National debates -- like healthcare and financial reform -- tend to focus on the big concepts, big ideas, and big solutions. What gets lost, unfortunately are all the small, cumulative causes of the original problem.
That's unfortunate because the causes are too often tied to our own behavior and choices. Choices that are too often tied to flawed thinking, which is influenced by (more than we'd like to admit) PR.
Take this latest news from the PR front (via O'Dwyer's/subscription required). Facial plastic surgeons are looking to hire a PR firm to give their image a facelift:
The American Academy of Facial Plastic and Reconstructive Surgery is looking for a PR firm to handle its $11K a-month budget to promote its specialty within organized medicine. The 2,800-member group is circulating an RFP to generate positive media coverage in 'health and beauty venues.
The AAFPRS wants a PR firm to develop story 'hooks,' pitch ideas, promote meetings, arrange a media tour/day in New York City with at least eight interviews for the national beauty/health print and broadcast media.
OK ladies. (84% of facial plastic surgery patients are women). Expect to see lots of inspiring stories in the next 6 to 12 months about successful surgeries that helped so many people live more fulfilling lives.
Expect to see heartwarming stories of service men and women returning from the Middle East who received (truly) needed reconstructions. The home page of the AAFPRS website features the organization's "Faces of Honor" program, offering subsidized treatment for those coming home from war.
There's Nothing Wrong With That
First: The AAFPRS "Faces of Honor" program is admirable and deserving of support. Only a heartless fool would claim otherwise.
And yes, just like any other businesspeople, plastic surgeons should be free to market themselves.
And yes again, their credentials are indeed impressive. The focus of the campaign is the extent of AAFPRS members' training -- i.e., according to the group, its members are "equipped with 'more comprehensive training in facial surgery' [face, head and neck] than other doctors who deal with the whole body."
And yes, furthermore, their clients should be free to pursue smaller noses, fuller lips, pinned back ears, or deeper eyelid creases, any and all efforts at self-improvement. (If one wants to categorize it as such.)
All wonderful. All true.
Does This Look Like You?
But there are other dimensions of truth to be considered.
The biggest one is that plastic surgery, like any business, has a product to sell. And according to the group's own statistics (download PDF), plastic surgeons are primarily selling to white women between 35 and 60 -- almost half of whom (48%) are repeat customers.
There are also some truly... um... "interesting" categories among the group's patient trends -- categories noteworthy enough to call out in their study:
- "cosmetic surgeries to remain competitive in the workplace" (someone call Oprah!)
- "teens undergoing cosmetic surgery" (someone call Child Services!)
- "plastic surgery as a gift" (is that supposed to be a compliment?)
- "mothers/daughters undergoing plastic surgery together" (someone call Maury Povich!)
The vast majority of patients are not war veterans. The vast majority are not horribly congenitally disfigured. The vast majority are not accident victims in need of life-saving treatment.
All those extreme -- and in some cases truly heartbreaking -- stories paraded before you in the media are put out there with a deliberate purpose: to make you think of plastic surgeons in the kind of heroic, safe, empowering way that encourages you to: 1) trust them, and 2) open your purses to shell out thousands of dollars, all while feeling positively WONDERFUL about it!
In short: it's PR. It's a sales tool.
And strictly from a commercial point of view, that kind of marketing program is a failure if it doesn't sell the product. In this case, if it doesn't get you into the doctor's office and into a treatment chair, or onto a table with an I.V. in your arm. Assuming you're predisposed to doing so. (Not that there's anything wrong with that, mind you. If you got the money and you want it, more power to you. Make sure you pick a good one.)
But What's The Long-Term Prognosis?
Effective PR has a kind of mind-bending quality to it. It sort of "softens you up" without your even realizing it. You see an inspiring story on Oprah one day. Then, a few weeks later you might see a story on the local news, or in the local paper. You start looking at yourself differently in the mirror. Then a friend twitters you about some awesome new product/procedure. (And she gets compensated for "word of mouth marketing.") And one day you get a coupon in the mail and figure, "What the heck. Those wrinkles do make me look kinda old."
