About 15,000 physicians from 22 specialty areas responded to the online survey, which was fielded in February, to better understand physician compensation and productivity trends. Medscape has published the Physician Compensation Report for 2011, which includes the full survey and feature coverage, on its Web site.

“Medscape’s first annual physician compensation survey highlights the significant compensation gap between specialties, with pediatrics and adult primary care on the lowest rung of the income ladder,” says Dr. Steven Zatz, executive VP, WebMD Professional Services. “Responses from WebMD’s physician community also highlight that a gender gap still exists in medicine. However, regardless of the disparities in compensation, the results also highlight that nearly 70% of physicians surveyed said they would choose medicine as a career if they had it to do over again.”

While the demand for primary care doctors continues to grow, specialists still earn the most money. Primary care physicians earn less than other specialties with average annual incomes of $159,000. The disparity is most evident when primary care compensation is compared to the top three earning specialties: orthopedic surgeons and radiologists both at $350,000 and anesthesiologists at $325,000.

Among the 15,000 physicians surveyed, men earned more than women across all specialties. For all physicians, females earned a median of $160,000 while males earned a median of $225,000. The same held true among primary care doctors, where female physicians earned $140,000 compared to their male counterparts who earned $170,000. The wage gap is likely a result of a variety of factors, but the survey revealed that the number of hours worked and the chosen specialty contributed to the lower pay. Female physicians spend fewer hours per week seeing patients than male physicians; by a two to one margin, women are more likely to spend less than 30 hours a week seeing patients. In addition, fewer women are represented in higher-earning specialties.

Physicians working in larger practices with 100 or more physicians earned a median of $167,000, when compared with solo physicians who earned the least, at a median income of $144,000.

Physicians not only spend time with their patients, but also spend a good part of their work week on other professional activities. Our survey finds that most doctors devote hours to paperwork, clinical reading, administrative and supervisory work, and other professional activities each week. Looking at primary care physicians in private practice, 31% work from 10 to 14 hours per week on non-patient activities, while 22% of employed doctors put in that much time on non-patient work.

Earlier this year I had interviewed Mr. Kamp for our Podcast series, The Med Ad News Show. In that discussion, we talked at length about how the pharmaceutical industry narrowly avoided an elimination of the marketing expense tax exemption in the healthcare reform bill. Mr. Kamp talked about how he believes that the idea remains popular in Washington and could rear its head again with potentially devastating effect for the healthcare communications industry.

In light of yesterday’s events, that idea could have more life than ever. The country is clearly deficit obsessed, so this will be a key issue for politicians in the coming year.

“The deficit is going to be something everybody from the Tea Partiers to even the far Left are going to focus on,” Mr. Kamp told Med Ad News. “And nobody is going to want to raise personal taxes between now and the presidential election, so there are going to have to be taxes on businesses. But nobody is interested in taxing business either in the middle of a ‘jobs, jobs, jobs’ economy. So there isn’t a lot of room.”

Every possible source of revenue is going to be on the agenda, and the revenue that could come from eliminating the tax deductibility of marketing costs could be enticing.

As far as the healthcare reform legislation itself is concerned, Mr. Kamp does not expect attempts to repeal will have much traction in the short term. “Last night’s vote means that nobody is going to control either house,” he says. “The only thing they’re going to control is the gavel. They won’t control the votes. Every vote is going to have to be bi-partisan, and I don’t smell a lot of bi-partisanship happening today. The idea that somebody could, in that context, totally reverse the healthcare reform vote and not get it vetoed by the President is just not going to happen.”

Some Republican ideas that Mr. Kamp expects could garner some Democratic support include the possibility of tort reform, enabling of low-cost insurance policies for low-income workers, and insurance reform that allows insurance competition across state lines.

One of the major changes will be the fact that Henry Waxman will no longer be chairman of the House Commerce Committee. “That means we’ll have less noise from him,” Mr. Kamp says.

