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Know your audience

Understanding GP and specialists' technology trends can help steer pharma's online offerings

A single microphone with a blurred audience in the backgroundFor many of us, our day begins and ends on the computer. Many of our 'conversations' happen via email and much of our 'research' takes place on the internet. 

Doctors, it appears, are no different. Even though their days are filled with hands-on patient consultations, their time in-between is spent at their desks, on their computers, and the future of their communications is definitely online.

According to a social media study conducted by ICM Research for Creston Health, both GPs and hospital specialists predict a sharp increase in their use of online materials – specifically, online medical media and virtual meetings.

Nine out of ten hospital specialists view online medical media as highly as they regard print, while one in four also rates online consumer media as useful for work.

One of the hospital specialists who took part in the research, Dr Vian Abdo-Nassri, explains: "Everything is going online simply because we all have a computer in front of us. If we hit any problem or need any information, we can Google it in seconds. It's handier, quicker and we can do it in front of the patient."

Dr Abdo-Nassri is a consultant gynaecologist in London and often has to deal with patients who have conducted their own internet research about their condition or read something in the consumer media that has interested or concerned them.

"I'm quite happy to talk to patients about what they have read. If I'm confident in my diagnosis, I should be prepared for any question," she says.

Dr Abdo-Nassri travels to work on the Underground. Her media consumption begins with GMTV, mainly to check the weather and the travel news. At the tube station she picks up a copy of free London newspaper, the Metro

At work, Dr Abdo-Nassri logs on to specialist sites, such as those of the Royal College of Obstetricians and Gynaecologists or the British Medical Journal, to catch up on latest news and studies in between seeing patients. At the end of the day, she may watch the six o'clock television news, but then it is family time.

By contrast, Cheltenham GP and clinical lead for practice-based commissioning in Gloucestershire, Dr Graham Mennie, drives to work. He logs on to the BBC News website at home, then listens to Radio Five Live or Radio Four in the car. 

"The first thing I do at work is open my post, which may include Pulse or GP, and if I have a chance, I might glance at these during surgery hours," he says. "In between patients, I tend to log on to or the BBC News website to see if there's anything there that catches the eye. At the end of the day, I might listen to the six o'clock news on the way home – but that's about it."

Dr Mennie believes medical publications are easier to read online, particularly as the printed versions are large, and not all articles may be immediately urgent.

"A lot of lead stories in Pulse and GP are about medical politics rather than clinical matters, so you have to flick through to find the clinical stories. Online, you can navigate your way through easier," Dr Mennie says.

One of the main reasons both doctors cited for their use of online resources is "time".

"From a GP's point of view, conditions such as diabetes and coronary heart disease are set to go through the roof during the next few years," says Dr Mennie.

"In the old days, GPs would read magazines and go out to meetings because they had time to leave the surgery, but now if you have five or ten minutes to spare, you might access information online instead. I use GP Notebook and the Royal College of GPs' website, but every doctor has their own favourite way of finding information."


GP & specialists social media study conducted by ICM Healthcare 2009
• Online medical media is already seen on a par with traditional medical journals by UK physicians; notably, one in three specialists perceive online consumer websites as useful.
• Social media is already central to the role of one in six physicians and they predict digital communication and information sources like e-Detailing and virtual meetings are to increase substantially.
• One in five will often have been actively reviewing forums; one in 20 UK physicians has actually written on a blog relating to their professional role in the past 12 months. Nearly half of specialists have used Wikipedia.
• Social media could have a defining role in UK healthcare due to the patient choice agenda, the virtual health experience and even virtual consultations.


Time pressures
Both doctors said their workload and daily schedules mean they rarely get to meet colleagues in a relaxed atmosphere to talk about specific clinical issues. While there might be emergency meetings about specific cases, education through peer-to-peer interaction is definitely on the decline.

In hospitals, the change to junior doctors' hours has had an impact on consultants.

"You don't have time to have lunch together any more. As a result of the European working time directive and waiting list initiatives, we are very busy," says Dr Abdo-Nassri. "Most of my interaction with colleagues comes through emails at home at the end of the day."

Dr Abdo-Nassri says virtual meetings and social networking groups may be the way forward for busy doctors. Dr Mennie agrees, observing that not only does the pharma industry appear to be sponsoring less meetings, but that doctors have less time to attend them. 

The ICM Research data showed that four in ten physicians predict they will attend fewer events, as symposia and networking opportunities become available online. Already, social media is central to one in eight UK doctors' roles.

While both doctors interviewed still see company representatives, these visits are less frequent and neither doctor strays into pharmaceutical company websites when online.

"I think the pharmaceutical industry probably needs to look at a different way of approaching things – perhaps sponsoring education initiatives on established sites for doctors," says Dr Mennie.

Trish Campbell, a consultant in medical affairs, agrees that sponsorship of educational programmes may be the way forward, although pharmaceutical companies may find it more cost-effective to develop something bespoke.

"Changes to the Code of Practice have made it easier for health professionals to access online materials generated by the pharmaceutical industry; a clear area on the site for doctors and nurses is all that is now required, rather than forcing companies to produce 'closed sites', accessible only by medical registration numbers," she points out.

The key to all pharmaceutical company activity is transparency with online content, clearly declaring any financial backing, raising disease awareness in a balanced way and not promoting an individual product, says Trish.

"More and more companies are producing their own educational websites to make sure that health professionals are educated in their areas of interest," she adds. "It's essential for health professionals to invest in educational development and sites which can help them collect their accreditation points are well received."

This view is backed up by the ICM Research data, which showed that 70 per cent of UK doctors were positive about industry-funded education and over 60 per cent thought it essential.

As for social networking, Trish states that there are a lot of discussions taking place, but no answers yet as to whether companies can sponsor these effectively within the Code. At the moment, companies must regulate what appears on forums and professional chat rooms to avoid off-licence conversations about products and identify any safety issues.

"The issue with presenting products electronically is that there's no real interaction, so it's still a challenge for representatives to get in front of doctors unless they have given previous approval to being contacted," says Trish.

Catherine Oliver, deputy managing director of Red Door Communications, says the challenges for pharmaceutical marketers in the future will be in keeping abreast of new technology and being active within it.

"We must not forget that healthcare professionals are also consumers of media and new technologies in the same way as everyone else," she says. "Nearly 50 per cent of respondents predicted that 'virtual consultations' will become a reality in the future. 

Lloyds Pharmacy has just facilitated this with the launch of 300 'virtual GPs'. The industry needs to understand how its customers' needs are changing and embrace these technological developments.

"It is critical to engage with healthcare professionals. Companies can no longer just 'release' information via digital platforms, such as flat websites, and see a return on their investment. There is a question mark over how to engage via social media at the moment, but there are other developments that we need to embrace."

The ICM Research material also shows a predicted decline in the amount of time doctors spend with pharmaceutical representatives – something which some companies are tackling online with e-Detailing.

Ben Davies, managing director of PAN Advertising, says: "The industry should not be too disheartened by this; sales forces have already been dramatically downsized by most of the major players, and the significant associated reductions in overhead will help to ease the pain of the tricky patent expiry years ahead.

"The key to effective and efficient communication in the future lies in a well-balanced and cohesive mix of both personal and non-personal communication channels."

But the burning question for everyone is how rapidly the move to online will take place. How near in the future are we talking?

Ben Gibbons of ICM Research, who carried out the study, said some aspects of internet activity, such as online consultations, may seem a long way off, "but the speed with which technology and trends are developing means pharmaceutical companies should start to examine what this, and the other findings from the insight, might mean for them."

The Author
Simon Warne, media and marketing director, Red Door Communications

9th November 2009


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