When it comes to finding the right PR and marketing agency, is bigger better?

It depends who you ask.

Early in my career as an agency leader, I was surprised that it was Amendola’s largest Fortune 500 clients who most clearly understood and could articulate the benefits of working with a smaller, boutique agency. As time passed and a few comparatively smaller clients switched to a bigger agency (often in response to reaching a major growth milestone) and subsequently came back, I realized that the larger, more well-established companies simply had the benefit of experience. They’d previously worked with one or more large corporate agencies, and already understood the advantages and drawbacks.

So why do many of the world’s largest, most successful healthcare and technology companies prefer to work with smaller, highly specialized agencies? It’s a fair question, and the answer can help healthcare/healthcare IT companies of every size find their ideal agency fit.

Depth of understanding is even more key in a complex industry

Many of Amendola’s largest clients voice frustration with the inconsistent levels expertise at big agencies, especially those that don’t focus exclusively on healthcare and healthcare IT.

As one Fortune 500 client said in our initial conversation, “We don’t feel like we’re getting any value from [large corporate agency]. They understand tech in general, but don’t really have a clue about healthcare IT. And they don’t seem to have any of the media relationships we need.”

Another prospective client put it more wryly: “We spend half our time explaining value-based care, and the other half reminding them to stop talking about it like it’s brand new.”

To be fair to larger agencies and the hardworking folks who make them hum, it’s all but impossible for anyone to be an expert on multiple complex industries. Especially if one of them is healthcare. In fact, that’s why Amendola serves only healthcare and healthcare IT clients, and has since the outset. There’s always something new to learn in healthcare, and always something on or just over the horizon that will impact the industry in unexpected ways. If you don’t eat, sleep, and breathe it, how could you possibly keep up?

Still, I can understand these clients’ frustration. If an agency needs constant coaching on what’s happening in healthcare, the best case is that the relationship becomes more time-consuming for the client.

The more realistic case? Missed opportunities, muddled messaging, and even missteps in the market.

It’s harder for large and multi-industry agencies to develop strong healthcare/healthcare IT media relationships

Clients also often mention that a larger agency they worked with was unable to secure high-quality (or even very many) media opportunities. I’m never surprised to hear it. After all, any junior PR professional can pitch journalists all day every day every…but how effective can they be if they don’t really understand the story they’re pitching?

Yet inconsistent expertise isn’t the only contributing factor. The fact is, large agencies have several things working against them when it comes to healthcare/healthcare IT media relations.

Imagine you’re a healthcare reporter. You’ve just been assigned a 1,200-word article about how healthcare organizations are screening for unmet social needs and addressing SDoH, especially within their high-risk/high-cost patient populations. Your editor would like to see you include perspectives from at least three different organizations. Either vendors or providers, but at least one of each. Oh, and it’s due tomorrow. End of day today would be better.

Now ask yourself who you’d reach out to:

The comparatively junior contact you have at a big corporate agency you know, the one who keeps pitching you out of the blue about the same one or two clients.
The comparatively senior contact you have at a smaller, healthcare-specific PR agency you know, the one with a diverse client portfolio who can probably be your one-stop shop for all three of the interviews you need to conduct.

Actually, any chance you could turn the article around sooner? It’d be great to get it out on social ASAP.

The hotter the topic and the busier the news cycle, the higher the demands on journalists’ time and attention. During the weeks preceding HIMSS, it’s not uncommon for a healthcare reporter at a top-tier publication to receive well over 200 pitches a day. From a purely practical standpoint, the only way they can wade through the noise is to focus on their most reliable agency contacts (who, by the way, have been regularly pitching and checking in on HIMSS opportunities for months, not weeks).

How much of a difference do strong media relationships make? Consider the Fortune 500 client I mentioned earlier.

In our first month working together, we secured more media opportunities for them than their most recent large corporate agency had secured over the course of three years.