Mr. Kamp cautions, however, that this does not mean Republicans will necessarily be PhRMA’s best friend. “PhRMA enabled healthcare reform, working with the Democratic president,” he says. “There’s going to be some old bad feelings there. I’ve heard, for example, that the new speaker of the house, John Boehner, is very upset with PhRMA as an institution.”

Overall, Mr. Kamp believes that industry will need to remain vigilant in light of the election results. “It’s a mix,” he says. “The battles that were fought last year will be part of the context of the battles next year.”

Participating in an Advertising Week panel in the dimly lit Times Center Theatre, Ms. Maiman was joined by Moderator Devin Leonard, Bloomberg Businessweek; Tracy Dolgin, president and CEO, YES Network; Ken Ray, VP and CMO, AT&T Advertising Solutions; Matt Sanchez, CEO, SAY Media; and Peter Schube, president and chief operating officer, The Jim Henson Co.

Grabbing a plush seat in the nick of time, I was able to hear Ms. Maiman’s foray into a discussion of what keeps advertising agency executives up at night. Her optimistic twist was in stating that it is the excitement of the constantly fluxing industry and the goal of engaging the consumer that actually gets her up in the morning.

“Every day we have to constantly come up with new ideas and innovative ideas,” Ms. Maiman says.

She explains that in this world of information overload, research with more than 1,000 consumers on three continents yields that there is about 6.5 whole seconds that matter to actually engage the customer.

“It’s not really what keeps me up at night, it’s what makes me go to the office and think of all those ways to engage the customer in that very very very narrow window that we have,” Ms. Maiman says.

With regard to challenges, Draftfcb encourages clients to adopt integrated and unified programs in the digital media landscape rather than focusing on individual digital trends as they arise.

“It’s kind of the shiny new penny,” Ms. Maiman says. “Either they saw a mobile app, which has them so excited, or something on social. We’re like you can’t be thinking about these one-offs, it really needs to be an integrated, unified program that we’re putting forth.”

Other challenges come from an economic standpoint. Clients are looking to do more with less, looking to be more efficient, and are always inquiring what the agency is doing for other clients, such as the types of working models being put in place. Many of Draftfcb’s contracts and agreements have an incentive-based portion built in.

Ms. Maiman believes in this economy and within the existing media landscape, a unified front is beneficial for clients. With regard to clients embracing Draftfcb’s approaches to digital, Johnson & Johnson (jnj.com) recently went through an agency consolidation exercise because they realized just how many one-offs, boutiques, and different shops they were engaging. Ms. Maiman says the client realized how this truly was causing a dilution of the brands themselves, creating inefficiencies, and creating a dilution of the brands messages.

“You need an agency that is prepared for the digital age,” Ms. Maiman says. “Every agency you engage with should be able to hit and embrace all of these channels and all of these customers. We partnered with [Johnson & Johnson] on an exercise where we really streamlined their different services and we serve as the brand champion and brand steward in concert with them.”

In the area of procurement a tough environment is becoming tougher, but is evolving on the healthcare advertising front. Procurement is not sitting in their offices dictating, but are rather looking to actively partner and share best practices. There is an openness for a relationship and a discussion rather than a mandate.

While procurement is not new on the healthcare side, there is more of an emphasis on efficiency as opposed to cost alone. Ms. Maiman believes that it was the merger between Draft and FCB Healthcare that has equipped the agency to handle challenges with ease. Combining Draft’s measurement skills honed prior to the digital explosion, along with the integration of CRM and eCRM, the agency can measure everything, which helps it to engage in more incentive-based contracts.

“We know we can deliver in that regard,” Ms. Maiman says. “Honestly we embrace procurement, because it’s much easier to keep your friends close and we really follow that philosophy.”

According to Ms. Maiman, the existing economy and changing digital landscape has positioned the agency greatly. An investment in talent is something the agency has focused on in the past year, while some companies are cutting back and letting their talent go. Draftfcb has hired more than 100 individuals in the last year.

“A lot of clients are fleeing mediocrity and flocking to innovation,” Ms. Maiman explains. “It’s not a case of rising tide lifting all ships.”

