Ouro. Gōruda. Bonzer.

If you’re not familiar with those words, you may be a US healthcare creative after the first-ever Lions Health award show in Cannes.

They’re the word “Gold,” as translated into Portuguese, Japanese, and Australian (sort of). We didn’t hear much of “gold,” “silver,” or even “bronze,” spoken in English that week. In fact, even though 40% of Lions Health entries came from the US, only 1% of our work was awarded. That’s more than just a language gap. That’s an Evel Knievel headfirst dive into the Snake River Canyon.

So was the fact that we didn’t set off any metal detectors at Aéroport Nice Côte d’Azur on our way home bad luck, bad work, or bad politics?

Well, let’s start with what it wasn’t.*

“The jury was stacked with non-Americans.” Fifty percent of the Pharma jury lives and works in the US. And one more juror worked most of his career in NYC and graduated from Bemidji State in northern Minnesota. What could be more American that that? Heck, I’m from Ohio. I was probably the most foreign judge on the jury.

“We have stiffer regulations in the US.” This is always the grand apology. And, on one hand, it’s true. Our DTC television commercials are victimized by 29+ seconds of “fair balance”. (Oh, wait. Ninety-nine percent of the world can’t even talk to consumers about branded products. How’s that for stiff regulations?) We also have to use the largest font size for safety information, and then we have additional PhRMA code guidelines! “Injuste!” we cry.

And then we look at the two non-non-profit gold winners in Pharma. One, from the UK, had fair balance hovering like a low cloud over the concept. And the other, from Australia, was an HCP film that had the disclaimers at the end. A silver campaign winner from Canada, for Cialis, utilized the “reminder” clause (i.e. showing the logo, but not mentioning the indication), and thus bypassed fair balance, which is also legal—though risky—in the States. I think when you’re spending half of your airtime airing potential dangers, the real question we should be asking ourselves is not, “Why all the regulations?”, it should be “Why are we even doing television?”

Okay, now with that out of the way, let’s look at what I believe are the real difference-makers between a “Thank you for entering” and “Wow, this is really heavy.”

Don’t Be So Direct. It’s what we’re known for. We’re Americans. We tell it like it is. But what’s seen as an admirable quality in most instances, doesn’t fly so well in international award shows. Our work, even though visually attention-getting, has a tendency to directly see and say. We show the strategy, we say the strategy. The metaphor. The icon. There is little patience for provocatively engaging a customer into the story. We have a more chest-bump, headbutt style (And, as we’ve seen from the World Cup, the rest of the world can’t headbutt.)

So campaigns that have fared well in stateside shows (e.g. “Best of Show,” multiple golds) didn’t even get shortlisted here. They were simply too easy. They deliver the message, but they don’t trigger thought. I put the blame not on US agency creatives, but on the prevailing executional research methodology: qualitative one-on-ones and focus groups. They guarantee work that quickly plays back the strategy in pure Pavlovian bell-ringing style. If work dares to take a more rewarding scenic route or gives one pause to think, they are judged “confusing” or “unclear,” and dismissed.

Are we executing against the tactic, or the purpose? As US creatives, we get a brief, for say, a print campaign or an IVA, and we immediately start filling the blank. While the tactic specified should be a guide, I would counsel that we need to leave port with a purpose, versus a deliverable. The purpose (i.e., what is the role of the communication?) should drive the creative, not the channel. The channels appear as the ideas get developed, not the other way around.

Awe-inspiring innovation comes honestly (and not as an afterthought) as we seek to intersect and connect with our customers to raise awareness, or deliver branded messages, or engage with unbranded arguments. When we focus on the tactic first, we limit the peripheral vision and the possibilities to do things better, more effectively, more creatively. More award-winning.

Technology is too functional. Yes, technology can do amazing things with the ordinary—organizing, simplifying, expediting. But, really, does making it easier for a sales rep to navigate several products really deliver on “life-changing creative” (The brilliant Lions Health tagline)? Technology can make the amazing, amazing. Golds in Pharma were awarded to a film, a bunch of print ads, and a classic integrated campaign of TV, print, web, etc. We wanted more technology there, we just didn’t see it. My advice is to challenge technology, don’t just apply it. What can it make possible, not just what can it streamline. Give it ambition, as well as functionality.

Don’t forget design. There were a few ideas that truly had the potential of greatness, but fell short when it came to attractive design. Now you can scream “Idea, and Idea alone, is King!” (though your argument falters as you tweet that with your elegantly designed iPhone 5s), but Cannes Lions has always been known for game-changing ideas intelligently produced.

And while Lions Health adds the new dimension of “life-changing,” “creativity” in all of its design glory still demands our attention. We may have dismissed a few strong, life-changing ideas in the midst of the 600+ entries, because they didn’t catch our eye and ear. It was definitely an ongoing discussion: is Design a powerful essential, or a superficial anachronism? And, hopefully, next year’s jury will continue the discourse. But, as American creatives, please pay attention to the look and feel, the copy and the imagery, of your brilliant life-changing ideas. Gold, at Cannes, is still in the details.

That’s my take on how we, as a US healthcare industry, can up our performance at the 2015 Lions Health, and steal the sōnā right out from under them.

*Forewarning: This is but one US Pharma juror’s, and silver Lions Health winner’s, opinion. It may not be anyone else’s!