Has industry co-opted patient engagement?

Here at Ethical Nag World Headquarters, I just figured out that it’s entirely possible I might have the concept of patient engagement all wrong.  Until recently, I accepted this basic definition, courtesy of the Center for Advancing Health:(1)

“Patient engagement: actions individuals must take to obtain the greatest benefit from the health care services available to them.”

Sounds good, right? As a heart attack survivor with ongoing cardiac issues, I really liked the idea that a whole bunch of us seem keenly interested in doing whatever it takes to obtain the greatest benefit from our health care services. In fact, many folks far above my pay grade maintain that engaged patients may just represent the future game changers of health care. Health IT strategy consultant Leonard Kish, for example, wrote in August that if patient engagement were a drug, it would be “the blockbuster drug of the century – and malpractice not to use it.”

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“Best book I’ve ever read!” Rave reviews for sale

A new restaurant opens nearby, and our favourite foodie blogger raves about it. We’re thinking of renovating the kitchen, so we seek out client feedback on local contractor websites. The performance run of a small indie play is held over because its word-of-mouth buzz goes viral on Twitter.

Thus lies the power of the good review.  Likewise, if others trash the restaurant, the contractor or the play, we can be equally influenced to stay away, too.

Reviews are powerful because, unlike old-style advertising, they offer some illusion of truth coming from real live people. But it turns out that a disturbing number of consumer reviews are bought and sold – just like everything else in marketing.   Continue reading

Sock puppetry, astroturfing, and the marketing ‘shill’ game

The American plastic surgery company called Lifestyle Lift allegedly ordered employees in 32 centres to post fake positive reviews online about their $5,000 quickie facelift procedure.  But last summer, New York Attorney General Andrew Cuomo stepped in, investigated the company for fraud, and ordered Lifestyle Lift to pay $300,000 in penalties (roughly equivalent to lunch money for the cosmetic surgeons).

The attorney general’s office said the case is believed to be the first in the U.S. addressing a form of ‘stealth marketing’ called astroturfing.

Astroturfing refers to political, advertising, or public relations campaigns that are formally planned by an organization or company, but designed to mask their true origins to create the impression of being spontaneous, popular “grassroots” behaviour. (The term refers to AstroTurf, a brand of synthetic carpeting designed to look like natural grass).  Astroturfing campaigns are widely considered by us PR types to be behind the growing trend towards noisy health care protests, town hall meetings, and the anti-plastic bag ban movement  in the U.S.

William Greider’s 1992 book, Who Will Tell the People, described a typical astroturf campaign run by Bonner & Associates in this way:

“It was a ‘boiler room’ operation with 300 phone lines and a sophisticated computer system, resembling the phone banks employed in election campaigns. Articulate young people sit in little booths every day, dialing around the country on a variety of public issues, searching for ‘white hat’ citizens who can be persuaded to endorse the political objectives of Mobil Oil, Dow Chemical, Miller Brewing, United States Tobacco Company, the Chemical Manufacturers Association, the Pharmaceutical Manufacturers Association and dozens of other clients.”  

In online astroturfing, employees like those at Lifestyle Lift pose as independent consumers to post positive web reviews about their own company.

Cuomo’s office said these phoney reviews

“ …constitute deceptive commercial practices, false advertising and fraudulent and illegal conduct under New York and federal consumer protection law.” 

Besides the cash penalty, Lifestyle Lift was ordered to stop publishing anonymous positive reviews online.

An astonishingly stupid press release issued by the company responded:

“Lifestyle Lift regrets that earlier third-party website content did not always properly reflect and acknowledge patient comments, or always admit the content was by Lifestyle Lift.”

I don’t know about you, but I do not think I would want my cosmetic surgery performed by somebody who is astonishingly stupid.  Continue reading