Following the panel’s closing remarks and mass exodus, I made my way downstairs and was able to meet up with Ms. Maiman for a little more than 6.5 seconds, which was just enough time for a firm handshake and quick thank you to her for a recent phone chat with me with regard to my upcoming “Women in Leadership” article for Med Ad News.

To read more about what Ms. Maiman and many other high-ranking female industry peers have to say about industry challenges and their rise to the top, pick up an October issue of Med Ad News.

Breaking down what the changing commercial business model entails, 40% of respondents identified the increased focus in market access strategies as the biggest change to the business model. Other factors cited as the biggest change to the commercial business model include primary sales force realignment (20%), increased focus on managed care (17%), increased focus on key opinion leaders (11%), and increased use of e-detailing channels (6%).

Beyond the changing commercial model, the Cegedim Dendrite survey found pharma execs anxious about pipeline growth (24%), the impact of regulatory reform (16%), generic competition (16%), cost, capital, and funding issues (3%), and patient involvement (2%).

Survey respondents stated that new product innovation and profitability growth are the most important business objectives in 2010. New product innovation and successful launch was cited by 67% of respondents as the top objective for 2010 and 51% cited profitability growth.

Not surprisingly, most survey respondents view prescribers and patients as their most important primary and secondary customer groups. What may be somewhat surprising, however, is a full 36% of respondents ranked patients as the primary customer over prescribers. Meanwhile, 27% cited managed care organizations as the primary customer and 24% cited government. Cegedim Dendrite analysts anticipate seeing the balance continue to tip away from prescribers as a primary customer toward these other groups.

The survey also sought pharma executives’ opinions on social media. Respondents are aware of and use social media, but it generally does not receive a large appropriation of their marketing budgets. Almost all (97%) of respondents indicate that they use at least one social media site on a daily basis, though whether that is for personal and/or professional use is unclear. The majority (51%) invest less than 5% of their sales and marketing budget in social media channels.

Social media is primarily used for external applications such as marketing and PR but is also used to a lesser extent for internal communications and human resources. Fifty-nine percent of respondents list “marketing” as the top way their company is using social media.

Software as a Service (SaaS) and cloud computing only seem relevant to a relatively small number of respondents. Only 7% cite the technology as “very important”, and 15% cite it as “important.” Many respondents do not appear to understand the topic, with 45% responding “Don’t know” to the question, “How important is SaaS or cloud computing in your sales and marketing initiatives?”

China was cited as the most strategically important BRIC country. Thirty percent of respondents chose China but 27% did not know which country was most strategically important for their company.

In reviewing the results of their survey, Cegedim Dendrite analysts came to the conclusion that the next six months of 2010 will most likely show pharmaceutical companies remaining focused on changing business models and product innovations. And as market growth in China and other BRIC countries has more of an impact on the industry, Cegedim Dendrite analysts expect to see pharmaceutical companies making changes to become more global-minded.

Houston numbers 2,170 physicians across 385 sites, according to SK&A. Meanwhile, San Antonio numbers 1,607 physicians across 332 sites, Fort Worth numbers 1,029 physicians across 303 sites, and Austin numbers 974 physicians across 137 sites.

Why is this? High skin cancer rates? Dust lung? The preponderance of bull-riding injuries?

Actually, as the Wall Street Journal Health Blog reported in 2008, “In the last three years, 7,000 doctors have moved to Texas. So many doctors want to practice there that the state has had trouble keeping up with the requests for licenses.”

Due, according to this opinion piece in the WSJ, to a clampdown on damages in malpractice suits.

But these clusters are major population centers, and Texas is a big state. Despite all the doctors in places like Houston and San Antonio, The Texas Tribune reported in January that, “Dozens of rural Texas counties have no primary care doctors, no hospitals, no pharmacies. Many Texans live more than an hour from basic medical care. Some border communities have so little health care that U.S. citizens cross over into Mexico to get it.”

