The students sitting in the lecture hall at Harvard Medical School, perhaps thinking ahead to their next encounter with a cadaver in anatomy lab, might not have expected the message the eminent physician was about to convey to them.
“The practice of medicine in its broadest sense includes the whole relationship of the physician with his patient …. The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal .… The reward is to be found in that personal bond, which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”
Although the word appeared nowhere in a nearly hour-long lecture that became one of the most cited and revered essays in medical history, Dr. Francis Weld Peabody was talking about empathy. The year? 1926.
Nearly a century later, Peabody’s words about “caring for the patient” remain a mantra, if at times an elusive one, for the medical and communications professions. We all have our own personal tales to tell of empathy — and its absence — in our lives as patients.
I remember the urologist who, running behind schedule, came bustling into the exam room. Staring down at his clipboard, he greeted me with, “You have some red blood cells in your urine.” Well, hello there, doctor, good afternoon, nice to see you. My name is Jeff and I’ll be your patient today.
On the more encouraging flip side of that coin was the surgeon who, calling from his car, devoted his entire 40-minute commute to walking me through the options after I was diagnosed with early-stage prostate cancer. This doctor showed true empathy: He actively listened, actively understood, actively cared, actively communicated. If FaceTime had been invented — we were about a year too early — he would have made eye contact, too.
So what is empathy and why does it matter? The need for empathy in healthcare is such that we now have a tool to measure it: the Jefferson Scale of Empathy, used in 85 countries and translated into 56 languages and dialects. The Jefferson Scale defines empathy as “a cognitive attribute that involves an ability to understand the patient’s pain, suffering and perspective combined with a capability to communicate this understanding and an intention to help.”
Business psychologist Mark Ingwer strikes a similar chord in his book Empathetic Marketing: How to Satisfy the 6 Core Emotional Needs of Your Customers. “A business that invests in empathy devotes itself to understanding the emotional needs and motivations of its customers and aligns itself to meet them.”
Empathy, then, is a concept that should travel well in the realm of healthcare marketing. To VMLY&R chief creative officer, health Augé Reichenberg, empathy means “understanding that we have the responsibility of listening intently to what real people with medical conditions are going through, both physically and emotionally. We must take in their experiences as if they were our own. We need to emotionally take a walk in their shoes before we even put one finger to keyboard or pen to paper.”
Wallye Holloway, associate managing partner at TBWA\WorldHealth, notes that empathy is not a new concept in healthcare communications. However, she believes the pandemic “has brought the issue front and center and helped us focus more intently on the empathetic idea of, ‘What is someone else going through, and how can we be of help?’”
In healthcare marketing, Holloway continues, “Empathy includes making sure your brand not only understands the condition that a patient has but also the experience of having that condition, encompassing both the physical and emotional impact. People are expecting that measure of empathy now. Patients and consumers know empathy when they see it. They know when a brand ‘gets it’ and when it doesn’t.”
Imre Health EVP, Innovators Kirsty Whelan describes “compassionate intelligence” as a core competency that all marketers should cultivate. “It’s important that we don’t just preach empathy to our clients but that we practice empathy ourselves,” she explains. “We believe empathy is a gateway to innovation, so we’re always looking for ways to develop our sense of compassionate intelligence and partner with those outside our walls who inspire and challenge us.”
With that goal in mind, Imre Health has arranged training sessions with Columbia University’s Digital Storytelling Lab and with Jefferson University’s Health Design Lab. The former demonstrated how to use empathy in ideation and storytelling, while the latter showcased the need to empathize with the challenges faced by people with type 2 diabetes. Participants in the session took their own blood glucose readings and prototyped solutions.
As for what true empathy looks like, Ogilvy Health chief digital officer Ritesh Patel notes that “historically, empathy in marketing was not always standard operating practice, but more of an afterthought.” He says this is changing.
By way of example, he points to a three-minute video in which an exhausted hospital physician, away from home for two weeks during the pandemic, connects via laptop screen with her husband and children. She tells them she will not be coming home for the religious festival; they let her know they will be OK and show her how they will prepare the celebratory meals. When she is called away to see a patient, her husband smiles and says, “Go and make us all proud.”
