fPatient – Ethics and Mediocrity in Healthcare Marketing

I’m not a fan of buzzwords: not only do they tire with time but they also constrict discussion and usually end up being the object of unimaginative and disconnected marketing efforts. In recent years, we have seen the emergence of the ePatient. And sure enough, we can now see that the term is beginning to be usurped by marketers. Of course, the ethics and effectiveness of that kind of marketing depends on the quality of execution.


A new service – which I won’t give direct attention-traction to by linking to its website here – promises to deliver revenues to healthcare organizations wishing to market to so-called ePatients. This service employs the use of a fictive patient named Sara Baker who even has a fictive Facebook profile. The bio on her profile (Page actually) discloses that she isn’t real but “represents healthcare consumers like you and me”. She is an fPatient.

Is that ethical? Is it an acceptable marketing practice to build a fake composite social object in order to facilitate the push for a product or service? There are differing opinions on that – some of which were raised on the weekly healthcare social media Twitter chat hcsm.

In my opinion, I think that the ethical standards for marketing healthcare ideas and products and services must be above board. Why? Because healthcare is a continuum, a stream, and when one part of the industry is tainted by fakery – no matter how seemingly insignificant – there’s always the chance that such fakery can leach into the stream.

One could argue that faux patients have been heavily used in traditional marketing: from billboard ads to television commercials. We perhaps can understand that kind of use given the limited nature of traditional media.

But when it comes to emerging media, especially the kind that allows conversation, it becomes critical that those conversations are honest and sincere and free of sham. That’s the key difference here: Sara isn’t conversing with consumers (someone else or some thing is) – and in spite of the tiny disclosure in her profile, there’s nothing in her stream to indicate that she’s not real – other than the fact that her status updates are droll and mechanical.


Which raises another question: Is the deployment of fake profiles in Healthcare Marketing even necessary? Marketing not only has to be effective, it also has to be respectable. Why create a fake social object when so much more social capital can be built by simply being honest and truthful and direct? Why not take advantage of direct interaction and feedback?

Marketing in the 21st Century is evolving. The properties of emerging media are different from the properties of the unilateral mass communications media of TV, print and radio. Marketers who fail to understand those differences and invest in the time and resources to acquire the skills and proficiency for remarkable healthcare communications will eventually suffer a creative anemia.

Sara Baker can fool some people and maybe she’ll help her creators deliver some revenues to their clients. But she’s a mediocre and fake substitute for the hard work required to be remarkable in healthcare communications.

Healthcare Marketers: if you want to have a well-paying career in ten years, know that the cost of Dreck is rising. Fakery is Dreck. In today’s world, Dreck isn’t just bad copy or ugly creative design: it’s in poor social design and mediocrity of voice. Do you honestly want your name associated with Dreck?

You can debate and justify the ethics of using the fPatient ad nauseum but you’re better off investing your time in becoming fluent and proficient in conversational media. Otherwise, forget about social media. You still have some time left to benefit from traditional marketing: most of your customers probably aren’t using social media that much right now anyway. But time is running out.


The fPatient raises one final point here about labels and it’s very pertinent to the fPatient marketing.

It’s convenient to have a simple label to convey a message and make distinctions. When it comes to health care, however, language matters because how we use words influences how we think and feel and behave.

Let’s take two sentences to illustrate:

  1. “Tom is a schizophrenic.”
  2. “Tom has schizophrenia.”

By referring to Tom as a schizophrenic, his disorder is overlayed on his person. But Tom is a human being who happens to have a brain disorder. Tom isn’t his disorder. Such labeling can potentially influence how providers and others interact with him.

But by saying that Tom has schizophrenia, we are clearer in our language and aren’t confusing Tom with his disorder. Make sense?

So let’s extend this reasoning to ePatient. By referring to patients as ePatients, we encounter a similar problem of confusing the person with an aspect of their behavior.

When we say “Tom is an ePatient” what does that mean to a nurse or a doctor? If Sally is also an ePatient, does that mean a nurse should treat Tom and Sally the same with regard to their ePatiency (how’s that for a neologism)?

For when it comes to Tom’s and Sally’s use of online media and the way they speak for themselves, they can have different empowerment styles:

  1. “Tom uses various social media to acquire health care information and communicate with his providers.”
  2. “Sally scours PubMed for her healthcare information, prefers to communicate face-to-face with her providers and actively participates in online diabetes forums.”

That added layer of information is more useful to a provider: she has a better understanding of her patient’s behaviors.

How much value is there in telling a nurse or a doctor that Tom and Sally are ePatients? Perhaps some. But ultimately, providers need to know the specific and relevant characteristics of their patients. A general label probably doesn’t help much.

