As a writer/producer, I’ve shot TV commercials and web videos in a variety of healthcare settings over the past 15 years — from small Midwest community hospitals to several large tertiary-care academic medical centers in Nebraska, Iowa and California. During that time, I’ve developed a few tips, tricks and rules that I follow in order to end up with a happy client (and a happy me).

Here’s the thing: healthcare advertising is in many ways a whole other animal when compared with marketing categories such as consumer packaged goods, education or finance.

First, you’re dealing with a client who has dozens — if not hundreds — of internal clients, all of whom believe that they are the most important people in the world (and some of them may actually be). This means that the approval process for strategy and creative can prove difficult for the client … which can translate into difficulties for the agency. This is why it takes an experienced account team to ensure that things go as smoothly as possible on both ends. Luckily, we have this part well covered here at Envoy.

There’s also the fact that you have a whole set of unique regulatory issues to deal with, which can change dramatically if your client is for-profit or not-for-profit. Add in the fact that you’re dealing with “products” that can range from deadly serious (oncology) to delicate (bariatric surgery) to obscure (robotic hysterectomy, anyone?), and you can begin to appreciate that marketing healthcare requires a particular skillset and a lot of experience.

This is especially true when it comes to shooting video for TV or the web.

The Concept

Advertising is fundamentally about telling stories, and healthcare is inherently full of drama. This gives you an advantage right out of the gate. However, unless you have a massive budget — and in all likelihood you won’t — you should resist the urge to produce a scripted spot that requires any acting.

There’s a reason why union actors from LA , New York and other big cities get paid what they get paid. Acting — especially the kind of dramatic acting we’re talking about here — is incredibly difficult to do well. And while local talent can be very effective for voice over work and myriad other applications, it’s somewhat unlikely they’ll be able to pull off the kind of drama we’re talking about here.

So if you’ve written a heart-wrenching script about a daughter caring for her lymphoma-stricken mother, my advice is to throw it out right now, unless your budget can accommodate top-tier talent. (By the way, that goes double for humor. As the great English actor Edmund Kean famously said upon his death bed, “Dying is easy; comedy is hard.”)

That being said, there are always exceptions to these rules. If you can find truly great actors locally, absolutely go for it. And treat them like royalty, because if they’re that good, they may end up on one of the coasts before long.

The bottom line is, you don’t want a great concept to be let down by less-than-great execution. But then that rule goes for just about everything, right?

A side note: don’t even think about having non-actors read scripted lines. That means doctors, nurses, administrators… whatever. If you do, you’ll want to tear your hair out when you get in the edit suite and start piecing together your spot, believe me.

So what does that leave you with? Well, plenty. You can get creative and go with an animated spot. Or one that features non-sync b-roll footage with a well-written voice over. (In this case, you should definitely spring for big-city union talent and set up an ISDN session with their preferred studio. Since they’ll be unidentified and not on-screen, this level of talent — even some very famous names — can be surprisingly affordable.)

Another highly effective approach is to use patient testimonials. These have the dual advantage of being compelling (no acting required) and relatively inexpensive (no actors required). Real people telling real stories about their experiences is pretty much the oldest form of marketing there is. Back when it was known as word-of-mouth advertising, it consisted of one person telling another. With TV and the web, it can be one person telling tens of thousands. But the story they tell is just as genuine because it’s true.

The one downside of the testimonial approach is that you won’t know what you get until you start shooting. This means that you and your client will have to do a lot of preproduction legwork to ensure success. The most important thing is to get more patient stories — hopefully twice as many or more — than you need. Then you should pre-interview them via Skype or FaceTime to gauge whether they’re telegenic and intelligible or not.

The Shoot

If you do go the testimonial route, you’ll want to interview your subjects off-site — either in a studio or in their homes. You need to pick someplace where you can control the ambient noise. And, believe me, a hospital is not that place, even if they do offer you a conference room in the basement. The last thing you want is for your subject’s tearful story to be interrupted by a PA announcement.

You should also make sure that you bring a competent sound engineer. Don’t think you can simply set up a DSLR and use its onboard mic. Audio quality is extremely important, as that’s how the story will be told. Make sure he or she records 10-20 seconds of “room tone” so that the postproduction audio engineer can use it to mitigate background frequencies when doing the final mix. The audio person should also use a lavalier microphone on the subject in addition to a boom mic above. This will give you multiple audio sources to help ensure a solid recording.

