Cultural Storytelling Why using semiotics, language analysis & cultural foresight builds more successful healthcare brands

All marketing is storytelling and all brands need to construct a meaningful narrative. 

A product tells us what it does, but it is a brand that tells us what it means to us.  Constructing a story around the product creates relevance and distinctiveness, and gives us reason to choose one brand over its competitors. A brand is a product with a compelling story about how it benefits your life beyond the simple facts of what the product actually does.

Despite being a seemingly ‘rational’ category, we believe that cultural storytelling power is vital for healthcare marketing, and is the key to building compelling healthcare brands and driving effectiveness. It does this by creating better health care professional and patient understanding, resulting in more actively-engaged behaviour and adherence.

And it can achieve this within the demands of regulatory guardrails.

Cultural storytelling power can be used to address a variety of brand challenges, including; refining visual identity, developing impactful claims and descriptors, improving product naming, and curating imagery and language in patient and HCP comms, etc.

There are three fundamental pillars which can be used to create a culturally-driven healthcare story:

1. Language Analysis: using the right words, names & TOV
2. Semiotics: the strategic selection of imagery and visual cues
3. Cultural Foresight: evolving the story of your brand over time

In this article we will take a look at each of these pillars in turn, to understand the approach and see how it’s been applied to real world brand challenges.

1. Language Analysis

Language analysis allows us to interrogate cultural conversation, unpacking not just what is said, but how it is said.

Many concepts can be communicated in ways that reveal radically different underlying worldviews, for example “argument” may be expressed using a metaphor of a “war”.

Expressions like: “his position was entrenched”; “they dug in”; “his points reinforced her views”; “their theory was shot down”; or “your claims are indefensible” illustrate this worldview, one in which an argument must have a valiant victor, and a vanquished loser.

But, this is not the only way of framing a disagreement. It’s possible to use alternative language such as: “his argument had strong foundations”; “he built to his conclusion brick by brick”; “their argument was well constructed”; “her points built on his perfectly”; “their theory collapsed”; or “your claims don’t bear weight” to communicate this situation. These phrases offer a narrative of an argument as a “building” – revealing a mindset that is more collaborative, and seeks to find ‘constructive’ solutions.

Unpacking apparently ‘surface level’ differences in the language used in each case reveals two different deeply embedded narratives.

Let’s now see a real-world case study. A global pharma company were looking to enter the dermatology space with a new range of treatments and the client wanted to understand the motivations of Dermatologists in China, Germany, Japan and US, as well as any barriers they faced. We performed a close cultural language analysis of interview transcripts, identifying unconscious cultural narratives underpinning the HCP responses. For example, a key shared narrative in this space was that of the oppressive ‘burden’ – the way in which the pressures of disease and treatment hold down and repress patients. In order to address this need with the new product, a new narrative of ‘liberation’ was needed instead.

But there were also different narratives in different markets, for example in the US and Germany, HCPs likened themselves to speedy animals (e.g. leopards, hawks), signalling a desire for fast acting treatment options. Whereas, in China and Japan, they referenced slower moving animals (e.g. tortoises, pandas), revealing a different cultural narrative that favors ‘slow and steady’ progress.

Our findings were integrated into a final report (alongside the findings of the qualitative research) to provide a culturally validated 360-degree view of the lives of dermatologists.  Our recommendations included a number of positive framing narratives, as well as identifying some of the key narrative barriers that could be used for the development of a product name, claims and descriptors, detail aids, comms, and a website going forward.

2. Semiotics

Narratives are not only communicated through words, and if we are to start to understand a broader range of cultural stimuli it is important to employ our second pillar, Semiotic analysis.

What is semiotics? Look at the image of the house below, can you imagine what is happening inside? You are probably thinking of a children’s birthday party, and there are likely associated sights, sounds, and smells coming to mind (e.g. upbeat music, children running round, jelly and ice cream). 

What if we changed the balloons shown subtly, and made them silver and gold? You may still be thinking of a party, but now it is an anniversary or a more adult occasion, perhaps with cocktails and canapés and some smooth jazz playing in the background. Small visual details can help us to construct vastly different narratives in our minds – visual symbols are shortcuts to communicate a whole story. 