The ad conveys respect, affection, gratitude, warmth, humor and, above all, an understanding of what families are enduring during pandemic times. The kicker: The spot comes not from a healthcare organization, but from iD Fresh Food.
“Pharma should have done this one,” Patel says.
To be sure, there are strong examples of empathetic marketing in and around healthcare. Holloway senses a strong undercurrent of empathy in ads for Kyprolis, a treatment for relapse of multiple myeloma. The brand’s five-step plan for (re)remission begins with “take a deep breath” and ends with “believe in yourself.” In between, patients are encouraged to “talk to your doctors and let them know how you are doing emotionally and physically.”
Furthermore, the patient in the ad is an older African-American man. This choice truly matters: Multiple myeloma is twice as common in Black Americans as it in white Americans, yet the notable improvements in survival rates over the past 10 years have benefited white patients more than Black ones.
Then there was the launch of Amag Pharmaceuticals’ Vyleesi for hypoactive sexual desire disorder. Showcasing the tagline “don’t get ghosted by your desire,” a digital campaign engineered by Imre Health recognized the frustration experienced by people with the condition and pointed the way to help.
“We understood our audience as women first, not patients,” Whelan explains.
Clearly, the road to empathy begins with listening. In a classic study of primary care office visits, conducted in 1984, the physician interrupted the patient 18 seconds into what was supposed to be a conversation. As a result, the patient was able to complete his or her opening statement of concerns in only 23% of visits. Meanwhile, those who did manage to speak without disruption weren’t exactly looking to filibuster. Most finished within a minute and none took longer than two and a half minutes.
On the marketing side, the most memorable campaigns are informed by personal stories. To that end, an Excedrin ad created for GSK Consumer by Weber Shandwick commenced with the following voiceover: “A migraine. It’s more than just a bad headache. If you’ve never had one, you can’t understand. Until now.” Then, via the magic of virtual reality, the mothers, mates and coworkers of migraine sufferers are transported into a world of auras, shrinking vision, blurred images and spinning rooms. The experience includes everything but the excruciating pain.
“This is the closest I’ve seen pharma come to understanding what a patient is going through,” Patel notes. The online videos were viewed 4 million times within a three-week period.
Indeed, capturing the authentic experiences of patients can be a powerful educational tool. At TBWA\WorldHealth, Holloway and colleagues created #BlackHealthNow, which features videos sharing “painful, personal and true stories from our colleagues as they discuss how being Black in America has impacted their access to quality healthcare.”
Launched during Black History Month in February 2020, the project has generated more than 50,000 livestream views, 2.1 million Twitter impressions and more than 35,000 video views. “It raised awareness among Black people regarding how they can advocate for their own health,” Holloway says.
As for what works best for healthcare organizations seeking to more authentically empathize with their audiences, Reichenberg stresses the need to know those audiences beyond the cold facts of their medical condition. “Find out what life is like for them,” she says. “Is it a long, complex, frustrating process to access their treatment? What emotional toll does the disease have on them? On their loved ones? Are they scared? Depressed? Like a method actor, I will soak up everything I can about this person and close my eyes and become them.”
Holloway says that “at a fundamental level, people just want to get better and feel better and manage their condition effectively.” And Whelan adds that healthcare organizations should strive to create marketing “that speaks to what people are thinking, feeling and doing.”
In the end, we return to Peabody and his widely quoted, diligently studied and forever relevant lecture. According to one scholar, Peabody’s take-home message is that “the effective physician needs to possess the virtue of compassion … backed up by a subsidiary virtue one might call empathic curiosity.”
When I imagine Peabody at the lectern I think of a grizzled eminence with tufts of white hair, a grainy voice and a slight stoop. The sadder truth is that Peabody died of cancer at the age of 45, just one year after his memorable lecture.
Somehow he found time to write an essay about his treatment, titled “Notes on the Effects of Morphine.” He completed it five days before he died. It was a parting gift to us, a fitting expression of empathy and love, for generations of patients to follow.