I’m glad that there are movements like the ePatient movement to raise awareness of the need for empowering patients. Patient empowerment is vital to health care. Responsible providers understand this.

But if words become objects in themselves and result in a new filing system, then they lose their value. Healthcare Marketers need to understand this.


As I said earlier: Marketing not only has to be effective: it has to be respectable.

When it comes to healthcare communications and marketing, anything less than professionalism and excellence and clarity is Dreck. Not only is it Dreck, it can be harmful: the farther away healthcare communicators are from patients, the easier it is to lose sight of the impact of their messages.

Language matters – no less in health care. Usurping words just because they’re in style may have some effect but in the long-run, marketing and communications require innovation and creativity, clarity and honesty.

Too often, Marketers opt for what appears to be the easy road. But in a world where people can talk back and retweet and take snapshots of your work, going down the easy road may turn out to be a nightmare journey.

If you use fakery to get your message out, don’t be surprised if your message gets drowned out by the sound of your competitor’s fans who adore and respect the real patients who love their products and services.

Let’s hear your thoughts!

Note: upcoming post will be on the uPatient: the Unempowered Patient. We need to have that conversation: there are more unempowered than empowered people in the world.

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  1. […] An eternal truth, with one exception: a proven concept without an audience might still need a gimmick. And perhaps all the discussion about these words comes down to the desire for a noble gimmick. Not an easy desire to satisfy. It’s a tenuous endeavor, a marketing problem really – one which can be brilliantly executed…sadly, more often botched. […]

  2. A great question!

    I can actually see some of the challenges in using Real patients – some practical and ethical issues that would have to be addressed, of course.

    In order for companies to be successful, they have to devote the right kinds of resources and passion and talent.

    That’s why I wouldn’t recommend companies do this kind of thing unless and until they fully understand the media, are willing to be utterly above-board ethically and have the resources to do it well.

    Thanks, Alicia!


  3. Phil – this is a great post. I’ve been watching this closely over the past few days.

    Perhaps this is a silly question, but why don’t they use REAL people or patients? Or is the good, the bad, and the ugly too powerful??

  4. Phil,
    I still hope write a post on this soon since I actually have met some readers who are confused by these pages and sites which claim to be “patient voices,” but are not. Not everyone who falls into the “ePatient” group is necessarily savvy. Folks go online for the first time ever just to find help with regard to their illness.

    Crazy thought: What if a company would hire some patients to help do social media in a transparent fashion? That might build trust.

  5. Thanks, Kelly

    I’m with you – I can understand using a composite character in traditional, non-conversational media. But to attempt to do it with emerging media just sounds strange.

    My view is: if a company (or agency) doesn’t have the interest or resources to commit to a conversational marketplace, it should just avoid new media until it does.

    And I know there will be people who say this isn’t unethical or a big deal – but the point is: it’s just lame, and shouldn’t become a standard of practice.


  6. Phil, I was re-reading this post since I missed the #hcsm & my head is spinning even faster than usual trying to figure things out. Thanks for the provacative discussion. Chats / Tweets are great too, but with a blog, we get a chance to reflect more & extend remarks.

    Jon, Just a thought on your last point: I have over 2600 Facebook “fans” and every one of them assumes when they fan my page that I am a real person. Whether the Sara page is proper or not, there are many “pages” of real folks who are not celebrity and do not represent any group or brand.

    You said, “The only people with pages are celebrities (of various levels of celebrity status). Beyond that, it’s groups of people, causes, common interests, and, yes, brands.” LOL, maybe thanks to my Facebook fans that will be coming true for me (developing group or brand, etc). However, it was certainly not the case for the first several months as I worked to earn fans and it’s not the case with the “pages” of many colleagues of mine who do similar work.


  7. Those are good questions – and yes, I do think this approach is a snooze.

    I just don’t see the pressing necessity for going this route anyway, regardless of the potential ethical issues.


  8. A couple of questions I would ask:

    1. What are the success measures for the profile?
    2. What were the business objectives? Is it tied to other initiatives?
    3. Is it just a test?

    The idea seems a little dull to me. *snooze* People talk to well recognized characters online all the time. Using an unrecognized “persona” that provides little value seems a little bit of a stretch for me.

    My 2 cents.

  9. This may be a little off topic, but I am interested in the growing Virtual Therapy space (this may not be the right term). Companies like Emmi Solutions are creating interactive media to engage patients—empowering them to take more active roles in their care.

    Personally and professionally (I’m a voice over artist), I think there’s a place for respectable and ethical on line help…..

