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February 12, 2008

Is the Cow Really Purple?

Purplecow In pharmacology, the placebo effect is a little-understood but long-observed phenomenon that some people who exhibit certain symptoms can improve their health by taking a sugar pill. The only catch is that, in order for this charade to be effective, the patient must believe the drug to be genuine. Once the patients know they are taking a sugar pill, it is ineffective. Seth's recent article got me thinking about these 2 questions:

  1. If it is the story the patient believes that makes the drug effective, was the patient really sick in the first place?
  2. If the patient wasn't sick in the first place, is it moral to sell him something that allows him to continue believing he was?

When testing new drugs, patients are split into a test group and two control groups. The test group gets the medicine, and researchers measure any improvements they exhibit. Researchers must also be careful to observe any undesirable side-effects.

One of the control groups gets no treatment (or traditional treatment), and researchers observe their progress.

However, since we know that some people will improve because they believe the drug will work, a second control group is included, but they are given the sugar pill instead of the actual medicine.

In general, a drug is approved by the company and the FDA if two major conditions are met.

  1. The medicine shows sufficient  promise to actually improve the health of the patients it was tested for.
  2. It does not cause any unintended, unmanageable, and undesirable side-effects.

Thus, not only must the medicine do no harm (or if it does harm, the harm is less unpleasant than the alternatives), it outperforms each of these cases:

  • no treatment
  • traditional treatment (although it might perform as well as this, but be less expensive)
  • the placebo

So when Seth Godin, the author of The Purple Cow and All Marketers are Liars, says that we marketers in the placebo business (and that there's nothing wrong with that), I have to wonder if he's describing the historical case or the normative one. In other words, is he saying how it is -- or how it should be?

If treatment outperforms the placebo, the placebo is unremarkable. What's worse, we not only rely on the lie that it is, but also we perpetuate that lie by leading the patient to believe their symptoms were genuine.

If there is no purple cow, don't pretend that there is. Give the straight scoop (in as authentic a brand voice as you can invent), and if you can't get behind that, find something more productive than perpetuating myths to do with your time.

If you must, create your own purple cow. You'll feel much better about yourself. - Cam Beck


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