All the Wrong Things to Say to Patients – In One Direct Mail Postcard

The “junk mail” diaries

How much thought goes into a direct mail campaign? Not surprisingly, a lot of man-hours and effort goes into producing each and every piece of mail (junk or not) that winds up in a person’s mailbox. But what makes a successful postcard? And how do companies get their postcards past the trash bin and in front of clients’ eyes to make a call on it being successful? 

Watch the video on MedPage Today

Video transcript

Most people seem annoyed by what we call junk mail, that incessant mound of unsolicited fliers, brochures, and postcards arriving in our home mailboxes daily. Not me. I actually enjoy perusing sales pitches from plumbers, tree trimmers, home painters, and carpet steamers. It gives me a sense of what they’re thinking. Or, should I say, what they think their future customers are thinking.

Naturally, I’m especially interested in healthcare junk mail. I live about a mile from a major urban hospital campus, where apparently lots of people think I might soon need a knee replacement, an emergency room doctor, a prostatectomy, or help having a baby. So far I haven’t taken anyone up on any of these offers yet. Thankfully, I haven’t had the need yet. But there’s another reason: I don’t feel that anything received in the mail so far really speaks to me as a healthcare consumer.

What’s the big problem?

Let’s take this postcard as an example. It really impressed me, but mostly in the wrong ways. In a gesture of professional courtesy to the marketing person behind this piece, I’ve blurred out some details. To that marketing person’s credit, the postcard features a patient, her healthcare provider, and her testimonial to his clinical skills. Now, we all love the persuasive power of testimonials. However, this one is 150 words long printed in a six-point typeface. Really? 150 words? Lincoln’s Gettysburg address was only 271 words. The featured provider is a podiatrist. But the postcard may as well have been for an ophthalmologist, with a headline saying, “Can’t read this? See your eye doctor today!”

Secondly, although the podiatrist boasts one of the warmest smiles I’ve seen in a while, he’s wearing surgical scrubs. Do you know what people with serious health problems think when they see surgical scrubs? Consciously or subconsciously, they think scalpels, blood, stitches, dissected skin and muscle, wounds that might not heal for weeks, an inability to swim or golf or play tennis perhaps for months, and surgical scars that could last a lifetime. In this instance, the average reaction is worsened by the photographic image of the patient still in a hospital bed.

Look, I’m no dummy. I’m in the business of helping surgeons find patients. Surgery is the bread and butter of the healthcare profession. But surgery isn’t what patients are really looking for. For them, surgery is the means to the end. Patients go to surgeons for relief, for a healthier life, for a chance to feel better in the long run. To be convinced of a professional healer’s skills, they don’t need to watch a blood-and-guts video of the operation itself on a hospital website. Heck, they’re going to be asleep the whole time anyway. And they don’t need a sartorial reminder of the forceful bodily intrusion awaiting them at the hands of a stranger.

Making a mountain out of a molehill

Lest you think I’m picking nits, let’s move on to the two largest misfires of this mailer. Number one, the main message front and back is about avoiding amputation. Do you want to keep your legs? The postcard suggests a surgeon might have to cut one or both off if you have a red or swollen ulcer on a foot or leg; fever or flu-like symptoms accompanying any redness, swelling, or an ulcer on a lower limb; or you’ve developed any of these symptoms after having had a previous amputation.

All right — all this is clinically accurate. But consider that an estimated 185,000 amputations occur annually in the U.S. — that’s one-twentieth of one percent of the population. Foot and leg amputations are exceedingly rare. Cancer is roughly 10 times more prevalent. Why would you introduce yourself to an unknowing, unsuspecting lay person by putting “skin sore” and “amputation” in the same sentence? Isn’t that a bit like saying the words “chronic headaches” in the same breath as “glioblastoma,” or mentioning “persistent cough” and “small-cell lung cancer” to a patient you’ve yet to meet, let alone examine?

Yes, of course, people with advanced diabetes and certain vascular diseases can be at significant risk of amputation. But most are likely already under the watchful care of a nephrologist or other specialist. Why take the chance of spooking any of the other 99.95 percent of the masses? Why risk tainting yourself among the public as a self-serving alarmist?

My second major beef is about the most nuanced of unintentional messages. The patient’s testimonial reads: “I trusted everybody [providing care] and never questioned what they did or said.” Well now. How old-fashioned. In today’s internet and social media world, total deference to doctors and blind faith in the healthcare system are becoming as rare as two-headed snakes. Too many patients are reading too many online posts and reviews by other patients these days not to be more discerning. Not ask questions? Is that what this doctor wants from his patients? Probably not. Yet the photo even depicts him standing over his patient in what might be interpreted as a dominant manner, as unintentional as the pose may be.

Let’s apply common sense. Let’s focus less on process and more on goals. Let’s give the patient the leading role in the movie and illustrate him or her far beyond the hospital bed, enjoying a healthy, happy life. Let’s also do better than a cellphone snapshot. Sure, throw in a picture of the doc, but only in a smaller, supporting role. And above all, don’t expect me to digest paragraphs of fine print. I’ve got a stack of other junk mail I can’t wait to read.