Closing the Trust Gap: Medical Lessons for the Toughest Agency-Client Relationships

Workshop Digital Tuesday Talks are a weekly tradition and an opportunity for a team member to share insights on any passion—from digital marketing to organic farming. Watch the recorded version or read the transcript below.

Nowhere are client relationships more critical than the healthcare industry, where persuasiveness has life-and-death consequences. So what does peer-reviewed research say about persuading the most challenging patients? And how do we apply those insights to digital marketing?

That's what Derek Gleason covers in today's Tuesday Talk.

[Video Transcription]

I’m here today to talk about AMA. And I know what you’re thinking, and it’s not Reddit AMA, and it’s not the American Marketing Association. It’s this one: Against Medical Advice.

Against Medical Advice is a way that patients are discharged from hospitals, and these are the patients that are pulling out the IVs, walking out the door, and signing away any liability the hospital has for their well-being.

Why are we talking about AMA patients? Because patients are clients. It’s an easy parallel that will help you understand how to build client relationships in the most challenging circumstances, with lessons from cases in which people’s lives were at stake, not just web traffic.

Uncertainty and Information Inequality

Before we get there, let’s back up a little bit to 1964 and the WHO. Not the band, but the World Health Organization, and this guy, Kenneth Arrow. Arrow is an economist who became the youngest ever to win the Nobel Prize for Economics in 1972. A few years before then, he was working on uncertainty in economics. The World Health Organization hired him to look at economic interactions in the healthcare industry and what role uncertainty had in those.

What he came back with, at the very end of 1963, was a fundamentally influential paper in the healthcare industry on information inequality. Quite simply, information inequality meant that on one side of the equation you had an expert (in this case, the physician), and on the other side you had a patient. These two people were involved in an economic transaction, but there was a big knowledge gap between these two parties.

What Arrow and his team found out was that it wasn't just that there was a knowledge gap, but that both parties in this economic transaction were very aware of this knowledge gap, and their relation was colored by that awareness. Every part of this transaction, as a result, was influenced by this knowledge gap.

Closing the Gap

We certainly see parallels in how we, as an agency, work with our clients. Ultimately, we believe we’re offering five-star knowledge, but because of a knowledge gap, clients perceive that as two-star knowledge. So the immediate question becomes, How do we take clients from what they see as two-star value to the five stars we know it is?

The first thought is always client education. Client education is important and can probably get you up to three stars. After that, what do we do? More client education? You’re probably still stuck at three stars. Maybe we kidnap our clients and take them for a secret 12-week boot camp to educate them? You’re still going to be there.

Because what Arrow found was that it’s not just a knowledge gap. You can’t close that final gap with knowledge because it takes years to become a physician, it takes years to become an expert in search engine marketing—it’s not a knowledge gap that’s going to get closed.

It’s a trust gap. Trust is how you get to five-star value.

In the case of physicians, Arrow argued that trust was not just a benefit, not just a cherry on top of the experience. Trust was a fundamental part of the commodity that the physician was selling.

And the same thing is true for agencies and clients. Trust isn’t added value, an extra that you want on top of great digital marketing results. Trust is a fundamental part of the equation.

How does medicine bridge the trust gap?

Medicine bridges the trust gap in three ways:

  1. Rigid entry requirements. You can’t just go online and quickly get certified. You can’t have an Internet connection and call yourself a physician. You need years of medical school, years of training after that, and, in addition, you’re talking about every couple of years having to get recertified with board certification. That’s one way that the medical community immediately builds trust with patients.
  2. Collectivity orientation. It’s unacceptable to think that your physician is giving you a prescription based on profit maximization. We expect that physicians work for our best interests regardless of how much money that makes them.
  3. Personal and family relationships. This one is familiar. It works across all industries, but it still matters. When somebody tells me that this is a great oncologist or this is a great dentist, I trust that. I walk in the door immediately trusting that physician.

When I read Arrow's report, I started thinking, What are our proxies in the digital marketing world?