The article explains the discrepancy as the “payer mix” problem: “Rural Texans, who are older and poorer on average than urban Texans, are often uninsured or on Medicare. Some are undocumented, particularly along the border. They aren’t profitable patients for doctors, pharmacists or hospitals struggling to stay in business in isolated communities.”

According to this December 2009 article in The Dallas Morning News, legislators in Washington tried to make a difference by getting some relief for the rural healthcare system written into the Senate and House healthcare reform bills in the form of higher Medicare reimbursements for some rural health programs and geographic areas and added resources to recruit providers to rural areas.

With passage of healthcare reform now on the rocks, however, even that help looks uncertain. Meanwhile, nonprofit rural clinics are struggling to fill the gap.

The Partnership for Prescription Assistance is also doing what it can. A year ago today the partnership announced that its “Help is Here Express” bus tour would be making stops in various cities throughout Texas in order to help uninsured and financially-struggling Texans access information on programs that provide prescription medicines for free or nearly free.

The Partnership for Prescription Assistance is a nationwide effort sponsored by America’s pharmaceutical research companies providing a single point of access to more than 475 patient assistance programs that help those who are uninsured or struggling financially. Nearly 200 of the programs are provided by pharmaceutical companies.

As future business leaders, today’s children are primed to work and collaborate in a real-time, 3D virtual setting. ProtonMedia is laying the groundwork for that future as the developer of ProtoSphere, a virtual social environment in which users’ computer avatars can meet for online teaming and collaboration. ProtonMedia’s customers include such life sciences companies as AstraZeneca, Johnson & Johnson, and Merck.

Although Ms. Kittrel acknowledged that as of now, interest in the possibilities of virtual collaboration far outstrips actual adoption, as her examples demonstrate, for the next generation of life sciences CEOs, researchers, and sales people, a second life will be second nature.

Microsoft’s Sam Batterman, who goes by the title “business intelligence evangelist,” spoke today about how these virtual collaboration environments function as far more than just the “N” drive on a company’s network. For example, in addition to document and application sharing, ProtoSphere provides the tools teams need to collaborate socially online, including holographic virtual spaces with interactive avatars and bots, VoIP audio conferencing, text chat, presence awareness, video streaming, blogs, wikis, feeds, role-playing simulations, content workflow, and enterprise social networking. For the life sciences industry, Mr.  Batterman suggests uses such as constructing virtual data rooms, a chemistry plaza, or innovation and ideation networks.

The big question is, why do all this in a virtual environment? Why transform the collaboration companies do every day into a massively multiplayer online role-playing corporation? The answer, according to panelist and ProtonMedia CEO Ronald J. Burns, is that in a virtual collaboration environment, it’s not just the charts and graphs and documents housed in the online environment that have value; the avatars themselves have value. The skills and expertise held by the real-world personalities behind the avatars are available and accessible.

But that’s not the only reason, according to panelist Tony O’Driscoll, a professor of the Practice of Business Administration at Duke University. He believes that virtual collaboration online represents the third generation of the Web, the point where the user is enveloped within the content.

The author of Learning in 3D: Adding a New Dimension to Enterprise Learning and Collaboration, Mr. O’Driscoll highlights the value of learning in 3D environments with the equation I x I = E. That is, Interactivity times Immersion equals Engagement. His research has found that bringing people together in virtual learning environments can have a positive impact on the learner’s engagement with the material. According to Mr. O’Driscoll, learning leadership is not only possible in the virtual environment, it’s an ideal venue in which to do so.

In the gaming world, roles change quickly and decisions must be made rapidly, on the fly. Gamers must assimilate numerous sources of input to develop strategies and put plays into action. The gamer must then quickly develop new skills in order to advance through the game. The same principles of learning, advancement, and reward can be transferred to the business world, according to the proponents of virtual 3D collaboration technology.

Before virtual collaborations can gain traction in the business world, however, a critical mass will need to be reached of senior leaders ready to adapt to new technology, according to panelist Tom Kaney, managing partner, MKP Partners.

It may just be a matter of time. Today’s 13-year-old 7^th level mage fighting orcs in Azeroth is tomorrow’s pharmaceutical sales rep or oncology researcher. She’ll be ready to bring the power of virtual collaboration to the workplace, if companies like ProtonMedia don’t succeed in getting there first.

