We have been telling ourselves a story about pharma communications for the past 20 years. We design pharma communications as though there is a single “general public” downstream of the HCP audience. They received correct information through the “wrong” channels — wrong only from the perspective of the deferrer-society architecture that pharma communications was designed for. I am saying that the operational defaults we have inherited do not match the media environment we are communicating in, and that the gap is widening rather than closing. It requires us to stop optimizing for an information environment that no longer exists, and to start designing for the one we have.