Advertising agencies effectively and, for the most part, efficiently spend over 100 billion dollars a year creating and distributing messages which have an almost magical catalytic effect, especially research shows, on people who claim to be unmoved by advertising. They are efficient shapers of facts which they convert gracefully into emotion. They tap regularly into an invisible world of digital information to produce and deliver low-content messages often with blistering effect. Advertising agencies have the leverage we need to change our way of thinking and acting. The best of them have successfully combined left brain and right, science and art, and head and heart into a relatively balanced unit of talent, diversity and drive. To boil it down to its basic transformational process, advertising agencies have account people whose job is to think like the client. And creative departments which, when they're running right, have the job of pulling the clients caution into the realms of the unseen.

Advertising is the ultimate multidisciplinary practice. Along with the analytical people who tailor mountains of statistical and demographic information, the advertising business I grew up in is comprised of people from a wide and varied cross section of American life. Along with the MBA's and other business types, there are all manner of renegades: artists, psychologists, ex-cab drivers, house painters, messenger boys, mailmen and occasionally shady denizens of the deep. There are fastidious obsessors over details, researchers, accountants, clerks, coordinators and deadline watchers. There are art directors, photographers, renderers, assemblers and writers. There are account representatives who must know something about everything and use it to represent the client's interests in the morning and the agency's interest in the afternoon.

Advertising agencies are successful because they are such a hodgepodge of characters, abilities and ideas. With so many different kinds of people sharing objectives as well as office space, an advertising agency is, when it's working right, a good example of a healthy community.

What makes this particular community healthy is not only its focus on the production of an actual product, it is also a shared character and culture in the workplace. Employees work toward a common goal in cross-functional teams — copywriter, art director, researcher, account manager — all using left brain and right. They all know how success is defined and what is expected of them if they wish to succeed.

Advertising agencies are often quirky places with singular customs and business styles. Some agencies are known for their dress codes, plush carpeting and wood panel work spaces. Others are known for their blue jean clad staff and exposed brick and pipe interiors. One of today's most successful advertising giants prides itself on its utter lack of individual work spaces, instead every employee gets a personal computer, a phone jack and the opportunity to work whenever they want. One agency maintains a sixty-year tradition of keeping a bowl of fresh apples on every reception desk; another, in honor of its first client, a cranberry grower, sends every employee a ten-pound bag of cranberries every Christmas. For a big business, advertising agencies tend to reflect all the foibles and charms of the people who comprise them.

It's small wonder that more than most other professions, advertising is in touch with the consuming American public. They're them. What's more, they know how to talk about and demonstrate benefits. More than politicians, more than pollsters, advertising people know what the public wants and how to get its attention.

The advertising business culture encourages and even rewards risk. Advertising agencies may talk a blue streak about research and planning. This is a profitable advertising sideline and research makes clients feel secure. But in the end, the production of every multimillion dollar television advertising campaign is an incredible act of faith. It involves the mixing of words and images, camera angles and character actors, nods, winks, whispers, music and sound effects into an incalculable stew — the recipe for which is forever hidden from view.

Those who want to bring about social, environmental or behavioral change love the idea that marketing might be some kind of magic. So, they turns to advertising agencies and marketing firms with their substantial state and federal dollars. But the reality of the hocus-pocus that produces the marketing brew is frightening to the medical mind. As a result, public health clients often end up fixated on that part of the marketing process that is closest to their own biomedical model: research, analysis and evaluation. Breaking the problem down and looking at it from as many angles as possible gives the health practioner the illusion of some kind of control.

A curious thing happens when you unite the already methodical approach of analytical science with the cumbersome machinery of a government bureaucracy, and then match this contraption up to an advertising agency. A sobering malaise sets in on both sides which all but neutralizes the creative fever which makes advertising a powerful catalyst for change.

Successful businesses are well aware of the primacy of risk and serendipity in their success. If we want to help foster rapid and positive change in the world, we have to first change our bureaus and departments into organizations with shared goals and values. We should rise above the level of administrative functions and create climates where not only products but personalities, boldness and fortuity are more likely to flourish.