"And you know what... my house could use a sprucing up. All the papers say that my house is my best investment. And the market is on fire! A home equity line sounds like just the thing. And with my credit score so low I'm lucky they offered me such a great deal. So I might as well take a vacation, too, while I can get the cash... because you just have to get a ticket before prices go up!"
And that's how disasters happen.
We are more impressionable than we like to think. And PR people count on this slow drip-drip-drip of impressions to add up to a wholesale change in thinking.
The High Cost of Low-Brow Thinking
For example, take the topic of "healthcare." Our national debate isn't really about either. We're not talking about health-plus-care; the issue is really medicine-plus-insurance. There's a big difference.
Put it this way: You may think your thin eyelashes are a horrible curse that's ruining your life, but sorry, you don't need medicine. Even if there is a drug for it, as well as a celebrity spokesmodel to sell you on it. Really, it's a lifestyle, self-esteem thing.
And that's the problem.
Thanks to decades of whiz-bang PR, our perception of "healthcare" has become so skewed that it now occupies an entire constellation of important, urgent, and very emotional "quality of life" and self-esteem choices, to which the industry's ever-more-expensive products and services are indispensable.
Natasha Singer has a good piece in the NY Times on the trend toward the medicalization of everything:
Creating a blockbuster quality-of-life drug... sometimes requires a drug maker to create and market a whole new category of disease.
The template goes something like this: Start with a legitimate quality-of-life issue -- like fitful sleep or shyness -- that does not yet have its own prescription medication and is debilitating to a few people a lot of the time. Next, position the quality-of-life issue as a medical condition with symptoms so common it covers vast numbers of people who had previously not identified themselves as having a health problem, or who thought they were just experiencing an occasional and normal annoyance.
[emphasis added]
I Had Cancer... I Know "Healthcare"
As a cancer survivor, trust me, I know the reality of medicine-plus-insurance.
And from this experience I learned that "medicine-plus-insurance" is NOT the same thing as "caring for your health." The first is narrow, focused and often quite urgent. The second involves lifestyle choices, belief systems, and personal habits that have nothing to do with buying medicine or seeing doctors. (Paging Dr. Ornish!)
But these days we make all kinds of momentous decisions based on a warped, emotional, highly medicalized idea of "caring for your health" -- public policy decisions, national economic decisions, family decisions, and personal medical decisions. Our choices and solutions reflect our bias, recalling the old saw that "To a man with a hammer, everything looks like a nail."
Lots of things that could be solved without buying medicine or paying doctors have become co-opted as "healthcare" issues, overburdening the system, adding to the cost, and generally off-loading our sense of personal responsibility to a guy in a white coat offering an orange bottle full of pills.
Patient Heal Thyself
The root of the problem isn't that there's a cabal of corrupt healthcare evildoers out there seeking to control your mind. It's really just thousands of big companies and small medical businesses all trying to sell you stuff and eke out a profit. All pitching the same line, that "healthcare" is more about spending than doing.
And here, the important thing to understand is that their sales pitch only works if you think a certain way and see things in a certain way -- more specifically, THEIR way -- which leads you to pick them and their products over other choices. That's where PR comes in. As much as PR people hate the word, it really is "spin."
The basic reality is: if you don't believe in their "story" at some level, then you won't buy what they're selling, no matter what the magazine or TV advertisement says. So when it comes to the "healthcare" debate, or a whole lot of other debates on important issues, do yourself a favor and inoculate yourself with a radical old idea, updated for the modern era. Instead of "Buyer Beware," tell yourself this: "Believer Beware."
Constantly ask yourself: Who wants me to think this way, or see things this way and why? What do they get from my believing this picture they're painting for me and how do they benefit from the choices I make because I believe it?
It might be painful initially, but trust me; the treatment has unarguable long-term benefits.
cross posted at www.LiteralMayhem.com