice guideline panels, and or lack of full disclosure of those conflicts. Part of the answer is the new Physician Sunshine Act, which we’ve written about previously, that requires the reporting of financial payments to physicians by pharmaceutical and medical device companies.
Avoiding Red Flags
The BMJ authors recommend that professional journals avoid the following red flags:
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Sponsor(s) is a professional society that receives substantial industry funding;
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Sponsor is a proprietary company, or is undeclared or hidden
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Committee chair(s) have any financial conflict*
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Multiple panel members have any financial conflict*
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Any suggestion of committee stacking that would pre-ordain a recommendation regarding a controversial topic
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No or limited involvement of an expert in methodology in the evaluation of evidence
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No external review
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No inclusion of non-physician experts/patient representative/community stakeholders
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*Includes a panelist with either or both a financial relationship with a proprietary healthcare company and/or whose clinical practice/specialty depends on tests or interventions covered by the guideline.
Please take note, healthcare PR professionals, healthcare marketing professionals and journalists. And for full disclosure, this Minneapolis healthcare PR firm works for the parent company of an online source of unbiased medical reference and clinical recommendations. The client had nothing to do with the writing of this blog post, and I take full responsibility for its contents.
Healthcare Transformation and Content Marketing
by Joshua Schneck | September 17, 2013
Healthcare transformation refers to the fundamental change going on in the healthcare industry, especially the ongoing transformation from a fee-for-services to an outcomes-based model. Transformation is being driven by meaningful use, value-based purchasing, accountable care organizations (ACO’s), the Affordable Care Act (Obamacare), and advanced clinical decision support. Summed up, these changes are about aligning incentives and using advanced technology to improve outcomes. For a Minneapolis healthcare content marketing firm, there is much to communicate about, and we’re excited to be part of this transformation.
The first step is to understand the bigger issues. As a Minneapolis industry analyst relations firm, we work closely with a number of the top research firms, including Gartner, IDC and The Advisory Board. Each of these organizations has written extensively about healthcare transformation. In addition, some of the better sources of information about healthcare transformation are The Center for Healthcare Research and Transformation, The Joint Commission Center for Transforming Healthcare, and The Institute for Health Technology Transformation.
It’s important to follow the law-making and rule-making processes in government. As a Minneapolis government relations firm, we develop and implement effective government relations strategies. We keep clients up to speed on legislative and regulatory trends and developments, and represent our clients before Congress and Federal agencies. Snow has worked with the FDA, HHS, OMB and other agencies. Snow prepares comment letters to Federal and state agencies, meets with Congressional staff to share perspective and seek assistance, sets up meetings with policy makers, produces testimony and whitepapers, and arranges for legislation to be introduced.
Based on well grounded, current knowledge, we provide strategy development and implementation. Suppliers to the healthcare market must communicate how their products and services will help providers meet the new challenges and opportunities in healthcare. Providers must reach out to patients in new ways, emphasizing better outcomes and patient engagement.
For a Minneapolis healthcare PR firm like ourselves, we understand the need to help clients create strategies for thought leadership through content marketing, PR, SEO and SEM and other, integrated approaches. Working with our clients, we help them create original content to drive aggressive content marketing that builds recognition for our client’s solutions, products, people and perspective, while also driving improved SEO and social media.
Smaller Testicles, Good Dads, Bad Reporting
by Joshua Schneck | September 12, 2013
Dads with smaller testicles are more nurturing fathers, according to a rash of news stories run by Time, NBC, USA Today and other news organizations. Trouble is, the underlying story is far more nuanced – based on a study published in The Proceedings of the National Academy of Sciences, “Testicular volume is inversely correlated with nurturing-related brain activity in human fathers.” As healthcare PR professionals, we should be concerned when healthcare reporting sensationalizes scientific findings and fail to accurately rerport on these findings.
The key word there is correlated.
As Gary Schwitzer points out in his excellent HealthNewsReview.org blog, most of the news organizations failed to accurately report on this study. Gary notes that the authors of the study, at Emory University, did not claim that they had found a causal relationship between testicle size and parenting skill. In fact, they allow that it could be the opposite: parenting activity results in changes in the male body, including testicle size.
In the Emory University blog the authors state: “We’re assuming that testes size drives how involved the fathers are,” Rilling says, “but it could also be that when men become more involved as caregivers, their testes shrink. Environmental influences can change biology. We know, for instance, that testosterone levels go down when men become involved fathers.”
