Promises To Keep
A proposal to

Now, GlaxoSmithKline

Written
by
John K. Mackenzie
Copyright © 1996
All rights reserved

O S T E O P O R O S I S

Introduction

Life, liberty, and the pursuit of profit are (alas) not infinite occupations. We've only got so much time to strut our stuff, grab some hugs, and make a buck or two; although our allotted time is certainly increasing.

But, for many, longer life is an ambiguous blessing when quality is severely diminished by progressive bone disintegration. And the promises we make to ourselves, and others -- those IOU's on the future -- may never be collected: An old friend unvisited, a grandchild never held, a trip never taken. All the more tragic as there are ways to postpone the onset of osteoporosis for those who haven't got it, and alleviate the problems for those who have.

Approach

Because osteoporosis is a disease (as well as a consequence of aging) discrediting compliant acceptance, along with its ancillary illusion of inevitability, is an important premise. So here are some of the promises we plan to keep in our (film) (video) for you:

• clarify the causes and scope of the problem.
• counteract the "inexorability" syndrome.
• make it clear that effective treatments are available.
• show the viewer the consequences of delaying medical care.
• hold out hope and encourage action (visits to physicians).

"Promises" must also accommodate multiple language tracks, while being something foreign television stations will be proud to promote and schedule: at some time other than 4:00 a.m. Sunday morning. (Here we're on uncertain ground as we don't know whether SKB will be buying time, relying on public service slots, or both.)

Concepts for Later Discussion

1. NURSING HOME - CAMERA'S POINT OF VIEW
as we climb the steps, go inside, look around and find an old lady with severe osteoporosis. The woman looks up, surprised, as a child's hand reaches out to her. The child, a little girl, is mysterious, beautiful, radiant and invisible to everyone else. Our child leads the old lady out into the sunlight to rediscover the life she might have led had she not been stricken with osteo. The little girl, of course, is really the old woman as a child.

2. KIDS PLAYGROUND
as our camera pulls back from child to find an old lady with osteo watching the children play. Flashbacks show us what she might have done to retard or prevent it, and what can be done now.

3. THE STATUE
in a sculptor's studio with time lapse. A sort of Dorian Grey approach. The sculptor remains young while he works, but his statue of a beautiful young woman begins to age and hunch over as narration provides osteoporosis commentary.

4. LIVING ROOM
as an older woman looks over her family photo album; with dramatized flashbacks and voiceover to show and describe the progression of the disease.

5. MUSEUM EXHIBIT
in the year 2000 to find a mannequin, dressed as old woman with osteoporosis, in a glass case. Visitors (listening to guided tour headsets) are amazed to learn that osteoporosis was once a problem.

6. MEDICAL SCHOOL
of the future with students using an interactive holographic visual-device to study the history, causes and treatment of osteoporosis.

7. A YOUNGER WOMAN
with a personal lifestyle creating internal conditions under which osteoporosis will prosper. Flash-forwards would be used to show what the future may hold for her unless she seeks medical advice.

8. GENERATIONS
traces a day in the life of a mother, daughter and grandmother; each with their own attitudes and ideas about osteoporosis. The grandmother accepted the idea that nothing could be done. The mother feels fine and doesn't think she needs to do anything or see a physician. And the daughter is angry at them both for their passivity and would take preventive measures if she knew what they were. (Not a bad idea, but might be tough to do in multiple languages.)

Celebrity Host

We plan to open our film with someone well known within each distribution country. A respected newscaster, established science reporter, or appropriate TV personality. An internationally known celebrity is another possibility, but could complicate multiple languages. Our host can appear periodically during the film for bridges and transitions.

Post-Program Follow Up

By keeping our film to 10 minutes or less, we can have another 5 minutes of "local customizing," or even another 20 minutes of a live, subject authority panel to take phone calls and encourage viewers to write in for a "Promises To Keep" brochure. (Distributed to physician waiting rooms also, of course.)

Rationale

Insofar as compression magnifies impact and memorability, we might consider telling our story in the form of a striking, three minute "informercial" with music and voice-over.

(This could be in addition to, or even in place of, the longer film.) Again, we might use a celebrity presence that's well known within each country.

Example #1:

An elderly woman trips while crossing the street or stumbling over something in her home. We watch her grim descent (in slow motion) while our narrator hits salient points about osteoporosis.

