In healthcare, separating perception from reality is like trying to untie the Gordian knot
There is a quiet elegance about the number 4. The four seasons, four directions, the quatrain (a verse of poetry with four lines), the four corners of a square, the four-leaf clover (a symbol of luck in some cultures), the four elements (air, fire, earth, and water), the four faces of Brahma in Hinduism, and the four gospels of the New Testament.
In many cultures, the number 4 had myth-like qualities. The Egyptians, for example, always drew honeybees in their hieroglyphs with four instead of six legs. This was despite knowing physically that they had six legs. The number 4 even became the subject of a paper republished in the National Library of Medicine, apart from several stories.
So, let’s talk about four stories.
In the opening chapter of his book ‘Homo Deus: A Brief History of Tomorrow’ – Yuval Noah Harari outlines the evolution of medicine and healthcare: the expansion of life-saving medicines, therapies, and medical miracles. He peppers his narrative with statistics; for example, in 2014, The Global Burden of Disease Report showed that more than 2.1 billion people were overweight, compared to 850 million who were malnourished.
Global child mortality is less than 5 percent, thanks in large part to vaccinations, antibiotics, improved hygiene, and a robust medical infrastructure. But, Harari says, the ‘flagship enterprise’ of modern life sciences is ‘to defeat death and grant humankind eternal youth.’ In the 20th century, life expectancy nearly doubled from 40 to 70 years. In the 21st century, given the rapid advancements in medical technology, it could more than double to 150 years. As Harari says, death is not an inevitable end but a technical problem to be solved.
Why, then, despite all these advancements, is the field of medicine still suspect?
Our second story is about the publicity bonanza that is created when celebrities become the best illustration for medicine. The sudden, rapid weight loss among a number of popular Bollywood celebrities – to be fair, it did originate in Hollywood – who looked better, fitter, and seemingly healthier brewed a storm of interest in Ozempic, followed by the interest in Mounjaro both meant for treating diabetes and obesity.
Following the celebrities, other socially popular people – the rich and wealthy – started to try it as well. For weeks on end, the entertainment pages focused on how good their favorite stars looked. Despite regulatory restrictions on the use of brand names when it came to medicines, Ozempic became a byword through most of urban India.
Studies comparing the weight-loss effects of Ozempic with that of Mounjaro found that patients using the latter lost more weight. One study, in particular, that used a statistical technique called ‘propensity matching’ found that after 1 year, participants who were prescribed Mounjaro lost more weight: 15 percent to Ozempic’s 8 percent. You can also watch the video explaining that study here.
Here’s a question: Why, then, is Ozempic more well-known?
The latest buzz in medicine is around the technologies – from wearables to complex scanners, linear accelerators, and other diagnostics or therapeutic equipment – and how they make the patient experience better. In his book ‘The Patient Will See You Now,’ Eric Topol, a leading voice in American medicine, asserts that we are entering an era where smartphones can provide blood test results from a mere drop of blood and monitor vital signs through artificial intelligence without necessitating a doctor's visit. Medicine is being digitized and democratized; diagnostic tasks traditionally performed by physicians are now being handled by computers equipped with vast data analytics capabilities that can be mined to find cures for many diseases that seemed incurable up to now.
But how great is our awareness of these technologies as patients? Do we trust them, or would we rather see a doctor in person?
Let’s look at visits to doctors in India. According to a report by Praxis Global Alliance, a management consulting firm, in FY21, there were 4 billion visits, or around 3.5 visits per year, per person. Now contrast that with health-related Google searches, which experts estimate at 5 percent of all searches, or over 182 billion a year, though Google says this is an estimate, not an exact number. Most of the questions pertain to disease information, fitness and well-being, and chronic disease management, according to Statista, the data warehousing and research firm. There are also questions about misinformation searches for doctor and hospital reviews and recommendations.
Surveys try to capture the reputation of companies; the Reputation Institute’s Global RepTrak 100|2024 ranks only three healthcare companies in the top 100 global companies: Lilly at 71, Roche at 79, and Abbott at 88. The Axios-Harris Poll 2024 Reputation Quotient Rankings list 4: Novo Nordisk at 28, Bayer at 38, Pfizer at 66, and J&J at 73. Last but not least, Gallup’s Business and Industry Rankings give healthcare a net score of (-20), which is the difference between total positive and total negative ratings through a poll.
Which brings us back to the same question: despite all the phenomenally great work done by the healthcare industry and its various segments, why do most healthcare firms get a bad reputation? Or is it that their reputation is badly managed? Are they doing things right? Are they doing the right things?
There are no simple answers. Those engaged in the reputation management business will have to search for or discover them.