When interviewing the subjects, sit just off to the left or right of the camera and ensure that they look at you instead of the lens. Unless you’re deliberately doing some sort of Errol Morris-esque thing, a subject looking into the camera can be oddly disconcerting. And when asking questions, make sure that the subject incorporates the question into his or her answer. For instance, when you ask, “What’s your name,” you want them to reply, “My name is John Smith,” not simply, “John Smith.” This is because your questions will not make it into the final edit, and you need to give the viewer context to understand the story.

When interviewing doctors and/or nurses, you’ll likely have to shoot them in their offices, so you’ll have to contend with a variety of audio issues. In most cases, patients are more compelling than providers anyway, but for political or conceptual reasons, you may have to interview docs, so just factor those issues in beforehand. The other thing you need to do is to explain to the client — who needs to explain to the subject(s) — that not everybody will make it into the movie. After all, you’ll be shooting more subjects than you will have final spots. This can obviously be a delicate subject politically, so proceed with caution.

At some point, whether you’re doing a testimonial or a narrated piece, you’ll likely need to shoot in the hospital itself. This means that your presence will not be welcome. The doctors, nurses and staff at a hospital have a tough enough time as it is saving lives without having to contend with a film crew traipsing around and getting underfoot.

To minimize your impact when shooting, you will need to bring a small crew that has experience shooting in hospitals. When you see these professionals in action, it’s actually quite amazing. They can almost literally make themselves melt into hallways and closets as doctors and nurses move past them. They know — as you must too — that however important their job, it is in no way remotely as important as the jobs of those whom they’re filming. On a side note, you’ll also come to realize that some doctors absolutely hate to be filmed and others just love it. For the latter, you’ll likely have no problems. For the former, you’ll have to handle them with kid gloves.

In addition to having an experienced and sensitive film crew, you will need a hospital liaison person with you at all times. Ideally, this person is known and well-liked by everyone on staff. They’ll be your point person as you go from set-up to set-up. And they will have done the advance work to warn the various people in charge that you’re coming. Believe me, you do NOT want to show up in a busy NICU unannounced.

When you’re shooting b-roll footage in a hospital, it’s very tempting to shoot technology: TV monitors, PET scans, etc. And the client will often mandate you shoot this stuff, too. After all, state-of-the-art medical equipment costs a lot of money, and they’re very proud of it. Plus, it just looks cool. However, you should be aware that it also ages fairly quickly as new devices come out and replace old ones. And while your target audience won’t care if that’s a 3T MRI or a 1.5T MRI in your spot, your client’s bosses certainly will. So try to get as much “timeless” b-roll as you can and at some point mention to the client that you may need to come out and shoot again in a year or two if they want to make some new spots down the road.

Post Production

When it comes time to put your TV spots or web videos together, you should have built enough into your budget to account for the offline edit — that is, going through hours of interviews and b-roll footage to make an edit-decision list or EDL. It is also worth the money to have the audio of your interviews transcribed. This will make it much easier to put together a “script” for your spot. I like to put together rough spots on my Mac using iMovie. It’s fairly quick, and it can give you a really good idea of your narrative arc. That, and it can help determine whether a line that looked good in the transcript is actually delivered in a way that’s both compelling and intelligible. Once you have your rough cut down, you can proceed to the online editing phase. And if you’ve done your offline work well enough, you can often let the postproduction house do it unassisted, as much of this will consist of color correction and long render times. It is fun, though, to bring the client in at the end to see the spots in the edit suite. It can be quite impressive and help them understand where their money is being spent.

When it comes to music, an original score is always preferred and money well spent, in my opinion. It can really be the cherry on top of a narrated piece and can, along with a top-shelf narrator, elevate your spot to a national level. If your budget won’t allow for an original score, you can opt for library music instead. This is less crucial with testimonial video, because the viewer will be concentrating on the interview subjects as they tell their stories. But be aware that while library music is generally a lot cheaper, you still have to factor in the time it takes to find the “perfect” clip. This is much akin to a photo image search and can be laborious and frustrating.

In the end, dear reader, no matter how much preproduction due diligence you do, you’re still going to have to tell a good story, and that of course is up to you. But I hope that the suggestions I’ve made in this piece will at least help you avoid some of the pitfalls unique to filming in a hospital setting.

Good luck and happy shooting …