Example #2:

Our camera pans around an orthopedic center to see braces, crutches, walkers and X-rays as the narrator tells our story.

Example #3:

Stark, severe "Bergmanesque" funeral scene in progress for a woman who died of complications arising from a fractured pelvis or broken hip. With flashbacks of what might have been as the coffin is lowered. (We can find a way to make this ecumenical.)

Pre-Program Advisories (For Physicians)

Direct mail, journal notices and group previews so physicians will know a film on osteoporosis will be shown on television. SKB reps can pass out program schedules along with "Promises" brochures.

We all know the bad rap a good firm can take if patients start calling physicians who were given no advance notice of a dramatic disease related TV program. (We figure you've got this covered, but mention it so you'll know we're thinking.)

OSTEOPOROSIS
Today & Tomorrow

A Film
for the
Health Professions
from
SmithKline Beecham

Introduction

Your strategy monograph identifies general practitioners as our primary audience. You also identify nine other target groups. Obviously, no one film can manage the specific needs of each; without patronizing the specialist and overloading the generalist. [A multi-level interactive CD might work, but that's a subject for another time.]

Having said this, it doesn't follow that we can't refer to the importance of other disciplines. There is, after all, a healthcare continuum here running from bone specialists down to nurses; each of whom impacts diagnosis and management in their own way.

Areas to Address

Your strategy outline has been very helpful in identifying the major subject areas for our film to cover:

Magnitude of the problem:

• present demographics
• review costs
• esimate future patient population

Etiology:

• post-menopausal
• androgens and estrogens
• bone remodeling mechanisms
• types of osteoporosis

Susceptibility profiles:

• the osteoporosis-prone patient
• lifestyles

Present diagnosis and management techniques:

• strengths and weaknesses of each
• consequences of missed diagnosis and postponed treatment

Electonin [Turbocalcin] therapy:

• mechanism of action
• pharmacology
• dosage and administration
• side effects
• contraindications
• dosage and administration
• costs
• clinical results

What's In It for Me? (asks Dr. GP)

In the final analysis, we feel all of the above should be presented in a style we might call "pragmatic humanism." We wish not only to upgrade current knowledge, but present practical information in a way that will motivate physicians to put it to work in their practices as soon as possible. (While also creating a receptive climate for SKB sales reps.) Let's convince physicians that they have promises to keep to their patients.

The Superstar Testimonial

Every profession has its high impact influentials. And medicine is no exception. And 30 seconds of a good review by a respected specialist is often worth more than 30 minutes of accurate but "anonymous" supporting material. [Hardly an original observation, but still valid.]

"If Dr. X thinks this stuff works, that's good enough for me. You can skip the details." Long after demographic projections, bone physiology and treatment rationales are cold, this 30 seconds should still be hot.

It's also worth admitting the inadmissible: in a subject like this we're lucky if the audience remembers three points out of thirty; no matter how good the script and producer. And a big part of our job is to see that key points are properly positioned and reinforced by our featured specialist(s).

Obviously, we're not proposing an entire film of nothing but testimonials. (We're not that brave and we'd like the job.) Besides, films in support of a new drug have acquired a procedure and protocol that physicians have come to expect, and we intend to follow. Predictability, in the service of sales, is a virtue not a vice.

But we see one or more celebrity endorsements, supported by clinical testing results, as our hallmark elements. Elements that will:

• increase SKB's image as a firm with a serious commitment to bone metabolism.
• counteract the "inevitability" mind set and establish osteoporosis as a disease that can be postponed and treated.
• overcome traditional reluctance to abandon "favorite" therapies and try a new drug.
• place cost concerns in perspective.
• dispel the idea that diagnosis and treatment must await some dramatic (trigger) manifestation.

In one sense, our entire film will be addressing these issues. But when clarified by a physician with a distinguished track record, we gain clout and credibility we can't get any other way.

SmithKline Beecham Follow Up

SKB sales reps can pass out videocassettes, a supplementary monograph, and initiate group film screenings at hospitals and medical society seminars. A multi-media "learning package" can be devised using laptops, an intranet, CD's, programmed instruction, video, and print.

A Mechanism of Action Film

It's not such a bad idea to consider preparing a special film devoted entirely to bone metabolism, and how Turbocalcin actually works; employing computer animation sequences.

Back to Health-Science writing menuto be continued.