Yesterday, PricewaterhouseCoopers announced a new report called “Pharma 2020: Taxing times ahead – Which path will you take?”, which looks at the forces that are driving up the effective tax rate for pharmaceutical and life sciences companies. The company calculated the effective tax rate of the top pharmaceutical and life sciences companies and found significant differences, which may make the industry as a whole or sub-sectors of it a likely target for increased taxes.

The report identifies several market forces making tax issues more complex. For one, the global recession has made tax authorities hungry for new revenue sources to overcome growing budget deficits and potential new costs associated with healthcare reform initiatives. As a result, they are focused on the use of tax havens that allow multinational organizations to move profits offshore.

Second, drug and device makers are shifting from a purely product-centric focus to a service model aimed at improved patient outcomes and prevention or cure, versus ongoing treatment, of disease. Pharmaceutical and life sciences companies not only could face new and higher taxes as a service provider, but they will have less ability to allocate profits to lower-tax rate locations.

Third, the need to fill the shrinking drug pipeline has fueled a resurgence in mergers and acquisitions, in-licensing arrangements, and formation of partnerships and joint ventures, which all come with significant tax implications, depending on how a company accounts for acquisition-related items, structures royalty payments, and shares profits and losses among different legal entities and locations.

Fourth, pharmaceutical and life sciences companies are interested in locating intellectual property development in areas that offer economic and tax incentives and to expand their presence in emerging markets that promise growth potential. International competition is intensifying to attract new investment by pharmaceutical and life sciences companies, particularly from emerging markets, such as China. According to PricewaterhouseCoopers, this trend may drive profit growth to the East, but companies will need to balance increased income with higher tax rates and potential price controls.

As part of PwC’s Pharma 2020 series examining key forces reshaping the pharmaceutical marketplace, this latest report looks at trends projecting out over the next decade. I’m in the process of preparing my Agenda 2010 feature for the January issue of Med Ad News, so I spoke with Michael Swanick, PwC’s global pharmaceutical and life sciences tax leader, to learn more about the tax trends that will affect the industry with a particular focus on some of the shorter-term implications. My conversation with Mr. Swanick follows.

Med Ad News: What particular trends will have tax implications for the industry heading into 2010?

Michael Swanick: One of the challenging issues in the short term is the combination of the economic crisis, at least in this jurisdiction, and healthcare reform. It begs the question about financing and funding those reforms.

We’re seeing it clearly in some of the examples that are coming through Washington as we speak, and we think that collectively, it probably translates into higher taxes for companies in this sector. It almost seems to us inevitable. Somehow this healthcare reform has to be funded, and they’re going to anyplace they can, to be honest with you. It seems that policy has been shelved, and everything is focused on where can we get revenue to fund these healthcare reforms.

We’re seeing it in some of the proposals where you’ve got specific taxes on the pharma companies and the medical device companies that they’ve been tagged to fund, in the case of pharma, something like $2.5 billion a year, and the medical device those numbers are around $2+ billion that they’ve been hit with. Excise taxes and things like that. And you saw it with some proposals on insurance plans, where you have these Cadillac plans where they’re being hit with taxes if the plans are too rich.

So you see the administration and the government, particularly in this country, looking to raise revenue and drive up taxes, and we think that trend could continue. We’ve got a request for more coverage and better quality coverage in this sector. Those things come with a cost, and nobody wants to pay for it. We’ve got a nation that doesn’t want to have their taxes increase. That seems like you’re going to find yourself migrating toward the corporate taxes.

Med Ad News: Is this trend across industries, or is it unique to pharma?

Michael Swanick: To answer your first question, the legislation that’s being proposed does not necessarily, in general, focus on pharma and life science companies. It’s changes to our tax code that will capture all corporate groups. With one exception I mentioned: they specifically targeted pharma and life sciences companies for those specific taxes to fund a portion of the revenue in there. So that’s one exception to what I just said.