This is not always simple. Look at the door of the second house above, what do you think might be happening here? Here we have deliberately juxtaposed two opposing visual symbols; we still have the party ballons and all of the positivity and joy they communicate, but now we also have a black wreath, a symbol of mourning and somber reflection. Approaching this house we would have no idea what is going on inside and how we would be received if we knocked on the door.

This is an example of a muddled story, and is exactly the kind of thing that brands can accidentally create if they don’t take the care to understand the cultural meanings of the imagery they are using across touchpoints. Overcoming these kinds of tensions and contradictions, empowers brands to take control of their meaning and ensure clarity of communication.

Voltaren, the anti-inflammatory drug and painkiller brand, was redesigning its packaging in China. Having developed two creative routes, the Voltaren team wanted to ensure the proposed pack designs would communicate messages aligned with their brand positioning and values. By conducting a semiotic analysis we were able to identify a tension between pack elements communicating joyful liberation on the one hand, and others suggesting prohibition and warning; a muddle of two fundamentally opposed cultural stories which would prevent consumers from fully understanding the brand and product benefit.

In order to move beyond this tension and communicate a clear culturally relevant message, we identified the most successful of their proposed design routes, and made further recommendations on how to refine the execution further, resulting in the final successfully- received pack design on the right hand side.

3. Cultural Foresight

The final critical issue affecting brands is that cultural narratives change over time. Our pillar 3 cultural foresight approach enables brands to navigate changing cultural context. In this approach we divide culture into Dominant narratives that frame mainstream patient/consumer and HCP understanding, and Emergent codes – green shoots of new meaning that suggest a coming new narrative.

For example, wellness is moving from a physically-focused discourse that frames the body as a machine, to patients/consumers thinking about their pain or medical issue as part of a holistic continuum involving, their physical, mental/emotional, and even spiritual wellbeing.

Due to this change a headache, which was previously a problem treated by pain relief medicine, is emergently thought of as being the result of poor sleep, or of spending too much time on the computer, or stress or burnout. So what patients/consumers are interested in is more holistic health management – they increasingly want proactive prevention, not just a reactive response.

Healthcare brands are under pressure to understand the broader narratives of wellness in order to best solve patient medical problems. This is a significant cultural shift from the simple problem-solution narrative when health care professionals prescribed a medicinal treatment to cure what was a highly localised medical condition. 

ViiV, the pharmaceutical company dedicated to research and development of medicine for people living with HIV, was launching an innovative drug which would drastically reduce dosage frequency and improve patients’ quality of life.

We carried out a semiotic analysis of the Dominant and Emergent cultural meanings of ‘Prevention’ and ‘Protection’, identifying a number of key cultural shifts, such as the change in the framing of patients from passive subjects to active agents.

Curating our findings into coherent and culturally resonant stories, we identified three potential cultural narratives, Trusted Testimonies, Active Agency, and Sustained Support, and provided a mood board and creative toolkit (imagery, claims, descriptors) for each.

Based on our recommendations, the creative team developed website comms, campaigns and activations that diversified casting, promoted an honest ‘real talk’ TOV, and empowered patient agency.

In conclusion, there are the three ways to apply cultural storytelling to build and create more successful healthcare brands. Refining language, using semiotic analysis to apply relevant imagery, and by constantly adapting to cultural change.

Using these approaches, whether in isolation or combination, empowers brands to tell relevant, rich, and compelling stories even within the constraints of highly regulated categories. Informed by these perspectives, language and imagery are not just creative tools, they are strategic vehicles for building a more powerful brand narrative.

HCPs and patients are people, and as people they can’t resist a good story. The three methods we’ve outlined offer flexible ways to create diverse and distinctive stories for healthcare brands. The beauty of these three approaches is that they work as well for an OTC painkiller as they do for a highly technical rare disease solution, and allow you to:

• Understand the cultural language and imagery of your category, condition, and patients.
  
  
• Proactively use that language and those images to create a distinctive version of the truth for your brand to explain the technical benefits and clinical difference vs competitors – even when working within regulatory guardrails.
  
  
• Use language & imagery to reframe the story of the category in a way that reflects changing culture so that patients and HCPs can clearly understand your brand’s benefit and relevance, across your communication channels.

Cultural storytelling – applying language, semiotics, and cultural foresight, helps overcome barriers and drives better HCP & patient understanding and engagement – a clear source of competitive advantage in a crowded healthcare space.

Mark Lemon, Director, & Alex Gordon, CEO