To be sure, some of the stories, like the ones in NBC and USA Today, do get to the nuance, but deeper in the article after most people have read or heard a misleading headline.
Why is this important to healthcare PR people? If the media can’t get a story like this right, where the information presented is fairly straightforward, how will they get complicated stories right, such as the appropriate treatment options for patients with low risk forms of cancer?
As a Minneapolis healthcare PR firm, we’ve heard clients complain that competitors can make unsubstantiated claims about their products and not get called out in the media. Schwitzer provides a watchdog service for healthcare news stories on a limited budget. His organization, and similar efforts, deserve support. But it’s important that health PR professionals, and healthcare reporters, conduct the checks and digging needed to provide accurate information to healthcare markets and customers.
Penn State Wellness Program: Healthcare PR and Marketing Dilemma
by Joshua Schneck | August 29, 2013
What can healthcare PR and marketing professionals learn from the controversy regarding Penn State’s $1,200 surcharge on employees who do not meet a new requirement of the school’s wellness program to provide certain personal information and undergo a free biometric exam?
Penn State made an official announcement of the changes in early July, after consultations with faculty and other stakeholders. The Chronicle of Higher Education reported on the story in mid- and late July, “Weigh in or Pay,” followed by NPR on August 2nd. By mid-August the story had made The Wall Street Journal.
Opponents challenged the new policy, beginning with a post by a Penn State professor on the blog maintained by the Pennsylvania division of the American Association of University Professors, followed by coverage on the faculty senate blog and a drive on petition site Change.org, where opponents of the new requirements have gathered more than 2,000 signatures to date. Analysis has occurred on independent blogs, including the Harvard Business Review blog – see “The Dangers of Wellness Programs: Don’t Be the Next Penn State.”
A few observations:
I don’t claim to be an expert on wellness plans, which are encouraged as part of the Affordable Care Act (Obamacare), but here are a few observations from a healthcare PR and marketing perspective:
1. Rewards are easier to market than penalties. If a plan reduces a member’s cost for taking a positive action, that’s likely to cause a lot less problem from a PR and marketing perspective than a penalty for not taking the same action.
2. Highlighting plan member self-interest is generally superior to highlighting the needs of the employer. It’s possible that too much of the Penn State wellness program focus was on how much money it would save Penn State. Positively engaging plan members is probably easier when the health and lifestyle benefits of an action for them are the main thing emphasized. As we’ve stated elsewhere:
3. Be prepared for controversy with vision, persistence…and evidence. Well-run wellness plans have demonstrated strong ROI, promoting healthier lifestyles and outcomes with genuine cost savings. Yet, critics of the Penn State plan, including the authors of the Harvard Business Review blog post (see above) attacked the merits and payoffs of the new requirements. Promoters of these plans must be ready to cite clear evidence that plan requirements result in better outcomes. And with social media, including petition sites, Facebook, blogs, etc., opponents have more tools at their disposal. It would be wise for plan promoters to have a comprehensive crisis management plan in place, including provisions for social media.
Physician Diagnoses Wrong Half the Time
by Joshua Schneck | August 27, 2013
Physician diagnostic overconfidence may be harming patients, according to a new study published in JAMA. The study was actually about overconfidence regarding internists’ diagnoses. Even in difficult-to-diagnose cases, where the internists were correct in their diagnosis only 5.8 percent of the time, their confidence in their diagnosis was high. In easier cases, they were right only 55 percent of the time. For the study, that made the physician diagnoses wrong half the time.
As Cheryl Clark reports in a story for Health Leaders Media, one of the authors of the study makes the point that hospitals could do a better job of providing feedback to physicians whose initial diagnosis is wrong. Hardeep Singh, MD, principal author of the study, told Clark that the opportunity for learning is sometimes lost when feedback does not occur.
Singh suggests there is a serious problem regarding diagnostic accuracy:
The whole medical enterprise is based on the fact that one goes to a doctor in the belief that doctors usually know what they’re doing, otherwise you won’t go. If a doctor said, ‘you know, I’m kind of wrong half the time,’ no one is going to come to them.
Patient Engagement Needed
As we’ve previously written, patients and their families need to be engaged and consult reliable online resources and/or seek second opinions.
