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Saul Marquez:
Hey, everybody. Saul Marquez with the HLTH Matters podcast. Welcome back to today’s episode and if it’s your first time joining us welcome, hit the subscribe button because we’re having amazing conversations with today’s brightest minds in healthcare straight from the HLTH conference this year in Las Vegas. So today, I want to welcome you and I’m having a conversation with Susan Manber, she’s a chief patient officer. Sue’s life and work are inextricably linked. After beating cancer as a single mother, Sue returned to work with an intimate understanding of the patient experience and an acute awareness of the role her many privileges played in her surviving a rare and aggressive cancer diagnosis. Now, as the communications industry’s first chief patient officer, Sue advocates for more equitable patient experiences and is deeply committed to using her privilege to give voice to those without one. And so with that introduction, I want to welcome you to the podcast, Sue. Thanks for joining.
Susan Manber:
Thank you so much, Saul, excited to be here.
Saul Marquez:
We’ve been covering a lot of interesting topics on the HLTH Podcast, but the thing I love about having you on is we’re going to be focused on the patient experience, health equity is a big part of that, we’re going to touch on cancer treatment. It’s going to be a great podcast, folks. So buckle in, get a pen. I’m excited for this one. Before we dive into the meat and potatoes of our discussion today, Sue, talk to us about you. What is it that inspires your work in healthcare?
Susan Manber:
Well Saul, as a rare cancer survivor, I understand just how challenging it can be to navigate the intricacies of a very complex and often overwhelming healthcare system. After learning how to and the importance of advocating for myself, I’m inspired to help others more effectively advocate for themselves and their own care. I believe in many cases what patients lack is the knowledge to feel empowered and to advocate for themselves. So now, for me, coming out on the other side of surviving a rare cancer diagnosis, I truly believe that my life purpose is to use communications to save lives. When people have the information and the motivation to take control of their health and well-being, it ultimately does drive better outcomes.
Saul Marquez:
That’s amazing, Sue. And first of all, I’m so glad you’re here.
Susan Manber:
Thank you so much. Me too.
Saul Marquez:
And it’s a miracle and a blessing that you went through that hardship. And you are not wasting that pain, you’re investing that to help others, and that’s powerful. Talk to us a little bit about Publicis Health and what is it that you guys do? How do you add value to the healthcare ecosystem?
Susan Manber:
Well, Saul, the role of chief patient officer is still fairly rare and completely unique at healthcare communications firms. When I was just a strategist, I think it was a little harder for me to get into rooms and conversations with some clients because I was coming from the commercial marketing side. Now, as chief patient officer, I find that clients and advocacy groups are really interested in what I have to say. And frankly, for me, representing the perspective of patients is incredibly rewarding, especially because there’s still a lot of work to be done for the healthcare ecosystem to be genuinely patient-centric.
Saul Marquez:
I love that. I think you’re so right. For example, we’ve done a lot of podcasts here and think you’re the patient, right? Like the one. So we’ll have to dig into that and definitely get a couple others next week. And maybe we work with you, Sue, to identify those.
Susan Manber:
I would love to.
Saul Marquez:
To have them on the microphone. So thank you for bringing that up. It’s about action, folks, it’s about acknowledging that there’s work to be done and doing something about it ultimately. And that’s how you move the needle. So what excites you, Sue, about your work with data and research?
Susan Manber:
So I’m a behavioral and cognitive psychologist by training, but I think the most important thing to think about data, we know that we’re overwhelmed and overflowing with data. Just in the last two years, more data has been created than in all of human history, and it can be overwhelming to say, well, too much data, not enough insight. But I truly believe that data are people in disguise. And so now we have spent the last three years building our health labs. I just said, I feel like I’m a kid in a data candy store. If you were like, what? And I said, because for the very first time, we now have the ability to put together real-world medical claims, RX claims, lab claims, pathology claims, not what you told me you go through, but what you actually did. And with our acquisition of Epsilon, we can combine that in a completely HIPAA compliant way with the deepest, richest lifestyle data. And so, by able to knit together patient data with their real-life data, it’s really a game changer because it starts to disrupt silos and really connect a broken system. When you think about all those pieces, and I kiddingly say I really can identify and understand people who might have heart health disease and are doing their best, but they’re having their steak and a Lipitor and, you know, Diet Coke with what, watch a NASCAR. And so that breadth of perspective, of understanding, yes, people as patients, but patients as people. They have lives and hobbies and jobs, and they’re not just patients. And frankly, all too often we still wait till the end to talk to patients to validate what we’ve already done. But the power of using patient data and co-creation to begin with, to start with the real world data. And so what we’re saying is we’re flipping the foundation. I’m a market researcher through and through, but instead of starting with market research, let’s start with this real-world data and then use our rich ability to use market research to dig in and understand those gaps and those nuances and the emotion. I mean, let’s face it, as rational as we all are, and as much as we think about numbers, 95% of our decisions are emotional and that means doctors too.
