Working with the creative team on a promotional piece

A promotional piece in a medical communication agency is made by medical writers working with art directors and designers, and the piece depends on how that partnership works: why agencies pair them, the relationship and the creative brief they align on, the scientific and regulatory guardrails the story stays within and the committee that reviews it, how a brainstorm is run, and the emotion the piece carries.

The creative team's place in medical communication

Pairing writers with art directors has an advertising pedigree. ¹ In the late 1950s Bill Bernbach, founder of DDB, integrated copywriters with art directors as a team. ¹ Because the approach worked undeniably well, other agencies gradually followed, and by 2021 most advertising agency creative departments in the world comprised such cross-functional teams. ¹ Medical communication agencies have by and large followed too, with writers, art directors and designers as the core team that ideates and produces every piece according to the brand's strategic imperatives and the client's direction. ¹ The client service team makes sure both are followed. ¹ In some agencies the creative team sits under shared services, as an editorial department does; in others each account has its own creative steward, which resembles the closer relationship Bernbach proposed and lets writers and art directors work together throughout a brand's trajectory. ¹

More than a year and a half into the COVID-19 pandemic, with congresses cancelled and personal interactions confined to the virtual environment, promotional medical education had elevated digital tools and channels, creating an appetite for more involvement of creative teams in medical communication. ² Art directors and designers migrated in large numbers from consumer agencies, which advertise products outside health care, to medical communication, bringing a fresh perspective into the industry's sea of sameness. ² Their growing presence created new working dynamics for medical writers, whose scientific background tends to give them a greater focus on pure science than on creative elements such as visuals and engagement tools. ² These changes pushed many medical writers to ask how best to work with creative teams, how to get the best of two such distinct trainings, and how to stir each other's motivation towards the most compelling piece for the client while ensuring scientific accuracy. ² The incoming creative teams have also given medical writers a new opportunity to explore new approaches to storytelling and visual engagement. ³

The relationship and the creative brief

A good pharmaceutical promotional piece is an amalgam of a relatable narrative and agreeable visuals, resulting from a highly synergistic relationship among medical writers, art directors and designers. ^{1, 4} When it comes to innovation and creativity, a collaborative relationship increases the likelihood of producing a piece that touches the lives of its audience in a memorable way. ^{1, 4} Aspects of the partnership that have been shown to increase those chances include respectful communication, alignment on the brief, mutual encouragement, and lay language in discussions and brainstorming sessions. ⁴ Building a synergistic relationship between the medical and creative departments is imperative to bring differentiation and excellence to the industry. ³

Whether the creative team sits under shared services or with each account, a solid relationship between the medical and creative teams is one of the indispensable ingredients of a memorable piece. ¹ Its basics are the same as in any human interaction: listen to each other, respect each other's point of view, and do not expect the other to be perfect, since nobody is. ¹ Some could argue that these basics do not always come easily, especially because moments of intense creativity can drive people to submerge in their own experiences and emotions. ¹ At other times the disconnect may come from each department's training, which may bring mismatched creative repertoires to the surface when the two brainstorm narratives and visuals together. ¹ One approach to overcoming these challenges is to turn the team's attention to the client's interests and the brand's success. ¹ Although challenging each other may feel uncomfortable at times, emerging from a brainstorm for a few moments to realign on the client's interests reminds the team to keep the conversation respectful and on the brand's strategic imperatives. ¹

It is essential that the medical and creative teams inspire each other daily. ⁵ The medical side brings deep knowledge of the data and the creative side crafts evocative expressions of it, and when the two inspire each other, the work is strong. ⁵ Neither team should show any disagreement in meetings with the broader team of account, project management, editorial and strategy. ⁵ Both teams need to reach internal alignment before sharing their proposals with other departments, to avoid undermining their credibility with the team. ⁵ When creating an innovative piece, the medical and creative teams should weave into each other and become a fort with a grounded understanding of the brand. ⁵

Another key approach to the partnership is alignment on the creative brief, the document that outlines a project's strategy. ¹ It contains the project's purpose, audience, messaging, scope of work, timeline and other key information that helps every member of the team understand the piece they will develop, and it can be altered if the objectives or the scope change. ¹ A creative brief covers this key information: ¹

• Company requestor
• Project description
• Objective
• Audience
• Unmet need
• Desired response
• Project overview
• Creative approach
• Project scope
• Constraints and assumptions
• Timeline
• Success criteria
• Budget

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The problem the brief sets has to be clear to both the medical and the creative team before their initial conversations and brainstorming sessions. ¹ This is a critical step for a medical communication agency, because most art directors there have no scientific training, whereas in a consumer agency the copywriter and the art director tend to have similar backgrounds. ¹ A good way to bring the whole team to the same starting point when discussing a brief is to present the project's problem or unmet need in lay terms. ¹ It is reasonable for the medical, creative and client services teams to write the creative brief for each project together. ¹ Joining brand strategy, which also reflects company strategy, with solid scientific evidence, and translating the problem the brief sets into approachable language, can enhance innovation and lead to a much more productive relationship between the medical and creative teams. ¹

