Thought Leadership

In the next era of No Normal, the stakes will be higher

By Revive
posted Dec 4, 2020

Back in summer 2020, which feels like about 25 years ago, we started talking about the No Normal period we found ourselves in at the time. Everyone was asking: when will things go back to normal? Or, what will the new normal look like? Meanwhile, we were focused on what was happening at that moment, and what changes were likely to hang around post-COVID-19, permanently or semi-permanently. No Normal seems certain to last until a widely distributed vaccine takes hold and could stay around for years.

Now that we’ve all marinated in No Normal for six months, we are beginning to see the contours of flu season and a No Normal 2021 in front of us. Trust is the dominant and defining factor in the No Normal – trust in government, trust in vaccines, trust in hospitals and physicians, and the (lack of) trust providers have in health plans who help the entire system work financially.

There’s no need to dwell on the issue of trust in government – whatever your political persuasion, you believe public health has been politicized in a way we’ve never seen before in the U.S. The presidential election is not going to resolve that issue, rather it will simply shift the shoe to the other foot. This is incredibly important, yet I think we all realize that there is only so much the healthcare system can do to solve deeply rooted societal and political dysfunction.

Yet, there is a huge reason to dwell on trust in new COVID-19 vaccines and how those will be approved and distributed. Most people acknowledge that safe and effective vaccines will be the difference in a strong economy, safer nursing homes and hospitals and schools, and eventual herd immunity. That trust will begin with vaccine adoption by physicians, nurses, and other front-line healthcare workers. If the people who know the most about healthcare in any community are reticent about a vaccine, the ripple effect on patient confidence will be significant and negative. The healthcare system must embrace the COVID-19 vaccines for all Americans to embrace the vaccines, and there is a lot of work for us to get there. This may seem temporary in the No Normal, but odds are we will focus on this issue for 9-12 months.

This issue of trust in vaccines is so important that Revive recently completed bespoke research on the topic. In interviewing and surveying consumers, it’s clear skepticism in the safety and efficacy of the vaccine candidates is widespread. To make matters more challenging, consumers’ most trusted sources of information on the vaccine — their doctors — aren’t overflowing with confidence either.

Our research shows: 

  • Physicians and nurses hold the keys to vaccine adherence.
  • Doctors and nurses will be skeptical of the vaccine if they think it might be rushed.
  • Doctors won’t take well to any “requirements,” especially if they don’t believe the vaccine went through due process.
  • Even consumers who want to get the vaccine right away will delay if their physician thinks it’s fine for them to wait.

Trust in hospitals and physicians is another key element of the No Normal. The public’s relationship with healthcare providers has fundamentally changed during COVID-19. We saw when hospitals paused elective procedures, they also paused their business models and forfeited hundreds of billions in revenue and billions in profitability for the public good. Is there any comparable action any industry has taken in modern history? Not even close. 

At the same time, we must recognize the risks posed by the third, fourth, and even fifth waves of COVID-19. To date, hospitals have been (rightly) let off the hook when it comes to preparation for COVID-19’s assault in 2020 – the lack of PPE, ventilators, ICU beds, staff training, testing, data transparency, and any number of other issues. The industry’s heroism overwhelmed any doubts or criticism. And to be fair, it would be unreasonable to expect a high level of preparedness for a first-ever worldwide pandemic in the modern era.

Yet, the “pass” is unlikely to last forever. Unprecedented levels of public support will fall if there is another PPE shortage, or if care is rationed due to inadequate ventilators, or if elective surgeries become unavailable again. Hospitals got a pass the first time, but few organizations can excuse the failure to prepare for the same event twice. The first pandemic was unprecedented – the next disruption may be seen as preventable.

Trust in hospitals and physicians doesn’t stop there either. The healthcare system has forever been oriented around physicians, not consumers. Scheduling, billing, waiting rooms, every aspect of the healthcare system values the physician’s time over the consumer’s time, and the physician’s convenience first, second, and third. Nowhere was this clearer than telehealth and digital health experiences. The surge in telehealth usage was caused by two things – massive consumer demand fueled by the disruption in the usual access points, and desperation from physicians and hospitals to serve patients in new ways given the financial duress they were under in the depths of COVID-19’s first wave. The result? New revenue streams, satisfied consumers, and a new consumer-centric method of access for people who need care.

We can’t stop there. Consumers will trust a healthcare system that puts them first. They have also demonstrated they will consider alternatives when they don’t feel valued, respected, and safe. And that’s where trust can enable a new set of competitors if hospitals and physicians aren’t careful. After all, if we let the camel’s nose under the tent, someday soon, there will be an entire camel in there with us.

COVID-19-driven disruption is playing right into the hands of the new entrants, particularly those retail giants and health plans who are suddenly focused on new and improved access to digital and in-person healthcare for consumers. This COVID-19-driven disruption drives demand for virtual care, retail pricing, increased reliance on the home setting, and a new urgency around consumerism. All these factors are holding providers back while simultaneously giving serious tailwinds to competitive sectors — huge, sophisticated, data-driven, well-capitalized competitors.

Back in summer, many of us had the now-quaint thought that there would be a big gap between the first wave and second wave. We thought maybe No Normal would transition to New Normal in January, or at least Q1 2021. And we thought patient volumes would return to normal in 2020.

It’s now clear that the struggles of 2020 will extend into the second quarter of 2021 and maybe longer. The first wave just shifted from New York and Seattle to the rest of the country, and now has intensified to a frightening level in many communities. Some hospitals have so many COVID-19 patients that they may not be able to staff to appropriate levels or even levels required by regulation. That could easily lead to pauses in elective surgeries, even if states and municipalities don’t require it. It could also lead to more “missing dominos” going into 2021 – patients avoiding doctors’ appointments and diagnostics will make schedules even lighter 45 to 60 days later, and possibly beyond.

The No Normal continues to show up in many other ways — big and small, good and bad. Wearing masks and avoiding handshakes. Delayed vacations and one-way grocery aisles. Planting backyard gardens and riding bicycles again. Displays of love and human kindness that stand in stark relief to the sadness we all feel when we see racism and human cruelty. Now we will see what No Normal looks like in winter, and then again as spring comes next year.

Healthcare marketing must adapt to the current circumstances and prepare to stay in this uncomfortable mode for an unknown period of time. We cannot show up the way we did in February and March, or even the way we showed up in the summer, and expect it to be effective. “Then” was Rapid Recovery, now is flu shots and patient appointments to avoid the “missing domino.” Yet we also can’t assume the current state is the New Normal — it’s not.

In the No Normal, the winners will figure out how to stay busy, how to be busy again after a lull, and how to win the hearts and minds of every patient. The losers will be half empty, cash-starved, and looking for an acquirer to save them.

The healthcare brands that lean into this discomfort and uncertainty to meet consumers where they are will thrive. Those that don’t will be facing a difficult future.

Healthcare marketing leaders will take the reins by considering several key fronts:

  • First, health systems must take a hard look at what they want to stand for — and revisit messaging and brand voice accordingly.
  • Second, health systems must consider their payor relations strategy and how contract renewals will be different now, including new terms around telehealth.
  • Third, health systems must consider their M&A strategy — are they buyers or sellers? The market will undoubtedly continue to consolidate during the No Normal and beyond.

We still believe healthcare brands can thrive in the No Normal. That is our agency’s purpose, and the work has never been more important.