The other thing that becomes particularly challenging if not punitive for the pharma and life science companies is that these companies, particularly the large corporate groups, tend to be very international, and the biggest fund-raising piece of the proposal are focused on international provisions, which will impact this sector the most.

So, it’s going to affect all big companies and international companies, but given that most of the major pharma companies are international, they’re going to feel the pain particularly because they’re doing business overseas and some of the biggest revenue raisers are focused on that structure. That is, companies that are doing business that have a lot of earnings and profits off shore, and what the administration is trying to get at is, if you’re going to leave the money off shore, we’re going to tweak our tax code to defer some of your expenses until you repatriate that money to the U.S. And that will particularly hit the multi-national groups, including the pharma companies.

Med Ad News: Are the smaller specialty and emerging companies more insulated from tax increases?

Michael Swanick: I would say so. I would say the smaller, wholly domestic companies. We’re seeing some proposals in the R&D, for example. I think they created a special R&D credit for small start ups who have less than 250 employees and things like that. The administration is still trying to be benign and helpful to these companies to promote growth, to increase investment and intellectual property here in the U.S. So from that perspective, they are probably a little bit protected from some of these big revenue-raising provisions.

The other point too that’s worthy of mention is that you just got an administration in Washington, you have the G20 group that’s very focused on this concept of tax havens. It seems that a lot of the governments are very concerned about the use of low-tax jurisdictions. That includes countries that the pharma company invests heavily in. They’re taking advantage of the environment in Ireland, Singapore, and Puerto Rico and places like that. It’s not clear and there’s not consensus among all those governing bodies and leaders as to what’s a tax haven, but it seems that anybody that has a low rate is being characterized as a tax haven.

So, for example, we’ve seen such traditional countries like Switzerland and Ireland being tagged in some lists as tax havens. Those are very normal and traditional countries that the pharma companies have operated in that have been flagged, so there’s a lot of concern about whether they’ll continue to be included in that group, and if so, what does that mean from a corporate, commercial, and tax perspective.

Med Ad News: In terms of what the industry can do about all this, your report lays out some suggestions, but in terms of timing, are these things that should be thought about in the short term? Or are they more longer-term fixes?

Michael Swanick: As we speak, most of the corporate groups are very concerned about the trend in the administration and the policy and proposals on taxes at the moment. And very concerned meaning that they are trying to do a lot about it. Number one, they have their people studying the proposals very hard and quantifying the impact on their taxes and in general their income statements and financials, etc. Which is a logical reaction. But they’re maybe more proactive than they historically have been in terms of communicating the impact of these proposals to their representatives in Congress in trying to make a compelling argument about competition and leveling the playing field.

On that latter point, I would say the argument is that their competitors, i.e. the Swiss pharmas, UK pharmas, and a number of other non-U.S. based pharmaceutical companies have a much more benign tax regime to oversee the taxation of overseas profits, for example. It seems the U.S. is probably saying, if you’re going to keep your profits offshore, we’re going to penalize you by up ticking your taxes a little bit by deferring these taxes. So therefore you might say the effort of lobbying and communication and communicating with the representatives has escalated to a great degree. That’s something we’re seeing a lot.

Then, thirdly, they’re asking themselves, maybe they need to change the way they’re doing business. The historical, let’s manufacture offshore and then sell into the U.S. model with the blockbuster driving a lot of the profits there might need to change. And if the blockbuster model is expiring and there’s this escalation of personalized medicine, these companies are probably saying we need to abandon the historical model of operating and move toward a change.

There is a holistic look at where do we want to do our R&D, where do we want to own our IP, how do we get closer to the market. How do we service in this personalized medicine arena better than we’ve historically done? What we’re seeing is corporations reassessing the way they structure themselves, what’s their strategy for everything from R&D to sales and marketing to their ownership structure. And knowing that change is coming and they have to be out in front and planning for it.

Med Ad News: These efforts they’re undertaking, is it important for them to publicize the fact that they are making these changes to prevent the fear among their shareholders that a report like yours might generate?