Scientific and regulatory guardrails

Creative teams from consumer agencies are known for nurturing powerful storytelling in pieces that face fewer guardrails than medical communication does. ⁶ Robust storytelling is critical to the success of a promotional medical piece, but ensuring scientific accuracy and avoiding misbranding are also key to complying with the ethical paradigms of medical communication and with the regulations of the US Food and Drug Administration (FDA). ^{6, 4} The partnership between the medical and creative teams therefore combines freedom of creation with regulatory and scientific guardrails, and it requires a strong sense of respect for each other's views and expertise. ^{4, 5} When medical writers and creative teams develop a promotional piece together, they must make sure that every claim is appropriately supported and that every comparison is derived from head-to-head studies. ⁶ In crafting the narrative, it is indispensable to account for fair balance throughout the piece: for example, a section that alludes to the overall response rate after use of a medication needs to depict the safety data in the same section. ⁶

Because certifying that every promotional piece complies with FDA guidelines is important, a promotional review committee of representatives from the pharmaceutical company's medical, legal and regulatory (MLR) departments is charged with ensuring that materials are fairly balanced and meet function-specific standards while achieving marketing's goals. ⁶ Each representative on the committee has specific responsibilities and characteristics: ⁶

• Medical representative: someone with an MD, PharmD, PhD or other advanced degree, responsible for critically evaluating material for scientific and medical validity and consistency with the FDA-approved labelling.
• Legal representative: an attorney with a JD degree, responsible for advising on legal risk by broadly reviewing materials for compliance with federal and state laws and industry codes and guidance, with expertise in copyright and trademarks, fraud and abuse, and anti-kickback issues.
• Regulatory representative: someone who generally has an advanced degree in the sciences or health care and acts as the representative in interactions with the FDA or its Office of Prescription Drug Promotion, responsible for ensuring that the material complies with all applicable FDA laws and regulations on drug promotion.

^{7, 8, 9, 6}

Brainstorming

Account services is the department that ensures the client's needs are met accurately and on time. ^{10, 5} Once the medical, creative and account services teams are aligned on the creative brief and have identified the project's key aspects, such as the unmet needs, the chosen tactic, the timeline and the supporting scientific data, it is time to let the creativity flow. ^{10, 5} Creative teams are more familiar than medical writers with the techniques that boost the production of ideas for narratives and visuals, but the medical team has a critical role in shepherding brainstorming sessions to ensure both scientific accuracy and compliance with FDA guidance. ⁵

As a rule of thumb, the medical and creative teams should follow the classic recommendation for brainstorming sessions in their everyday interactions: never use the word no. ⁵ In a brainstorm, avoiding the word keeps any idea from being ruled out, because at that early stage of development every idea should be received positively. ⁵ The word no also tends to make people unwilling to participate and to cause negative emotions overall. ⁵ Instead of saying no, a team member can modulate their tone of voice to make clear they are unconvinced. ⁵ It is crucial to avoid long debates: rather than spending minutes or hours trying to kill each other's suggestions, it is preferable to use the time to put forward new ideas. ⁵

Several discussion techniques optimise the partnership during brainstorming sessions, each pairing what one team member wants to say about an idea with how to say it: ^{5, 11}

• Acceptable, but we can do better: "Good."
• Follows the strategic imperatives but is not very interesting: "Yes, that works", in a neutral tone of voice.
• Something interesting that does not work: "Good — let's develop this idea a bit more."
• Off-brief and not interesting at all: "I see", in a neutral tone of voice.
• Terribly off-brief: "Can you say that one more time?"
• A very boring idea: "OK."
• Terribly off-brief, boring and uninspiring: "How about a coffee break?"

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Emotion in a promotional piece

Health care providers, the audience for HCP-focused branded and unbranded promotional pieces, have been overwhelmed with content and messages from an increasing number of stakeholders through numerous channels, and this reality demands unprecedented outputs. ¹³ One agency director holds that cutting through that noise starts with a big idea and requires clarity, originality, consistency and stand-out design in its execution, and that the fundamentals of creativity have never been so important. ¹³ In the same director's view, great creative work delivers an instant understanding of the problem and the solution on both an emotional and a rational level. ¹³

When handling medical content, it seems natural to keep emotion at a distance, as most physicians do. ¹³ Physicians are taught to remain detached from emotion to maintain the objectivity considered crucial to accurate clinical decision-making. ¹³ Yet emotions are already highly present in the patient–physician relationship. ¹³ Jodi Halpern argues in From Detached Concern to Empathy: Humanizing Medical Practice that emotions should be recognised and used constructively in the service of empathy, and that critical clinical decision-making and diagnosis depend not on emotional distance but on emotional engagement that gives the physician a deeper understanding of, and insight into, the patient's experience of illness. ¹³

Emotional connection can likewise be used to innovate in promotional medical education pieces. ¹³ Making room for emotions provides a sense of identity and genuineness, and emotions create a bridge for health care providers to connect with their patients on a human level. ¹³ Some perceive an emotional connection between a promotional piece and its audience with skepticism, but it is a powerful storytelling resource that should be explored whenever applicable and executed according to FDA regulations. ¹³ Tapping into emotions creates a memorable learning experience and gives the audience a chance to relate to the patients they treat. ¹³ Technology can help create a highly engaging piece that catches the audience's eye, but that does not necessarily make the experience memorable. ¹³ A conference booth with an interactive game can be an enjoyable pause from long and tedious presentations, but if it creates no emotional connection, its audience will likely turn its back once the activity is over and soon forget the core messages, if not the product altogether. ¹³ Exploring genuine and relatable emotions in a piece requires complete alignment between the medical and creative teams and enthusiasm for working together. ¹³ Anything less than a solid alliance will likely not tap into real emotions, and so will not result in a memorable, innovative piece. ¹³