Blurred Lines: Marketing and Ethics in the Brave New World, Part 1

February 4, 2019

// By Daniel Fell //

Danny FellThe following article was adapted from the panel presentation Blurred Lines: Marketing and Ethics in the Brave New World held at the 2018 Healthcare Internet Conference (HCIC) in Scottsdale, Arizona. Panel members included Karen Corrigan, founder and CEO of Corrigan Consulting; David Feinberg, chief marketing officer at Mount Sinai Health System in New York City; and Greg Green, chief data and analytics officer of Valassis. 

Daniel Fell, president and CEO of ndp (and member of the eHealthcare Strategy & Trends Editorial Advisory Board), moderated the panel. Part 1 touches on some of the broad ethical issues in using digital marketing in healthcare today and some of the current practices in our industry. Part 2 will address some of the emerging challenges as both technology and our industry evolve, and what marketers can do to better prepare themselves and their organizations.

FELL: eMarketer recently surveyed a little over 1,000 adults in the U.S. about their concerns with digital advertising. Forty-two percent of the respondents answered that brands are “too aggressive in following me on every device or browser,” and another roughly 20 percent said that digital advertising understands their interests and needs, but they find it “creepy” at times. 

At the same time, almost daily we read about new breaches in online personal data, privacy, and security issues among the major social media platforms, and growing concerns over consumer tracking and targeting. 

Is there more of a heightened awareness among healthcare marketers today for how we market to consumers digitally and creating boundaries for ethical marketing?

David Feinberg, chief marketing officer at Mount Sinai Health System

David Feinberg, chief marketing officer at Mount Sinai Health System

FEINBERG: One of the big challenges of digital is what we’re talking about today. How do we draw the line directly around our principal goal of helping patients get the necessary care that we have available and do it in a way that’s ethical — in a way that protects that really sacred trust that we have with patients and in terms of how we use data.

I think there’s certainly a heightened understanding, awareness, and concern at the C-suite level. If we’re found either losing data or using data inappropriately, I think either one of those has the potential to do a significant amount of damage to our reputations in ways that might be lasting. My sense is that the public is becoming more attuned to this as well, as they read about all these breaches and what have you.

Greg Green, chief data and analytics officer of Valassis

Greg Green, chief data and analytics officer of Valassis

GREEN: My interest is in helping marketers navigate that space between doing the right thing for the consumer, where we’re trying to help people find and meet a need, and not annoying them with marketing. So, in keeping things relevant and helping them, there’s an altruistic purpose there. Whether it’s cancer treatment or other health services, we’re not just doing marketing.

So, it’s important to get the information out, but at the same time it’s important to protect that trust, and make sure that we’re not crossing the line. I find that when we do it right, it works for the consumer, it works for the patient, and it works economically for us. So, it’s good on all sides.

Karen Corrigan, founder and CEO of Corrigan Consulting

Karen Corrigan, founder and CEO of Corrigan Consulting

CORRIGAN: You know the reality is that the technology and the tools are developing every day, that allow us to get at more and more granular levels of information about individuals and groups of people almost faster than we can reimagine the policies or write the policies that would oversee it all.

So, I think we as marketers and healthcare executives, we have a responsibility to ensure the safety of the data that people entrust us with, and any kind of breach can, as David pointed out, create a loss of trust. But then there’s the privacy issue, right? So that’s the big discussion.

The difficulty with the privacy discussion is that my definition of privacy and David’s definition of privacy might be two completely different things. So, what I’m comfortable with in terms of how you use it, and what he’s comfortable with, differs, and I think that’s the challenge for us as keepers of the data, to figure out where the ethical boundaries are in terms of usage.

FELL: Is there a disconnect between how the industry has used existing privacy laws like HIPAA and how patients think about these protections? For example, are we more focused on protecting ourselves versus actually protecting the public and how we use their information?

FEINBERG: HIPAA dates back to 1996, and Google was formed in 1998. So, HIPAA predates Google and hasn’t been updated for this digital world in any way, shape, or form. But be careful what you ask for. There will be a tipping point where Congress or regulators say, ‘All right, we have to update HIPAA’, but then that opens up a whole Pandora’s box, as you can imagine.

GREEN: As an analytics professional, there is so much more data available to me, and every year there’s more. And now I have location data, which wasn’t really even conceived of back then. No one really thought we would all be carrying around a device that would give us location data all the time. You’re not really aware how much location data you’re giving out. And you’re not even opting in to giving it out. Some of the new regulations deal with this, but the problem is, as soon as they address it with one regulation, then the technology changes and we’re collecting it in a different way.

FELL: I wonder if the other side of the coin for HIPAA is that maybe we default to it and say as an industry, “As long as we check the HIPAA box, we’re protected.” Do marketers need to think about it differently today?

CORRIGAN: I’ve got to echo David’s thoughts on this. We’re looking at a regulation that was put in place prior to a digital world. It’s out of step with what we need to do. I’ve stood in front of corporate attorneys who are talking about HIPAA this, that, and the other, and the very patients they’re talking about are online revealing all of their medical issues. So, it’s just out of step for where we are today.

FEINBERG: I think the technology cuts both ways, right? We can personalize so much more today. We can be very specific about individuals — what their wants are, what their needs are — and try and target you with information that is relevant. Well, could you flip that? Could you say we’re going to personalize our messages the way you want us to use your data?

So rather than a one-size-fits-all [solution], why can’t we have a dialogue online and say, ‘All right, we have this data from you, how do you want us to use it?’ And give us specific guidelines in a way that’s easy. Some people would say, ‘I don’t want you to use it at all. No thank you.’ And others, ‘Oh yeah. I’m all in. If you can help me, give me updates or whatever, and everything in between.’

FELL: Greg mentioned location data. Some healthcare organizations are experimenting with geofencing and serving up ads based on location data and relevant content. What concerns do you have around healthcare organizations tracking consumers or the use of location data to target them?

GREEN: My concern is that these strategies require a little bit more context and thought before we just apply them. So, if we take something like geofencing in a healthcare situation, it’s a little bit different for CVS to use geofencing versus a hospital. I just feel like we need to be more thoughtful. And this is a level that I feel will never really be regulated. I just feel that in some industries it’s a less sensitive issue. I don’t have to be as thoughtful. In healthcare, I feel that we need to be more thoughtful.

FEINBERG: I think it has a tremendous impact. How many of us have the Starbucks app? You’re near a Starbucks and they send you a promotional offer to come to Starbucks. That’s proximity marketing. I’m struggling with how that works in a hospital. Come in today and you get 20 percent off?

GREEN: It’s coming. Somebody’s going to do it.

FEINBERG: What we were talking about at Dana Farber was using geotargeting to help patients navigate better. So, if we know somebody is coming in for a therapy, we can make sure when they get there it’s ready, instead of having to wait to check in. So, there are ways to use this technology to actually improve the customer experience. And to the extent you think of this as part of marketing, which I think a lot of us do, then it’s highly applicable.

Part 2 of this article will appear in the March issue. 

Daniel Fell is president and CEO of ndp, a full-service marketing communications agency in Richmond, Virginia. He is a frequent speaker and writer on healthcare marketing topics and is a member of the eHealthcare Strategy & Trends Editorial Advisory Board. Email him at or call 423-752-4687 ext. 300.