My Jerry Maguire Memo to the health system marketing industry
In the 1996 Oscar-winning movie Jerry Maguire, Tom Cruise plays the titular character, a sports agent who has a crisis of conscience after realizing his industry has normalized protecting criminal clients, pushing players to continue playing even when risking their health, and causing sports costs to inflate so high it priced out the average fan. His realization? “I hated my place in the world.” The night before his company’s annual conference, he has an epiphany and writes a new mission statement for his agency, one that calls for less clients, less money, doing the right thing and focusing on the people they care about. He titles it “The things we think and do not say.”
This is my Jerry Maguire memo to my industry – health system marketing.
Healthcare in the United States is increasingly unaffordable for millions. In the face of our country’s healthcare crisis, I’m launching ServingOverSelling, a movement that encourages health systems to reallocate their promotional marketing to instead put the resources, energy and focus of our institutions back where they belong: on helping the people we exist to serve. As part of this movement, I’m asking marketers to take The ServingOverSelling Pledge, which calls for health systems to reallocate their promotional marketing spend in whatever way they can to efforts that help those we serve rather than simply sell to them.
Why focus on health system promotional marketing?
To be clear, there are many reasons for the crisis we face in our country’s healthcare system, many of which don’t even relate to health systems themselves. For-profit health insurers, PBMs, and pharma companies, drastic cuts to government health coverage, growing access issues, etc. etc. etc. While all of those need to be addressed, I’ve chosen to focus on an area I know intimately and one where I believe I can make a difference: health system marketing. While dramatically reducing promotional marketing in the health system space won’t solve the larger systemic issues we face by itself, it will still have an important impact.
We’ve provided in-depth rationale for putting ServingOverSelling, but there are three primary reasons we believe health systems should reallocate their promotional marketing spend wherever possible and focus on serving patients and their communities rather than selling them:
Healthcare in crisis
The healthcare system in the U.S. is broken, most health systems are financially struggling, and providers are increasingly called out for their role in rising costs. For most of the time since the inception of the formal health system marketing space four decades ago, systems could invest more in marketing and spend more promoting themselves, and no one outside the organization really cared (including consumers – see below). Those days are gone, and when every dollar matters in healthcare – and increasingly is noticed by the public – health systems should reconsider the value of their promotional marketing spend.An opportunity for higher impact
This may be a hard pill to swallow for many, but it’s the hard truth: most health system promotional efforts do little to support the growth of their organizations. Brand campaigns, US News ranking expenditures, sports sponsorships, service line promotion – these typically fail to impact the strategic growth of your organization in a material way. Systems pour billions collectively into promotional marketing, but ask yourself: how does marketing that’s focused purely on selling actually drive material revenue or margins to your organization? Now consider the opportunity to divert your time, energy and budget from selling people to serving them, such as improving the patient experience, access, community health or internal engagement? Not only will you avoid high-profile promotional efforts that can draw unwanted scrutiny and a reputational hit, you’ll be investing in your brand experience, which is the real way you can drive value to your organization over time.A Good Night’s Sleep
Given the awful state of healthcare in this country, the terrible financial future our organizations face, and the colossal amount of money and energy health system promotional marketing efforts constitute, how can a marketer in good conscience continue spending time, energy and money on efforts that often fail to deliver any real value? Can we sleep at night knowing we’re potentially wasting billions as an industry on self-promotion instead of putting that money and energy into helping people?
The conscientious objector
Given my reputation in the health system marketing space, you may be wondering how I spent 25 years helping hospitals and health system market their organizations and am now calling the reallocation of promotional marketing spend to other efforts.
Since the beginning of my career in health system marketing in 2000, I had convinced myself that what I was doing was necessary, normal and ethical. I told myself that like it or not, the U.S. has a market-driven healthcare system, and for organizations to succeed, they needed to grow, attract more patients, build brands – they needed marketing. Over time, I became a leading expert in the field, writing books, delivering keynote presentations at conferences, hosting my own retreats, and leading countless provider organizations in marketing, branding and promotional efforts. This was the system we had, and I was OK building a successful career in that system.