Physician Payment Sunshine Act Update
by Joshua Schneck | August 22, 2013
Since our post on 8/1/13, the Physician Payment Sunshine Act has received little attention, despite the recent start of record-keeping requirements for drug, medical device and certain other healthcare companies that make payments to physicians, and upcoming public reporting of such payments. However, The Wall Street Journal ran a story yesterday, “Doctors Face New Scrutiny Over Gifts.” The Journal reported that some physicians are already reconsidering what gifts, free dinners and other reportable compensation they receive from covered companies:
“John Mandrola, a cardiologist in Louisville, Ky., said he has been paid a total of $1,500 to $2,000 this year by medical-device makers for speaking engagements. Knowing that such transactions will become public has caused him to be more cautious about what fees to accept, he said. He avoids industry reps visiting his office, believing he can get information on new drugs elsewhere. I’ll continue to weigh the benefits and the negatives, and I think the Sunshine Act and the public reporting of all this stuff makes us think about that,” said Dr. Mandrola. “And I think that’s a good thing.”
CMS Advising Physicians to Keep Records
The story reported that the Centers for Medicare and Medicaid Management are advising physicians to keep records of all payments and transfers of value from industry.
Reporting to the Public Begins in September, 2014
Healthcare PR professionals can expect to see increased media coverage of this issue, especially when the data begins to be available on a government website beginning in September 2014. That’s a year away, but the reporting has already begun.
Healthcare PR Pros: Don’t Call it Cancer
by Joshua Schneck | August 7, 2013
If you’re a healthcare PR or marketing professional, please note: Over-diagnosis and overtreatment resulting from cancer screenings has led an expert panel to suggest that the word “cancer” should not be applied to conditions that are not lethal. The U.S. National Cancer Institute commissioned a panel to study the problem created by too many growths found through screening that are clinically insignificant and indolent in nature. Writing in The Journal of the American Medical Association, the panel reported:
“Screening always results in identifying more indolent disease. Although no physician has the intention to overtreat or overdiagnose cancer, screening and patient awareness have increased the chance of identifying a spectrum of cancers, some of which are not life threatening. Policies that prevent or reduce the chance of overdiagnosis and avoid overtreatment are needed, while maintaining those gains by which early detection is a major contributor to decreasing mortality and locally advanced disease.”
The authors note that while mortality from certain cancers – e.g., breast and prostate – declined between 1975 and 2010, the incidence has increased significantly because the screenings found large numbers of insignificant cancers. In contrast, they note, screening for colon and cervical cancer decreased incidence as well as late-stage disease through detection and removal of precursor lesions.
The panel’s advice? Reclassify non-lethal lesions as “IDLE” – indolent lesions of epithelial origin. What’s the implication for healthcare PR and marketing professionals? Use caution when promoting screening programs or technologies. Be aware that overtreatment and over diagnosis is a significant problem, and communications about screening or screening technology should reflect this. For example, testing for PSA (prostate specific antigen) should include “informed consent” between patient and doctor, in which the pros and cons of PSA testing are discussed. Healthcare PR professionals should consider including some cautionary statement in their promotions for screening programs and screening technologies. Cancer screening has saved many lives, but patients should be aware of the risks.
With the rise of patient engagement, candor and full disclosure are the new standard.
Physician Payment Sunshine Act: Implications for Healthcare PR
by admin | August 1, 2013
Data collection begins today for the Physician Payment Sunshine Act (Sunshine Act). Part of Obamacare, the Sunshine Act requires that manufacturers of pharmaceuticals, medical supplies and biologicals report payments they make to physicians and teaching hospitals. This is designed to bring transparency to these financial transactions, most of which are for legitimate purposes.
Some of these payments have raised concerns that prescribing physicians may not be impartial in what they choose to prescribe for their patients. With the Sunshine Act, these payments will now be in the light of day and it is hoped that this will encourage appropriate payment practices and improve confidence in the impartiality of prescribing physicians.
What Are the Implications for Healthcare PR?
What are the implications for healthcare PR? Healthcare PR professionals who work for companies covered by the act or who have such companies as clients should make preparations to handle inquiries that might arise from the media, including bloggers. An audit should be done of payments reported under the act, and potentially controversial payments identified. A plan should be thought through and put in place to handle any media inquiries. This plan would identify spokespersons, have basic answers drafted, and include specific steps for handling inquiries. If needed, spokespersons should receive media training. Key messaging should be prepared that connects back to the company’s core values and product development strategy.
For more information on the Sunshine Act, go to CMS.gov. The program is administered by The Centers for Medicare and Medicaid in the Department of Health and Human Services.