A few years ago, I had a procedure done in a doctor’s office in which a small camera at the end of a tube was inserted into my body for the purpose of observing the inside of my bladder (you can imagine through which aperture.) I have never been so terrified in my life. I was trembling and could not stop . I was out of my mind with anxiety.
A nurse stood next to me where I lay and held my hand. She patted my head. She rubbed my chest. I held her hand with my two hands and put my cheek on her hand so she wouldn’t pull away, holding it for dear life.
“You’re gong to be fine,” she kept saying. “Shh…” she said, stroking my forehead. She spoke to me in such a way that she recognized my fear without embarrassing me..
When it was over, she got me up off the table, and walked me naked across the floor. She sat me down on a chair where I continued to shake. She got me a paper cup of water and held it up to my lips and tipped the cup gently so I could drink. She handed me my clothes, but I couldn’t put them on. My body was rigid with anxiety. She dressed me, helped me stand and balanced me with concentrated watchfulness.
Year after year, nurses are deemed the most trusted professionals in the world. Perhaps because they watch, and listen, and minister, and are not selling anything except care and thoughtful attentiveness. I never knew my nurse’s name, but to this day I can see her face and hear her voice. To me she was an angel of mercy, and I’m sure she is still out there like an angel, ministering with unflinching tenderness to wimps like me.
As a student of human communication, and the president of a small New Jersey consulting firm, I am interested in the behaviors that create trust, because much of leadership, salesmanship, and interpersonal influence depend on the communicator creating trust with her listeners. While year after year nurses are rated as the most trusted of all professions, the pharmaceutical industry is about as trusted a Big Oil, Big Tobacco, and Big Government
Lance Armstrong is alive today thanks to pharma. Magic Johnson is alive today thanks to pharma. My neighbors Donna, and Lucy are alive today thanks to pharma. Bob and Liddy Dole are enjoying themselves, thanks to pharma. For these people, and millions of others, the pharmaceutical industry has been a savior. Its remarkable rise to power during the last half of the 20th Century is paralleled only by the meteoric rise of the personal computer and the internet. A staggering number of people alive today owe their lives to the medicines developed and distributed by pharma. The industry not only saves lives: It improves the quality of life for many chronically ill people, provides millions of high paying jobs, and leads the way to new discoveries that will benefit future generations. Pharma is a savior—day after day.
But then why is pharma named in survey after survey as one of the least trusted industries in the country? And what can the industry do to regain the trust it has lost?
Charles Green and Andrea Howe of Trusted Advisor Associates may have the key ingredients pharma needs. They offer a Trust Equation, which goes like this.
Trust = Credibility + Reliability + Intimacy Self-InterestLet’s test the equation. Does pharma have a high degree of credibility? I would say that it does. It is a hugely successful industry on which millions of people rely for their health and well-being. The industry may have its detractors, but name me an industry that doesn’t.
Is pharma reliable? Yes, 99% of the time their products are manufactured and distributed in a safe manner, and people are well-informed of the side effects. Occasionally there have been cases in which new drugs, which have been tested in a relatively small group of patients, will produce side-effects in the broader patient population that were not seen in the clinical trials. And some companies have hidden from the authorities and the public the dangerous side effects caused by their products, and they have been fined for their criminal and unethical behavior. But for the most part, pharma is extremely reliable and under close scrutiny.
Does pharma create a sense of intimacy with its customers–doctors, patients, and payers? Yes and no. Pharma reps can become trusted advisors to the doctors they call on, but since they are compensated for selling their companies’ products, and they often change territories, the likelihood of a sales rep being able to ascend to the exalted role of trusted advisor is small.
Can pharma become intimate with patients? Yes and no. Many companies provide outreach to patient groups, providing them with resources so that they can lobby health authorities for access to new drugs. They create special websites where patients can get information about their disease, and they strive to make sure that patients take their meds in the prescribed way. I also know that the people within pharma who have these jobs are sincere in their desire to help. But the industry and the individual companies remain monolithic entities, bureaucratic and bound by the need to meet quarterly earnings goals.
Is pharma intimate with payers, the insurance companies and health authorities that purchase the bulk of their products? The answer is no. The two parties are at war with one another over the price of drugs, which is as it should be. Currently, pharma is striving to move the negotiation away from price and focus it on the value that the products create.
Finally, let’s talk about self-interest, the denominator of the equation, and therefore the most powerful element. Trusted Advisor Associates teaches that to be trusted, one needs to have a low degree of self-interest, to put the interests of the other party first, to do well by doing good. Does pharma do this?
It tries. It creates the drugs that help people, but it needs massive amounts of money to develop and market the products, and the tension between the piles of money they demand and the compassion that drives their work is contradictory and hard to hold in one’s mind.
Having been around pharma as a communication consultant for 20 years, I’d say the opportunity lies in the area of intimacy. The general public does not know what goes on inside the industry, or how things are done and why.
More than outreach to patient groups, pharma needs to tell its story so that all of us can come to know and trust it. It will never be trusted like a nurse, but any effort to explain how and why the industry operates should yield, drop by drop, a healthy and increased dose of trust.