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'Living Proof' ads feature real patients, not actors, scripts

Ben Schmitt
| Monday, Aug. 29, 2016, 9:00 p.m.

They call it "Living Proof," the new, robust advertising campaign by Highmark Health and Allegheny Health Network stretching across platforms ranging from television and mobile devices to social media and digital billboards.

It's ambitious — 30 short stories delivered on television and online in 30 days.

Most viewers will probably find the 30-second spots emotional: In one sequence that aired last week, a man with Parkinson's disease shakes uncontrollably until a doctor activates electrodes implanted in the patient's brain. In another, a female patient cries as a cochlear implant restores her hearing.

Each ad ends with a social hashtag accompanying the words #LivingProof.

The goal, according to AHN Chief Executive Officer Cynthia Hundorfean, is to convey reality with patients and doctors filmed in unscripted scenarios. The commercials contain no actors.

"I think people are hungry to know and understand the kind of medical treatments available here in Pittsburgh," she told the Tribune-Review. "Showing patients and physicians in real time illustrates all of the great things we are doing throughout the system."

The strategy to saturate the market with medical-related ads is nothing new, locally or nationally. Rival health care giant UPMC's cross-platform ads are rampant in Western Pennsylvania.

The national health care industry spent $13.2 billion on advertising in 2014, according to Kantar Media. Last year, the figure rose to $13.6 billion, nearly a 20 percent increase from 2011. Highmark Health and AHN did not disclose how much they spent on current campaigns.

Still, ethicists and even some doctors cringe at the increase in health advertising and wonder whether the ads unfairly play to viewers' emotions.

"It's not surprising that we're seeing these personal stories," said Yael Schenker, assistant professor of medicine and director of palliative care research at University of Pittsburgh. "They're very persuasive. But are they coupled with true information that people need?"

Absolutely, said Cindy Donohoe, senior vice president of marketing for Highmark Health. She helped oversee the recent campaign designed by Doner, an ad agency headquartered in Southfield, Mich., a Detroit suburb. The agency operates with a slogan, "Ideas that move people."

"We really wanted to bring the campaign to life to help explain what patient-centered quality means," Donohoe said. "What better way than actions and qualities that prove that a fact is true? We are showing what quality means, in the moment, in action."

Schenker studied advertisements for cancer centers in 2014, concluding that "common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions and society."

Schenker worked with Alex John London, a philosophy professor and director of Carnegie Mellon University's Center for Ethics and Policy. The findings were published in 2014 in the Annals of Internal Medicine.

London shared Schenker's concerns.

"Advertising that primes patients to want particular treatments or to expect rosy outcomes may make it more difficult for clinicians to actually help people make good medical decisions," London said. "There is a real potential for conflict here between the institution's profit motive and their responsibility to act in the interest of patients and help them make the best medical decision for their particular situation."

After viewing several of the AHN television spots, London complimented them as compelling stories of redemption through medical care.

"For patients with conditions similar to those of the people profiled, the narrative portrays what anyone would want — a largely complication-free encounter that brings about cure, remission or symptom control," London said. "There is little mention of treatment risks, potential side effects or how typical the profiled case really is."

AHN's Hundorfean, who arrived in Pittsburgh this year from the Cleveland Clinic, said the new advertisements are believable "because they are true."

"You have to be careful about not stretching out what you are capable of doing, and we are going to do that," she said.

Prescription drug advertisements are regulated by the Food and Drug Administration; health care ads are not. For prescriptions, manufacturers can advertise their drugs only for the disease for which they received federal approval, and they are required to list risks and side effects. Those are often done in speed voice or as quick flashes of small text at the bottom of the television screen.

For health care ads, in general, "it's hard to find evidence there is any rigorous oversight," Schenker said. "Basically, these ads are in the same classification as cars, cereal and other things."

Marketing experts contend the evolution of medical advertising is a natural reaction to consumers' ability to select places to receive treatment.

"Companies are trying to distinguish themselves from the competition," said Pete Spender, Doner's brand leadership director. "People's expectations of what health care systems should be have changed."

Pittsburgh is a hotbed of health care competition with AHN and Highmark locked in a battle for patients with UPMC.

Spender, whose agency helped conceptualize AHN's and Highmark Health's Living Proof concept, has worked in advertising for 25 years.

"This is one of the most exciting, ambitious and out-of-the-box campaigns I have seen us do and have been privileged to be a part of," he said. "It's dramatic and impactful and cannot be missed."

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