So yesterday, after having poked at Pharma Guy’s stance on gamification, I got called out pretty severely by John Mack. Reading between the lines, I feel like he called me out as some sort of gold-digging digital con artist, so that was fun. Maybe it’s a case of, “You’re nobody in this town until Pharmaguy makes fun of you.” Perhaps I should take it all as a weird compliment.
Ignoring the ad hominem attacks, I’d like to dive deeper into Mr. Mack’s argument against the likelihood of the FDA ever approving a game as a proper treatment, the likelihood of a doctor prescribing a game, and the likelihood of an insurer paying for any of it.
The truth is, there is no proven science that games can, in any way, treat a patient’s condition better than a drug. Mr. Mack drills that point home pretty hard, which is fine because it isn’t the point I’m making.
The point I was making is that just because something doesn’t work now, it doesn’t mean that it can’t work in the future. In fact, the entire pharmaceutical industry is predicated on the idea that this particular clump of atoms form an unusual molecule, which when applied to certain people, cause certain outcomes. At one point, penicillin was just mold that grew on bread. It didn’t cure anything until we applied some science to it and learned what it could do.
And, like games, the first time we tried penicillin, it didn’t work. We learned, through trial and error, applied via the scientific method, the best way to use it to stop infections. I wonder if there was a Mr. Mack in 1928, claiming that no one would ever eat the mold off of bread because no one had ever been cured by it before. Or that no one would pay for moldy bread bits.
This all gets even more interesting in light of Mr. Mack’s post today in which he is supportive of the idea that people play games in order to stave off the onset of Alzheimer’s disease. You’ll excuse me for being confused by his position. Regardless of what the FDA will or won’t do tomorrow (as my crystal ball is in the shop), pharma’s reason for being is to discover find whatever solutions to people’s health care issues they can, no matter how unlikely or unusual the source. They were skeptical of tree frog venom, once. Video games seem obvious in comparison.
Frankly, the day pharma can build a game that treats a disease (in a scientifically-provable manner) nearly as well as a brand, is the day pharma finally realizes how much money can be made from this. That’s when pharma takes gamification seriously and issues about the FDA will be figured out.
Also, since games probably won’t have much in the way of side effects, does the FDA really need to be called in to do anything more than verify that the game does what it says it does? Indeed, proving one’s claim hasn’t stopped, say, magnetic jewelry makers and vitamin salespeople from edging in on what should be solely pharma’s domain.
The real issue is that pharma, by playing ostrich, is letting tech get a huge head start. Kodak used to believe that no one would want digital pictures to much the same effect. Acting outside the traditional pharma section puts tech in a position to be a true disruptive agent. Ten years ago, no one thought a guy with a list named Craig would be able to put thousands of journalists out of work. So let’s not assume the protective force-field of the FDA will stop tech companies from trying to do to pharma what Craigslist did to classified ads.
So, in an honest attempt to learn where Mr. Mack stands on the issue of gamification, I will ask that he define his stance free of argumentative distraction like the FDA, insurance providers, and things not necessarily germane to the issue at hand. I think that would be very enlightening.
If you haven’t read Malcolm Gladwell’s The Tipping Point, you probably already know the thesis: In order for an idea to be adopted by a large group of people, you need an influencer, someone who wields sway over large groups of people. That one person who may not dominate the conversation, but the one people listen to when they speak.
It’s a great theory, and you can see why marketers adopted it: reach and influence a large number of people by leveraging a relatively small number of key people. The hard part is to figure out who those key people are.
This is a theory born in modern communication models. The greatest example may be that of Walter Cronkite and how his feelings on the Vietnam War swayed millions of opinions against it. Or MLK influencing millions of Americans of every color to stand up and demand equality. It’s also the basis of every celebrity endorsement.
And it might not really be true.
What if we were looking at the idea of influencers backwards? In a system where we feel like the one can hold sway over many, who’s in charge? The one or the many?
Influence is two separate processes held together: one person wielding an opinion and many people interested in listening. If the group isn’t interested in listening, what good is the influencer? If I’m not in the mood to buy a car, how important is Eminem’s feelings about a Chrysler?
Perhaps what we see when we see the key influencer effect is the natural aggregation of like-minded and interested people congregating and getting themselves ready to listen. At which point, someone (or anyone) with some basic credibility can take the mic and make their case. Is that person truly an influencer or are they leveraging a very ripe environment? Was MLK influencing people who previously had no opinion on civil rights? Or was he tapping into the existing desire for equality?
Once a congregation occurs, social pressures work to encourage people to act in the same direction (for example, you are more likely to laugh and laugh louder when those around you are laughing), thus reinforcing the idea that the influencer is influencing.
In Albert-László Barabási’s study about connection (he was the first to suggest that we’re all just six degrees separated from Kevin Bacon each other), he finds that there are no key influencers, no selection of people influence more people than others. What he saw were groups, connected to each other by a series of strong and weak bonds. You talk about something and someone on the edges of your social network hears it. They talk about it and someone on the farthest edges of their network pass it along.
In my own work, I looked at people I considered very influential people: social media gurus. These are people who have tens and thousands of subscribers and followers, people who have ideas about social media that get disseminated very quickly (e.g., Chris Brogan and Jeremiah Owyang).
When they post an article, I read it. Their ideas are now part of my thought process. Thus, they are seen as influencers. But who’s in charge, the person trying to influence or the people who have come to listen?
This is problematic because pharma relies heavily on KOLs to be its brand-supported influencers. And if influencers really don’t wield an inordinate amount of influence, where should pharma be focusing?
Again, let’s return to the model: it’s the congregation of interested people that leads to influence. It’s more important to find (or build) those groups than to find someone to influence them. Once you find the group, standing in front of them (depending on the medium) with some basic credibility will make you look like an influencer.
For example, should you try and find an all-star pharmacist to talk about your brand? Is there really a pharmacist that all other pharmacists listen to? If there is, could you point that person out to me? Or is it more true that each pharmacist is probably professionally friendly with a handful of other pharmacists? If we could reach a few of them, the ones interested in our brand, they could influence the handful of people in their own networks. Isn’t that how you commonly learn about new ideas?
Perhaps pharma should spend more time and resources cultivating these congregations of people interested in learning about new treatments and brands than trying to find people with special influencing powers.