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April 25, 2010

Fake Facebook profiles and other portents of the end times

One issue up for discussion in this evening's free-form health care social media tweetchat was the fake Facebook page of eSara Baker, posted as a form of marketing for a company providing online health-related services (which sound like typical patient portal stuff like scheduling appointments and accessing test results).  The page prominently states: "If you haven't uncovered our secret yet, here it is: Sara isn't a real person."

The identity of the company and the services provided are not at issue here.  The issue discussed in the #hcsm tweetchat was whether using social media to market a health care service through the use of a fabricated profile was unethical and/or harmful to authentic uses of social media for health care.

I disagree with some of my #hcsm cohorts who tweeted their upset with the fake Facebook page, saying it represented a setback for health care social media (i.e., that it would harm "authentic" health care social media efforts). 

My take: This is just an example of the medium's coming of age.  Marketing on Facebook can now be as fake and manipulative as it may be in other media.  Infomercials, product placements, dramatized ads using characters from TV shows, guys and gals in white coats pretending to be doctors in TV commercials, etc., etc. -- social media is not immune to manipulation, because despite the many differences from mainstream media, there are still many ways in which "old media" and "new media" are alike. 

Hey, it's the end of the "underground" era, that's all.  FM radio started life without ads, and now that it's saturated with ads and hyper-segmented and targeted, many programmers and listeners have migrated to other platforms: internet radio, XM, podcasting, etc.  Whether this is the end of the beginning or the beginning of the end, all that the appearance of this fake Facebook profile (which wasn't super-engaging, or convincing, by the way) says to me is that the health care social media pioneers have a choice to make: they can take this to be one more reason to bemoan the collapse of Western civilization, or at least Facebook ("nostalgia isn't what it used to be"), and migrate elsewhere -- or they can have one more reason to keep doing what they're doing incredibly well, because if they maintain a continuing, authentic, transparent interaction with their public, developing trust and influence, then the presence of some fake profiles (that really, at the end of the day, do not pose a threat to this level of engagement) shouldn't really bother anyone all that much.

What do you think?

Medseektweets Update 4/27/10: Check out the twitter exchange I had with the marketing communications manager for the company that put up the fake Facebook page (read bottom-to-top), and see also another perspective on the issue, posted by Phil Baumann.

Update 5/5/10: The conversation continues at WEGO Health, courtesy of Alicia Staley.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting


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Good thoughts, David. I agree that it's not nearly as calamitous as some might think. Just because some people and organizations use Facebook in a non-authentic way doesn't "wreck" it for the rest of us. Do it right, and you'll be fine.

Well, you're right about the ubiquity of fakery in traditional marketing, but I hope you're not arguing that just because it was done that way in the past, it's not as unethical to do it now.

Why give people who use fakery a an easy pass?

If giving fake medications was something we accepted as a practice of bad people that doesn't mean we should acquiesce?

No, there isn't any room in healthcare for this sort of practice - language corrupts, and corruption doesn't know its limits.

Furthermore, a question: is setting up a fake page necessary? It's just so uncreative, unimaginative and cheap.

There are plenty other ways to market a product and these new media just create a new set of conditions that need to be understood before just jumping in without fully knowing how their work (or don't work).

It's unethical to use fakery to market healthcare products and services. Period.

Phil, I could imagine some expressions of this approach as being unethical, but this one was very clearly marked as fake by the author. It seems that you're making a "slippery slope" argument -- if this practice is left unchecked, bad things will happen. In my view, the execution of this fake FB page was not very convincing, and thus liable to be seen through by many visitors. To me, this points up one of the strengths of social media - the dearth of interaction on this page since it went up months ago demonstrates the fake page's weakness, or even failure, as a social media experiment. If, as you say, setting up a fake page is unimaginative, then the wisdom of the crowd -- expressed by lack of interaction -- has shown that the fake page approach is essentially a failure. I'm not advocating for fakery; I just don't see this example as particularly objectionable.

I really have to admit, I don't see the issue here. If this company was trying to play off Sara as real and hoping to lure you into hearing their marketing pitch, maybe I'd be bit bothered.

Here's the thing, this page clearly states that Sara isn't real. There's not even a remote possibility that anyone viewing this page would think that she was. Why? First, the clear disclaimers, but second, it's a page. It's not even a profile. It's a page. In other words, you don't become friends with Sara, you "Like" her (previously "Became a Fan"). So, you should have a pretty good idea that this isn't a person. The only people with pages are celebrities (of various levels of celebrity status). Beyond that, it's groups of people, causes, common interests, and, yes, brands.

This is nothing more and nothing less than a clever way to promote your company on Facebook. It's not deceptive, it's not misleading, it's transparent and a unique way to advertise on Facebook.

That's my two cents anyway.

Dose of Digital

Thanks for this post, David. I opted out of participating in last night's tempestuous teapot for a variety of reasons. Glad I waited for others like you, Jon, and Lee to make the case more articulately than I would have by tweeting, "What's the big whoop?" Like no one in the marcomm industry has never cobbled together a fictitious-yet-rooted-in-reality endorsement?

eptSara: Good marketing idea, worthwhile yet poor effort and follow-through. That's it. The sky ain't falling.

I'm with Phil on this one. May be we can disagree on the goals of marketing, we do. Fine. Moreover, what bothers me is the lack of grasp of how this sort of campaign confuses the majority of folks who are not SOME literate.
Yes, I can see the fakery (unacceptable from my perspective but I guess that's marketing) but that's not the case for a most folks. From the inside, this is a discussion. From the outside, this is bringing more confusion and discredit to the notions of transparency, participation, collaboration, and quality in healthcare as it relates to the ehealth and/or epatient terms. There's plenty of junk out there, I thought, this idea would be more related to making things better.
There are of course other more complex issues that may be less folks care and it is the the sort of patient portrayed in the f-Patient profile, something we also discussed at #hcsm

To fake anything in the health arena (even with clear disclaimers), especially a product or service of real health benefit, is just dumb and unlikely to work. In this case the proof is in the number of ‘likes’, of which there are 57 today, hardly a rip roaring success!

At 12:30 CET on 1 May 2010 a COPY/PASTE of the ‘disclaimer box under the profile picture reads: “ If you haven't uncovered our secret yet, here it is: Sara isn't a real person. But she does represent heathcare consumers like you and me. Each of us has our own "Sara Baker" story about a healthcare experience... share yours with us!”

A sane person’s response to the request to ‘share’ with Sara is "NO I WON'T". Who wants to share a healthcare experience with a person who is made up! The whole idea is just plain stupid. There is also a deadly typo in the disclaimer: I don’t know what a ‘heathcare consumer’ actually is anyway!
OK a typo is forgivable (I might have one in this comment)but I think it just highlights that the whole concept is stupid and shouldn’t set any benchmark in healthcare marketing online :+)

In terms of ethics, making stuff up (faking it) is poor form. In healthcare marketing I believe EVERYTHING should be credible and transparent, which through engagement leads to trust... There are simply too many dodgy (and potentially dangerous) healthcare claims out there on the web already.
This doesn’t mean that there isn’t room for cleaver use of irony in marketing (Sara isn’t ironic by the way), it’s just that wrapping your healthcare product or service in fakery just isn’t healthy for anyone.


Pharma has enough credibility problems without trying to "fool" patients with more fakery.

But, to me, the basic problem is the misunderstanding by so many that "e" in e-patient refers to electronic. It does not, and yet, as long as we insist on calling us "e-patients" that misunderstanding will remain.

I have offered up a change in title to "emPatient" meaning empowered, of course... maybe it's time to shift the conversation - for this reason and many more.

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