  1. Case studies. Case studies offer a way to provide quantitative data to back up marketing speak: We’re not great just because we’re telling you we’re great; we’re showing you the results. That’s probably the best proxy we can get, possibly folding in those little client logos on the homepage as well—if this works for other Fortune 500 companies, it will probably work for me, too.
  2. Integrated services. If you only sell PPC, you can only recommend PPC. If you only sell SEO, you can only recommend SEO. But if you offer the full suite of integrated digital marketing services, you can look at a client and say, “Okay, What do you need? What is going to benefit you the most in the digital space? We can offer that.” This helps with the collectivity orientation, the idea that we can align our goals with our clients’ business goals. And that goes a long way in building trust.
  3. Referrals. These are no different than the personal and family relationships that medicine benefits from, but it’s the idea that when a client comes in the door, they have an added factor of trust built into the relationship right away.

Why Patients Leave AMA

AMA patients are the absolute toughest patients to work with in the hospital setting. Certainly, there are parallels to the agency setting, with clients who, for whatever reason, are challenging to work with. The initial tactics we mentioned probably work great on your average client; they might work well for bringing in new business. But for working with the most difficult patients, we need to dive in and find out what makes a difference.

There’s a traditional demographic profile in medicine that most AMA patients are young, male poor, often addicted, and sometimes dealing with mental illness. These are reasons that patients leave AMA. But for many physicians, this definition was insufficient. They wanted to look at other influencing factors, and these are the factors that are most relevant for the digital marketing space:

  1. External stressors. Things outside the immediate relationship that affect that relationship.
  2. Divergent expectations. A patient or client walks in the door on Day 1 thinking something’s going to happen in a certain timeframe or in a certain way, and it doesn’t happen.
  3. Superficial self-evaluation. I feel better, so I am better; my website looks great, so Google must love it.
  4. Negative past experiences. What kind of baggage does somebody bring?

These are the things that, as an agency, we can manage, and we’re going to dig into those right now.

Understand past experiences

What does a client bring to the table? When they come in, Do they bring trust in digital marketing? Do they bring skepticism? Not just generally, but very specifically: If you previously had a PPC vendor, did you like them? You loved them. Well, what did you love about them? Was it the way they communicated? The way they reported? The frequency of reporting? Did you not care about any of that, but they got great results? Understanding these things helps you know what to provide for that client.

If they come in with skepticism, what was bad? The results? Just the communication? The personality? The more details you get, the better prepared you’ll be.

Communicate the “length of treatment”

In a hospital setting, this means that when somebody walks in the door, they know how long they’ll be there. If that expectation isn’t met, if they think they’re walking in for an eight-hour visit and it turns into a one-week visit, it causes tremendous problems. Of all the research we looked at on patients leaving AMA, this was the biggest factor.

If they enter with expectations that are not met during the experience, it doesn’t even matter how good the experience is. It’s not about the results. It’s not about getting better. It’s not about getting 100,000 more clicks. It’s about whether that result matches up with those expectations.

Be a personal physician

Open explanation outweighs mistakes. Trust allows the transparency that you need for an effective relationship. In the most extreme circumstances, AMA research showed that trust even beat out clarity from the physician. If that trust is there, it really lowers the burden of how much information you need to provide.

Uncover root goals

You might have a CMO to whom you’re providing great digital marketing results, but that CMO’s actually stressed about another piece of the marketing puzzle. Or you’re providing great results for core services, but the focus and the pressure from the CEO is on a short-term promotion.

Broadening the terms of engagement will help you understand all the things that stress out or excite your client, and how to frame digital marketing results as helping them achieve those broader goals. In the absolute best-case scenario, and in a somewhat sentimental phrase used by the medical community, you’re looking to build a therapeutic relationship.

Convey the benefits—and the consequences

Finally, in digital marketing we’re really good at talking about what could be achieved, what could get done. But what’s equally as important is what’s not going to get done. And so sometimes a last resort, if you’re dealing with a really difficult client, is explaining not just what you can offer, but what the negative consequences might be if they don’t take advantage of that opportunity to increase impression share, or if they don’t keep up with technical SEO aspects that maintain their site’s presence.

Thanks for joining us for this AMA. Now you can find me on Twitter, and ask me anything.