Now, did our agency-wide expertise in healthcare and healthcare IT enable us to craft higher quality, more sophisticated pitches and thought-leadership content? Absolutely. Did we also do a better job targeting the right reporter/editor/publication with the right pitch at the right time? You bet your bylines.

But the wealth of opportunities we had to choose from were partly a function of a fundamental truth about healthcare/healthcare IT PR. As a boutique agency exclusively serving healthcare and healthcare IT clients, we hear about opportunities that larger and less focused agencies don’t because healthcare journalists’ lives are already hard enough.

Another key difference: Who’s *really* doing the writing?

The complaint I hear most frequently from prospective clients is the amount of time they spend rewriting the content their current agency produces. The shared sentiment is, “in the time we spend rewriting everything, we could have just drafted it ourselves.” And that isn’t just an idle thought for many companies when I spoke with a large publicly traded company last week, they explained they use their current agency for media pitching only, having brought all content creation back in-house after years of constant rewriting.

Obviously, any agency of any size can hire bad writers. And, at least conceivably, any agency with the resources to do so can hire good writers.

So where’s the breakdown?

First (and this is the last time I’ll mention it), lack of expertise plays a role. If the writers assigned to the account aren’t strong on healthcare/healthcare IT, there’s no covering it up. Especially if they’re writing based on input from deeply knowledgeable subject matter experts.

Second, depending on the agency, even a reasonably large healthcare or healthcare IT company might be comparatively low-priority when it comes to resource allocation. The bigger and less healthcare-focused the pond, the more likely that other accounts or client-types will be seen as the truly big fish. And the big fish gets the worm, which in this modified idiom represent the more senior writers.

It sure would be nice if there was a just a checklist of what to look for in an agency

Wouldn’t it? I’ve always thought so. So here are consolidated insider tips and key questions you can use to streamline your search for the perfect agency.

Expertise Do they know your space? Do they understand the lingo? Have industry connections? Will they have senior level executives on the account, or will you be delegated to a junior team? Check references and make sure the agency is everything they actually say they are. If you’re making your decision partly based on writing samples, make sure you see the samples of the writers you’ll actually be working with.

Range of Services Do you need a PR firm only, or are you looking for an integrated marketing communications firm that can handle all of your marketing needs? If the agency only handles one service line, do they have partner agencies for other areas?

Team – Make sure you ask to meet your team. Very often with a big agency, the high-level execs you met at the presentation aren’t the team who will be working on your account. That’s unfortunate, because experience and compatibility matter.

Ideally, at least one of the people who would be on your team will also be at the initial presentation. If they are, chat them up. Are they someone you would enjoy working with on a regular basis? Remember this is going to be a close relationship, so comfort and rapport are key!

Budget/terms/scope of work – Be sure to compare apples to apples when assessing services and quantities/deliverables. Are you going to engage in an annual retainer program or project work? Will you be billed by the hour or by scope of deliverables? Based on my experience, the latter will get you more value. Teams won’t be clocking out the second your hours for the month are used up; instead, they’ll work tirelessly to successfully execute your campaigns with no limit to the time they put in. And don’t get caught in the trap of assuming a higher retainer equals better service, especially if you aren’t going to be one of the agency’s largest accounts or if they don’t specialize in healthcare or healthcare IT.

The fit matters

Once you’ve narrowed the field of potential agency partners to a fully vetted top five, you can reasonably assume that any of them are capable of handling the nuts and bolts of PR and marketing. That’s why I recommend focusing on the fit to help you make your final decision. Does it feel right? Is this the company and are these the people that you want to serve as an extension of your own team? And where do you fit in their agency world or to put it another way, what’s the pond look like?

Ultimately, every organization has to decide what’s right for them based on a host of factors. Understanding how agencies differ beyond the simple metric of size will help ensure the strengths of the PR and marketing agency you do select align with the work you want them to do and the results you want them to deliver. In some cases, a bigger agency can be better but as many of the largest healthcare and healthcare IT companies already know, it isn’t always best.