‘We only ever budget for digital’
That was the line from a client that stuck with me most after presenting at the EphMRA conference recently. My colleague, Lizzie and I had just wrapped a session comparing traditional and digital ethnography through the lens of a deeply sensitive and complex topic, menopause.
We each brought different perspectives to the table - I’ve long been a digital advocate who of course still respects traditional methods, and Lizzie shared her POV how digital shifts have led to us to forget about the true value that ‘true’ ethnography brings. So, to test our assumptions, we ran a self-funded study to explore the pros and cons of both approaches.
The power of traditional ethnography
We kicked off our talk with a powerful example of ethnography in action: the This Girl Can campaign from Sport England. This initiative, launched in 2018, aimed to address the gender gap in exercise. It was informed by a rich, immersive ethnography, which found that emotional barriers like fear of judgement were holding women back from activity so much more than simply time or access.
This case study spoke to the true strength of traditional ethnography: it surfaces deep, often unspoken truths. We need to hold onto the power that these insights bring to human understanding.
Why menopause?
We chose menopause as our topic to explore that for a few reasons. It affects half the population at some point, yet conversations around it still often feel surface-level or over-sanitised. And while awareness is growing, menopause is still poorly understood. So it was the perfect test bed for immersive research.
The design
We spoke to two groups of women experiencing daily menopausal symptoms. The traditional ethnography group had a one-day in-home observation, followed by a depth interview the next day. The digital ethnography group did a seven-day WhatsApp diary using our Whycatcher tool, with wrap-up questions at the end.
This setup allowed us to compare apples with apples as far as possible. So, what did we find? To explain, let me talk you through the experiences of two women, one from the traditional group and one from digital.
Anne: the traditional perspective
We spent a day with Anne, our traditional ethnography respondent. She is a freelance journalist and mother of three living in London. She's been managing menopause with a mix of HRT and holistic approaches. Through the traditional ethnography approach, we were able to step into her world - literally. We were able to see vision boards by her bed that she used as motivational aids, an electronic eye massager to relieve tension in her face and her chaotic home. These all gave us subtle but powerful clues about her mindset, coping strategies, and values
Most importantly, the in-person time allowed us to build trust. Anne opened up with vulnerability and candour, offering a rich emotional layer to her story.
But there were challenges. Scheduling around her family meant we only had access during school hours. And although she was managing symptoms, we didn’t observe any live during our visit. As Anne herself noted, a diary or follow-up could have helped capture more of her day-to-day experiences which are always changing.
Jo: the digital perspective
Jo, in contrast, took part in the digital arm. She’s a civil servant in her 50s and has been on HRT for three years. Over the seven days, Jo logged a wide range of mental and physical symptoms including anxiety, mood swings, hot flashes, night sweats, and heart palpitations.
Her diary entries offered a real-time view of how her symptoms fluctuated throughout the week, and how they impacted both her work and home life. She spoke openly about not applying for a promotion due to her symptoms and about tension with her partner. Despite the distance of a phone screen, Jo was frank, consistent, and emotionally present in her reporting.
That said, digital had its own limitations. Self-reporting can lead to over- or under-reporting. Filming quality was inconsistent. And while Jo was very open, there was a sense of emotional distance - likely because we only saw her face and not her full surroundings or body language. As Jo herself admitted, she might have shared even more if we’d met in person.
These two women stories really neatly showed our experiences varied depending on how we engaged our respondents.
So, which is better?
The short answer? Neither…and both.
Traditional ethnography gave us deep emotional context and environmental cues but was logistically complex and time limited.
Digital ethnography offered greater access, flexibility, and longitudinal data, but at the cost of some emotional nuance.
Ultimately, the most important thing is not choosing one approach over the other - but ensuring that the methodology is thoughtfully chosen based on the research needs, context, and constraints. And yes, that includes budget.
Making digital work harder
Pharma has shifted and continues to shift to be more human-centric , but we need to carefully craft research approaches that facilitate easy participation and rich, meaningful insights. Digital ethnography can get us closer to the everyday lived experience, but if we’re genuinely serious about building more human-centred healthcare experiences, we need to make these methods work harder. Here are a few things you can do:
- Blend methods where possible. Even a small number of immersive sessions can add richness and depth to digital studies
- Ask the right questions, at the right time, in the right way. Keep prompts more open ended, so you don’t lose those hidden insights and almost bias the inputs
- Brief respondents properly. Clear expectations ensure better media, more relevant content, and less drop-out
- Think longitudinally. Choose timeframes that allow symptoms or events to unfold naturally while keeping the research easy
- Go beyond the topic. Get films of their home and environment, ask about worldview, and broader behaviour to find unexpected insights that make a powerful lens for analysis
Reflections on menopause: trends
As a bonus, when we analysed the experiences across all respondents (traditional and digital), we saw some powerful themes coming through. So, we consulted with our colleagues at Crowd DNA who have been tracking emerging trends in the world of women’s health. Observing these trends really spoke to the power of bringing both methods together:
First, the Roaring 50s trend celebrates women reclaiming midlife - not as a decline, but as a powerful new chapter. Anne, in fact, said she’s enjoying life more now than in her 30s.
Next we saw the trend of Collapse of “Having It All” which is a shift away from trying to "do it all" toward prioritising wellbeing and balance over traditional achievement.
Finally, the trend of the Sacred Self, which is a rise in romanticised or ritualistic self-care - like vision boards or holistic routines - blending emotional wellbeing with health management.
Where next?
The future of ethnography will evolve a lot in the coming years – wearable tech and other digital devices are becoming much more commonplace and are quickly making it easier for us to capture lived experience (with biometric data to back it up).
This study reminded us that how we gather insights matters just as much as what we learn. So, we need to design (and budget for) studies that help us reach that final goal. Whether you're standing in someone’s living room or reading their WhatsApp diary, the key is creating space for people to be real, raw, and reflective.
When we do that, we retain a level of humanness in our research that gets us ever closer to the person at the end of it.
We’d love to hear your thoughts - whether you’re wrestling with methodology decisions or exploring trends in women’s health. Get in touch with Lizzie or Maria to carry on the conversation.
Maria Colarusso | Lizzie Eckardt, Aug 25
English (UK) 
English (United States)