There aren’t many people in healthcare marketing who have lived the RFP process from both sides of the table — long enough on each to know exactly what’s broken and why. Jean Hitchcock is one of them. After 20 years within healthcare systems, including 9 as CMO at Scripps Health, she joined Yes& last year. Jeff Nowak, the agency veteran of the partnership, has spent his career on the other side of every awful version of the process.
Together, they’ve built a framework for the healthcare RFP. Not a pitch tactic. A working argument for how the process should go — at a moment when budgets are tightening, FDA enforcement is climbing and compliance stakes keep rising.
The diagnosis
Hitchcock’s diagnosis cuts to the bone. RFPs as a tool didn’t come out of the marketing world. They came out of procurement — a financial construct designed for buying beds and widgets, where the lowest qualified bid wins, and the relationship doesn’t matter. Marketing isn’t beds and widgets. Picking an agency is picking a partner.
Nowak sees the same problem from the agency side. In healthcare, broken RFPs sit on a spectrum. On one end, the vague brief asks the agency to “think about something” because the client hasn’t yet figured out the problem. On the other hand, a deliverables list that skips strategy and orders assets like a takeout menu. Both leave agencies guessing.
“Healthcare is the great equalizer,” Nowak says. “You cannot fake it.” The category is regulated, political and a magnet for social issues. Faking it does not survive a hospital system.
The framework
The Yes& framework runs on three layers. The first proves the agency understands healthcare from a strategic, business and category perspective. The second brings a clear, research-driven point of view on the actual problem the client is trying to solve, plus the capabilities to deliver.
The third is the one most agencies skip. It is the partnership itself — a team that not only knows the client’s business but also cares about it, one the client will like working with. That layer doesn’t fit on a slide. The client has to feel it through the process. It’s also the layer that determines whether the work will be good and whether the relationship will last.
What the brand side wishes the agency side knew
Hitchcock’s brand-side wisdom is the part of the framework most agencies are missing.
Healthcare has its own cultural geometry. Inside any large system, there is the mothership hospital and the satellites. There is specialty care, and there is primary care. The smaller ones always feel they don’t get anything. An agency that doesn’t read that reality back to a client lands as an outsider, and creative reviews go badly fast.
When Hitchcock was hiring agencies as a CMO, she never asked for references. She asked for two clients the agency had lost in the last three years, and why. Then she went and talked to those clients. A reference will say wonderful things. A breakup tells the truth. The agencies that didn’t shy away from the question, she says, were always the ones worth hiring.
There is also the leadership slide. Most agencies still put one up showing all the men running the firm — what Hitchcock calls PMS, pale, male and stale. Eighty percent of healthcare marketing leaders are women. The slide isn’t a bad look. It’s evidence that the agency hasn’t paid attention to who they’re pitching.
Why this matters now
Healthcare marketing has spent decades being cast as overhead, the first thing cut when budgets tighten. Hitchcock says the tools to flip that — better data, better financial partners, real ROI conversations — have finally arrived. “That puts them at the leadership table,” she says. “And they’re not an afterthought.”
The RFP, done right, is where the leadership-table conversation begins. The agencies that show up with an understanding of the business — not just the deliverables — earn a different kind of relationship. They become the call clients make when something is going on that isn’t even in their scope. Trusted advisors, not vendors.
That’s the real argument inside the Yes& framework. The RFP isn’t a hurdle to clear. It’s the first chapter of the partnership. For too many agencies and clients, treating it as anything less has been the source of the problem for decades.
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