The Opportunity Healthcare Marketing Can’t Afford to Ignore

Written By Catharine Szefcyk

Why marketing’s role needs to begin earlier and shape outcomes beyond campaigns.

By Tim Duer, Causeway Solutions

Connecting Is Getting Harder … And It’s Not a Messaging Problem

Healthcare outreach keeps getting tougher. And not for the reasons most people usually assume.  Teams are expected to grow in volume, educate patients, support public policy goals, and build trust, often with fewer resources than ever.

When results fall short, the usual questions come up:

  • Is the message right?

  • Are we in the right channels?

  • Do we need to rethink execution?

But the real problem isn’t any of those. It’s whether the audience is even willing to engage.

People are harder to reach and slower to respond. New patient acquisition is more difficult.  Education efforts are questioned. Even basic public health messaging gets filtered through a layer of skepticism.

What’s changed isn’t just the tactics — it’s the environment.

Healthcare used to benefit from a baseline level of public trust. That trust made it easier for outreach to land. But that’s no longer guaranteed.

The conversation has shifted, and audiences have changed. Messages that once worked now struggle to break through, not because they’re wrong, but because people are more guarded.

To make real progress, healthcare systems need to stop thinking about outreach as just a marketing challenge. The real shift is happening upstream, in the public affairs context that shapes how people hear us in the first place, and downstream, in patient census trends and financial reports.

The Assumption Most Outreach Still Operates Under

A lot of healthcare outreach, whether it’s aimed at patients, communities, or policymakers, still operates under a basic assumption: if the message is clear, backed by solid evidence, and repeated often enough, then people will listen.

But that assumption is being challenged.  It relies on a high level of trust in the healthcare sector as a whole.  And that level continues to decline.

Public confidence in healthcare overall, like in many other institutions, is on the decline. After peaking early in the pandemic response, the Gallup Health and Healthcare Survey shows that now only 36% of Americans have a “somewhat” or “very positive” view of the healthcare industry.  The Kaiser Family Foundation reports that even trust in one’s own healthcare provider to make the right health recommendations has dropped - from 93 % to 85 % between 2023 to 2025.  

These declines signal a larger shift. The inherent trust that once made healthcare messaging so effective is no longer something that can be taken for granted.

That shift is landing squarely on the desks (and budgets) of marketing and communications teams. In an environment where confidence is slipping, even the best-designed outreach has to work harder to get noticed. And harder still to be believed.

Public Affairs Now Determines Engagement Potential

Shifts in public trust and engagement aren’t just making outreach harder — they’re changing what has to happen before outreach can work at all. In that environment, public affairs has taken on a more central role. What once sat alongside marketing, communications, and policy now helps determine whether audiences are receptive enough for engagement in the first place.

Part of the challenge is that public affairs is often misunderstood or confused with other operations. While it overlaps with public relations and government affairs, it serves a distinct purpose. Public relations is primarily focused on reputation and media narratives, often in response to an issue. Government affairs centers on relationships with elected officials, regulators, and policy processes. Public affairs operates within a different scope — shaping the broader context of trust, legitimacy, and belief that influences how all external engagement is received. Public affairs is neither tactical nor reactive; instead, it shapes the conditions that determine whether an audience is receptive to any message at all.

Public affairs issues now shape trust, influence patient behavior, affect how access and referral decisions get made, and shift the economics of patient acquisition and engagement. When these upstream factors aren’t addressed, they become barriers that all other outreach efforts— from patient acquisition campaigns to advocacy efforts — need to overcome. That usually means higher costs, slower gains, and more frustration.

This is why acquisition feels more expensive, advocacy feels harder, and engagement feels less predictable — even when tactics are sound. The external context has changed, and unless public affairs are addressed early, everything else downstream has to work harder just to keep up.

Why This Matters Across Every Outreach Goal

  • Patient acquisition becomes inefficient when distrust suppresses readiness - increasing cost per acquisition and lowering conversion rates, regardless of message quality.

  • Patient satisfaction erodes when institutional intent is questioned, accelerating disengagement and undermining long-term retention.

  • Policy advocacy weakens when public legitimacy isn’t there to support it, forcing greater effort for diminishing influence.

  • Legislative conversations slow when skepticism precedes engagement, delaying decisions and narrowing room for compromise.

It’s All Marketing: Public Affairs as the Prework for Progress

In the next phase of healthcare, public affairs won’t just support outreach, and marketing won’t just execute it. Together, they will determine whether engagement is possible, efficient, and worth the investment.

The organizations that recognize this shift won’t just communicate better.

They’ll operate with greater clarity, credibility, and discipline in a skeptical environment.

 

Marketing is no longer about promotion.

It's about owning context upstream and consequence downstream.

About the Author

Tim Duer is VP at Causeway Solutions, where he leads client strategy and heads Causeway's Results Roundtable series. Reach him at tduer@causewaysolutions.com.

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