I feel far different today, and my growing disillusionment with my situation led to me walk away from that career in late 2025. From where I sat, I could no longer rationalize supporting so much money going to promotional marketing efforts that so often failed to deliver any meaningful impact when I was seeing the growing dumpster fire that is healthcare in the U.S. My wife is a trauma therapist, and throughout my career, when I was introducing us at a party or social gathering, I made the joke “she puts into the healthcare system, and I take out.” I decided I was done taking from the healthcare system in this country and will be working to make it better for everyone.
The signs of unease
Looking back, I really became disillusioned during the final few years of my career. That was a combination of what I saw in the healthcare crisis in the U.S. and my personal experience going through a number of agency sales that changed my perspective on the health system marketing space. What I thought was a career focused on truly helping health systems and their patients became all about making the most money possible, in no small part thanks to the emergence of private equity in the healthcare marketing agency space. But as I look back at my career, my struggle with what I saw in terms of the frequent failure of promotional marketing was there all along:
The 2011 book Joe Public Doesn’t Care About Your Hospital, which is probably the number one reason I’m known in the industry, was a manifesto about how systems were wasting their time and money promoting themselves in massive brand campaigns.
In 2020 book The Gospel of Growth, I wrote the following:
“Unlike other industries, we can’t drive growth simply for growth’s sake. We’re not Oreo cookies, where the more cookies we sell, the better, no matter what, case closed. For starters, we’re in the business of healing people. We’re about saving lives, helping the ill, keeping people healthy. More isn’t better in the grand scheme of things. More is worse, more is unseemly. More is inappropriate.”
In 2024, I introduced Rome is Burning, which highlighted for the first time new dynamics that were risking the very role of the CMO, and which by 2025 had led to more than a dozen systems eliminating the role completely.
In 2024, at the Joe Public Retreat focused on the future of the CMO role, not one of the 40 marketing leaders or industry experts convened raised performance marketing or ROI as the solution to elevating the value a CMO to a health system.
In 2024 and 2025, I spoke at national conferences on Rome is Burning and the future role of the CMO, reminding marketing audiences that our research and feedback from leaders in the industry all pointed to a future role dependent on communications, experience and AI, none of which has anything to do with promotional marketing.
Yes, it’s true that throughout most of my career I believed that health systems should focus on growth, and touted strategies such as performance marketing and branding as a means to that growth. But over time that perspective changed. Not only did I grow disillusioned with how the healthcare system in this country was becoming financially unsustainable for millions, but the ineffectiveness of what I was doing and what I was seeing in the health system marketing space became overwhelming. It took the last year of being away from health system marketing to finally see the whole truth, and to figure out what to do about it. Many CMOs I have spoken to also believe in the principles of ServingOverSelling but have no choice but to continue these ineffective marketing practices.
That’s because if you’ve seen Jerry Maguire, you know that the outcome of sharing “the things we think and do not say” was initially met with his firing from his job, losing clients, and being laughed out of the industry. And that may be a fair concern for many of you. Could reducing your promotional marketing at your organization lead to the loss of your job, or the jobs of those in your department? It could, though as I lay out, I believe marketers can drive more value by reallocating that time, energy and budget. By the end of Jerry Maguire, he has landed on his feet, ushered in a new way for his industry to conduct business that does right by those it serves, and has found a happy, ethical and satisfied place in life. We think that’s possible for all of us in health system marketing as well.
With millions struggling to afford healthcare, every dollar we spend counts, and as marketing leaders at health systems, there’s something we can do to turn efforts focused entirely on selling to our audiences into efforts to serve our audiences and improve healthcare for all.
I believe it’s time to put ServingOverSelling, and I hope you will join me by committing to The ServingOverSelling Pledge and joining this important movement.