Saul Marquez:
Well said, Sue, you have a way of just making sense of things.
Susan Manber:
Thank you.
Saul Marquez:
Thank you for that. There’s definitely a lot of opportunity. And so with claims data mixed with the patient experience, we’re better able to understand, right? And I think that, that that’s one thing that we’ve been lacking for a very long time, it’s understanding. And so I’m excited to hear the work that you and the team are doing to help us better understand, because understanding the foundation upon which we could actually add value in a meaningful way. So let’s talk about retail pharmacy. How do you think retail pharmacy will transform the way patients receive healthcare?
Susan Manber:
I think these shifts are truly transformational. And the way we think about it is we start with the idea of patient.centered understanding and patient-centered insight. But we’ve come to learn that actually patient.centered insight has to be equity centered. And the way I started to think about it is that there’s actually three C’s of equity centered design when it comes to understanding the role that the retail pharmacy can play in the community. It all starts in terms of creation of medication with clinical trials, that’s the first C. And we know that we’ve been struggling to recruit enough people of diverse backgrounds into those clinical trials. We spend a lot of our time, energy and resources on commercial marketing, and that’s the second C. But the real power, we know that all healthcare is truly local. And the third C, of community health is where retail pharmacy can truly play. And so the way that we think about it is we’re seeing a transformation right now from retail pharmacy to truly becoming the front line of primary care. And we see it going on differently across whether you think of a Walgreens or a CVS or a Walmart. The truth of the matter is there are many people who may be 50 or 75 miles away from the nearest doctor, but they might have a trusted pharmacist just five miles away from them. So when you think about the trust that a pharmacist has and then the investment now in nurse practitioners and in physician assistants to come into the community, we also know that people want to be cared for by people who look like them, feel like them, understand their cultural sensitivities and nuances. And so when you are in the pharmacy and you have that staff that is of and for the community, there’s a much closer personal experience. The other thing that’s fascinating in this transformation is I think for a long time a lot of us were like, okay, I’m either going to work in retail pharmacy or I’m going to work in the back of the store in medical delivery. But the truth of the matter is we’re one whole person. And so when we get our lab results and then we don’t really understand them, and then we don’t understand why it’s important to be adherent to that medication or even why the doctor prescribed it, think of the difference of being able to then talk to that pharmacist, be offered, do you have a primary care physician? 20% of America does not have a primary care physician. 50% of millennials do not have a primary care physician. So they’re young, healthy and fit, and they want to do everything they can to stay healthy, but they don’t have that preventive care. And then on the flip side, the 60% of America who are dealing with chronic conditions and it’s confusing and it’s challenging and they may not understand their health coverage, what their condition is, why they need to be having those lab results. And so that’s why we see a lot of the falloff in care. We know that if we just got people to understand and take their medicine as prescribed, it will drive better outcomes. But if I don’t, then it’s really easy for me to say, you know what, I’ve got to feed my family as opposed to take this. And so people start splitting their pills and dividing their time or just not picking it up at all. So the value that I think the local pharmacist and the people there who know me and on a daily basis and where I can, and we saw during the pandemic as whomever would have thought the COVID center of experience would be your local pharmacy. And I think now our opportunity is to harness those new relationships for better care and ongoing relationships.
Saul Marquez:
Sue, thank you for that, that’s really insightful. And we have to think about those personal touch points, those relationships. And you mentioned a couple of the demographics. You know, the younger folks that 50% of them don’t have primary care physicians. The elderly that are, many of them lonely. We had a discussion around loneliness today and that pharmacists, the role they could play in that familiar face that is helpful and as part of my daily or weekly routine could be very strong. So thank you for highlighting that, I think it’s really important. What are the most substantial and stubborn lingering problems, Sue, facing organizations, pursuing greater health equity for patients?
Susan Manber:
Well, you know, Saul, one of the biggest challenges is with, when you see the last decade of all the advances in genomics and precision medicine and new cancer treatments and new ways of dealing, it’s so exciting. But unfortunately today I can still tell you more about your outcome based on your zip code than your genetic code, and that’s what we’re out to change. I know for sure that I am still here today because of my privilege, I was able to put together a care team, I was able to navigate the complexity. Somewhere in my attic I’ve got $1,000,000 worth of bills. If I didn’t have great corporate insurance, if I didn’t have the support of my company to go through that, then I truly know I wouldn’t be here. So I think that the notion that patient-centered design has to be equity-centered design and that when we think about where you are and the opportunity to provide better care, we know there are tremendous health deserts in this country. We interviewed people who were in, you know, pretty far flung rural areas, where if they were in an urban area they would have been hospitalized, but they didn’t have the resources or the need, and they can make wait months to be able to get standard screening and other care. So that really connects to what we were just talking about, is, when you can get those screenings, when you can get those early interventions, we know that early intervention saved lives. I know I’m still here because we caught my cancer early. So to me, that’s the stubborn, lingering problem, is how do we take our understanding? I mean, last year I lit up everybody I knew with a Atul Gawande’s piece in The New York Times about why Costa Rica has a better life expectancy than anywhere else in the world.