  10. Jon

    It wasn’t a dig at your agency at all. Not by any means.

    It was just a question. And it’s still open 😉

  11. I’m not saying I love the idea, but also that it’s not the tremendous transgression that it’s been made out to be (not necessarily by you, but others for sure). It’s a marketing ploy that’s transparent. You might think it stinks, but that doesn’t mean that it’s somehow morally wrong.

    Not sure the dig at my agency or our advice was necessary, but since you asked, you can talk to any of our Fortune 100 clients or take a look at any of the hundreds of awards we’ve won in the past couple of years alone (including those that you only get for proving results) and I think you can get a pretty good of the type of advice we give and programs we create.


  12. I noted this before http://twitter.com/faisal_q/status/12882131661

    There might be a business case for Medseek to create Sara. Most MDs still think e-patients are a thorn rather than a rose for care continuity.

    With polished pharma ad bombardment, maybe Sara was created to target directly to those MDs to showcase the potential of what an e-patient could be rather than us onlookers?

  13. Hey, Lizzie…got your point about FTC. You’re likely right…nonetheless, at best it’s just a big, fat gray area. This sort of unpaid “character” makes it even more befuddling.

    At worst, it’s unethical and in poor taste.


  14. Thanks, Liz.

    Agree about this approach being counter-productive.

    Also, as thes kinds of approaches fail or backfire, it may affect adoption of emerging technologies that help patients and communication efforts in the C-suite.


  15. Phenomenal post Phil – the best you’ve written. And let’s call a spade a spade – the Epatient phenomenon must be reeled it. The characterization you refer to, i.e. labeling and overlay, is not only relevant but critical. Monetizing the epatient, where you are consulting as one or pretending to be one via advertising, ultimately runs counter to the goal that you are trying to achieve – a two way conversation between the provider and patient in order to optimize outcomes.

    I applaud you for this post.

    And I disagree with Daphne about FTC violations. I suspect she is barking up the wrong tree unnecessarily. Just my $.02.

  16. Thank you, Daphne!

    You raise some good questions.

    I too would be interested in FTC and FB TOS matters.


  17. Ok, so here’s my take on it. First, MedSeek sucks at judgment. Period. Appropriating a movement that is so important to so many people into a bald-faced transaction is offensive.

    Second, Sara Baker may be fake, but she’s got fake twins and a fake family, and that’s frankly fake-ly over-the-top freaky.

    Third, is the concept of an “epatient revenue center” really the message we want to be sending to provider organizations? Um…”we’re not much concerned about you as individuals or even as a movement, but we’re sure going to jump on the bandwagon if we can make a blatant buck off of you?”

    MedSeek needs a new strategy, one that combines fiscal goals with intelligence and compassion. Is that seriously too much to ask?

    Fourth, there’s some question about whether this campaign not only violates Facebook rules, but also FTC regulations. I can’t answer this concretely, yet, but am looking into it.

    Finally, MedSeek’s response to all of this was lame, and basically indicates they’re unconcerned, they don’t really care and they’re poor monitors of social conversations. And, that’s offensive, too. And, kind of stupid.

    Finally, finally…whether you agree or disagree, we all have our points to make based on both professional and personal experience. And, we’re allowed to make them. Hopefully, without rancor and with respect.

    Daphne Swancutt

  18. Sorry Jon, I think you missed the larger ponts I’m making here.

    It’s not necessary to use fakery. That’s just laziness.

    I hope that’s not the kind of approach your agency offers your clients.

    Is it?

  19. Phil,

    Great summary of the latest issues out there yet again. I do take issue with the “controversy” about this “fpatient” situation. As I mentioned in my comment on Healthblawg (who wrote about the same issue), I don’t see what the big deal is.

    I really have to admit, I don’t see the issue here. If this company was trying to play off Sara as real and hoping to lure you into hearing their marketing pitch, maybe I’d be bit bothered.

    This page clearly states that Sara isn’t real. There shouldn’t be a remote possibility that anyone viewing this page would think that she was. Why? First, the clear disclaimers, but second, it’s a page. It’s not even a profile. It’s a page. In other words, you don’t become friends with Sara, you “Like” her (previously “Became a Fan”). So, you should have a pretty good idea that this isn’t a person. The only people with pages are celebrities (of various levels of celebrity status). Beyond that, it’s groups of people, causes, common interests, and, yes, brands.

    This is nothing more and nothing less than a clever way to promote your company on Facebook. It’s not deceptive, it’s not misleading, it’s transparent and a unique way to advertise on Facebook. Frankly, with all the attention this issue has gotten, I’d say it’s working perfectly, no?

    Dose of Digital

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