🥀 Charity Dean's Fake Flowers
And marketing for appearances' sake
Hello all,
I know: it’s been a while since I’ve written. Actually, I have been writing nonstop, but most of that has been on behalf of clients.
About a year ago, this newsletter arguably led to my first marketing client, and then arguably to a second, and now it seems my decade working for physicians groups is catching up with me: past colleagues are becoming clients and referring new business, and current clients are expanding and referring more. That’s all great, plus I love my clients—they know healthcare is messed up better than anyone, and that’s a lot of what I had been writing about here (and, it’s arguably what motivates them to build and grow their businesses).
So, now I plan to keep writing about that, but also share my current thinking on healthcare marketing, which I promise will be worth your while if you’re at all interested in marketing (I hate all the pure fluff that’s out there). With so much money currently pouring into healthcare and so much disruption, there are a great many healthcare groups for whom this stuff is suddenly quite essential. If that’s you: my consulting page is here.
Anyway, to the newsletter:
🥀 Charity Dean’s fake flowers (and Michael Lewis’ The Premonition)
There is no shortage of writing about what we might learn from the U.S. pandemic response (or, more likely, fail to learn). If you’re into this depressing genre, for my money I recommend Michael Lewis’ latest, The Premonition.
The hero is a public health official named Charity Dean. Toward the end of the book, Lewis explains that when Dean was 24-years-old and newly married she had a porch in New Orleans on which she tried to imitate her mother’s skill as a homemaker by adorning it with flowers. Tons and tons of flowers. It was so lush and beautiful that soon her neighbors came to admire and smell them.
Soon, however, they began to wilt. Charity Dean in fact was not a good homemaker, and the flowers were not getting enough sunlight—but also Dean didn’t have the time to tend to them—but also she didn’t want to disappoint the neighborhood by letting them all wilt and die. In short, Dean wanted to keep up appearances. So, naturally, she started buying fake flowers.
For months after, she was able to maintain the illusion that the flowers on her porch were real. But she had to be careful not to let her neighbors get too close. She had to distract them before they had a chance to inspect the fake flowers or smell them too closely, lest the illusion crumble. Until, one day, a neighbor did get close, did smell, and then it dawned on him: Charity Dean’s flowers were all fake.
🏥 The rot the pandemic exposed
Spoiler alert: Charity Dean’s fake flowers are the animating metaphor for the entire book. The point is that there was (and still is) a rot within America’s public health “system,” if it could be called a system at all. Especially, there is a rot at the CDC. I won’t trouble you with the whole summary of Lewis’ book—you should read it yourself—but I can say that everywhere I look now I see this rot.
Here, for example, is Scott Alexander on the rot at the FDA, which he chronicles in a long and maddening piece, Adumbrations Of Aducanumab. We already know about the FDA’s practically criminal failure to allow the country’s many independent labs to start testing early in the pandemic. But there is so, so much more, he writes:
I worry that people are going to come away from this with some conclusion like “wow, the FDA seemed really unprepared to handle COVID.” No. It’s not that specific. Every single thing the FDA does is like this. Every single hour of every single day the FDA does things exactly this stupid and destructive, and the only reason you never hear about the others is because they’re about some disease with a name like Schmoe’s Syndrome and a few hundred cases nationwide instead of something big and media-worthy like coronavirus. I am a doctor and sometimes I have to deal with the Schmoe’s Syndromes of the world and every f@$king time there is some story about the FDA doing something exactly this awful and counterproductive.
Ouch.
Read the whole piece for his examples—the most recent motivating one being the FDA’s approval of aducanumab, an Alzheimer’s drug that doesn’t appear to do anything for Alzheimer’s patients. So why approve it? Well, it appears that the FDA did it primarily for the sake of appearances.
😎 Marketing for appearances
To be sure, we humans do a lot of things for appearances, and always have—there are a lot of fake flowers in American life. Marketing is no exception. I see it in the institutional incentives of marketing departments to focus on all the wrong things: vanity metrics, ego-satisfying PR wins or industry awards, misguided measures of so-called influence.
But here’s the thing: if we’re honest, we must admit that appearances really can matter. If entire countries will go to war merely in order to save face, then we may forgive the PR department for submitting a nomination to get on some “best of” list, even if it is merely to stroke an executive’s ego.
Appearances matter because they often, in the end, lead to substance. A march on behalf of a cause is the definition of symbolic action: and sometimes those symbolic actions really do change things. And winning symbolic industry awards really can have a follow-on effect of strengthening a brand. The whole point of branding is to look after the sum total of how a company appears to outsiders.
Of course, all of this marketing (or acting) for appearances’ sake can go too far. Just like public health guidance issued for appearance’s sake can really backfire if the reality ends up too different, marketing that is too divorced from reality will come back to bite you—after all, one of the worst things you can be in America is a hypocrite (See Newsom, Gavin).
Thus, if you’re a business trying to do marketing, I advise you not to go buy fake flowers; but rather decide what flowers you are actually capable of caring for in the long term.