Saul Marquez:
I should go live there.
Susan Manber:
And it’s, yeah, maybe we all should, but the we.
Saul Marquez:
We must learn from them ….
Susan Manber:
Indeed. But what we can learn from them, Saul, is that when they created community health workers who literally go into the community with a tablet with all of your health information, a backpack with medicine and a cooler with vaccines. But importantly, they’re there to understand, yes, your medical and your health care, but they may see, oh, actually you have your medication, but you don’t have clean diapers, you don’t have good quality food, you don’t have good quality water, and so they can reallocate community resources. And that’s where I think community health can play a real meaningful role. But the problem is, right now, today, community health is funded one grant in a time or a year or two. So how we can really create more public, private conversations and connections to fund more of that work, to tap into the community? A big part of what we’re doing here is we want the patient voice at the center, but all too often we don’t actually compensate them. They volunteer their services to tell their stories. So part of what we’ve been doing here with, in partnership with the Health Foundation and with Savvy Cooperative is saying, you know what, we’re actually going to pay you for your time and your resource. We set up a genius bar, ask patients is their tagline. And that simple thing of, you know, we talk a lot in our industry about what we’re doing. We’ve created this incredible conference of new technology and new health tech, but not all of it’s been tested with patients. So my message is really start with patients, co-create with patients. And when we’re able to bring those patient voices in that level of understanding, it will make our tech better, it will make our experiences better. Because simple things that hospital systems do, they don’t always realize just how hard it is for people to navigate. And, you know, when you spend a lot of time in waiting rooms, you get a sense of what is really important. And sometimes it is just that simple thing, but after three days of doing interviews, the most important thing is just listening to patients and asking.
Saul Marquez:
Listen and ask questions to patients, folks, it doesn’t get any simpler than that, but just do it, just do it. Thank you, Sue. Well, I’ve got to say, you have shared so much, so much value on this podcast interview today. I want to thank you for that. The three CS, the power of a pharmacy and the community, the importance of asking questions to patients. Folks, hit rewind on this one and listen to it again because Sue has imparted so much valuable thought that we all need to consider and act on. Sue, thank you so much. If there’s any thought that you want to leave the listeners with, what is that thought and what’s the best place that they could reach out to you?
Susan Manber:
Thank you so much, Saul. I mean, truly it is that thought. It’s, when you’re doing all of your development, pause and say, did we actually ask patients? We talk about being patient-centered, but sometimes we don’t really know, we assume. So never assume. And please do add me on LinkedIn and visit us at PublicisHealth.com.
Saul Marquez:
Outstanding. Sue, thank you and, everyone, make sure you check out the show notes because in the show notes we will have all of the links and resources that Sue mentioned, including her LinkedIn as well as Publicis website, so check that out. Oh, and Sue, I want to read this article. I haven’t read it. The Atul Gawande one
Susan Manber:
Oh, it’s awesome. Last August in The New Yorker. And the last thing I, we absolutely will share with you.
Saul Marquez:
We’ll link that up in the show notes too.
Susan Manber:
Absolutely. And of course, I should have mentioned that just yesterday we launched in partnership with the Health Foundation and Outcomes for Me the State of Patient Empowerment Study. So I will share that with you. It’s a good read and there’s some tough statistics in there.
Saul Marquez:
Can you give us like a hook there? Like, what’s it about?
Susan Manber:
Saul, it was really about saying if we understand the breast cancer patients lived experience, how can we understand and apply that thinking to other forms of cancer? And so things like, do you know that one in four women who were diagnosed with breast cancer found out from their portal, not from their doctor.
Saul Marquez:
Meaning they got the test and then they looked?
Susan Manber:
Exactly. The unintended consequence of the CARES Act is now you get your results at the same time as the doctor. But if you’re like me, that means you could get a result on Friday at 11:30 at night and you don’t get to call the doctor’s office until Monday morning. So anxiety is real. We have to make sure that we’re thoughtful about having the resources to bear when patients get news to make sure that they understand. And far fewer people have access to their records and their understanding and even are offered genetic testing or clinical trials. So we have a lot of work to do. So that’s a great read. The State of Patient Empowerment, well share that as well.
Saul Marquez:
So there’s a hook there, guys and gals, make sure you check out the show notes because we’ll be posting that in there as well. Sue, you’ll get us a link to that, and thank you. This has been a true pleasure.
Susan Manber:
Thank you so much, Saul. Have a great day.
Saul Marquez:
You too.
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