Michael Swanick: That’s interesting you say that, because there is a lot of discussion in the financial realm about disclosure. Everybody is trying to be more transparent and avoid the surprise, particularly to their shareholders. And we have seen disclosures and some financial statements about the proposed legislation in Washington clearly just as a heads up, if you will, to give their shareholders and investors an upfront notification that if this is enacted, it could have a pretty negative impact on the bottom line vis a vis increased taxes. But I haven’t seen any requirement to do so other than just good financial reporting standards. But I don’t know that we’ve seen any U.S. GAAP changes or anything that would require such disclosures. But good governance folks are looking at it and asking themselves, is this impactful to such an extent that we should disclose it to our shareholders?

But that’s kind of like the proposed Washington legislation. In terms of the planning and anticipation that corporations are doing, perhaps in anticipation of these changes, I don’t think we’re seeing anything in that regard. Corporations are just doing their work and trying to handicapping the likelihood of passage of some of this legislation.

Some of the largest healthcare advertising agencies and networks – including McCann Healthcare Worldwide, Sudler & Hennessey, Ogilvy Healthworld, Grey Healthcare, CommonHealth, Euro RSCG Life, and Cline Davis Mann – have collaborated with the American Association of Advertising Agencies and the Coalition for Healthcare Communication to put together a presentation. You can read it here.

The presentation will actually be given by John Kamp, an attorney at Wiley Rein and the executive director of the Coalition for Healthcare Communication. Reading it, I see they’ve come up with a new acronym for us: FRI, or “FDA regulated information.” The pharmaceutical industry and the agencies want to fight “widespread Web healthcare inaccuracy and fraud” and work with FDA to set standards for FDA regulated information. The idea is that, “robust FRI would support legitimate sites, easier browsing by professionals and consumers and better information supporting public health.”

Establishing a standard for FDA regulated information and being able to designate sites as having FDA regulated information would help “professionals and consumers … recognize sites, networks designed to offer authoritative, accurate information”; “visitors would know industry promotion is overseen by FDA”; and “would create ’safe street’ alternatives to sometimes ‘unknown street’ environment.”

The coalition also says FDA, CDC, CMS, and the FTC need to coordinate efforts to combat “false, dangerous information” and provide “quick, visible enforcement.” I know the industry is frustrated about the information distributed by the quack shillers of dubious herbal and other medicaments, but so much of this information is passed on from person to person in places such Tribe.net, where there are more than 2,000 forums devoted to health and wellness. There are vendors of alternative medical services and goods, but most of it is well-meaning people giving advice such as this (how to “naturally” combat MRSA with something called usnea). And the participants are not just the United States, but around the world. How an interagency effort can even begin to touch stuff like this, I have no idea.

The main point made by the industry in the coalition’s presentation, however, is that FDA must consider site control, not content, in its regulation of industry information. This seems to point the FDA away from clubbing pharma companies for Sidewiki-contained information, since these companies cannot control who puts up a Sidewiki on their sites.

In the end, the FDA will take all of the information presented and come up with guidelines the industry can live with. Or it won’t. But seeing the runup to the hearing continues to be interesting.

One new agency, founded by Mike Rutstein called StrikeForce Communications, has adopted a sharpshooter approach to target clients’ needs and trim costs in healthcare marketing. Mr. Rutstein says StrikeForce uses a “SWAT Team” model, deploying a select group of talented industry people to pinpoint problems and deliver effective solutions.

Much of Mr. Rutstein’s existing DTC approach was honed during his years at DraftFCB, where he was simultaneously executive VP, director of consumer healthcare and chief growth officer, and at JWT, where he was senior partner, business development, and managing director at Health@JWT. Clients included pharmaceutical giants, such as Merck & Co., Roche Laboratories, and Boehringer Ingelheim GmbH; and more specialized operations, such as Barr Laboratories, Alcon Laboratories, and Cord Blood Registry.

Stay tuned for more detail about StrikeForce Communications in the December issue of Med Ad News.

11:30 a.m: Getting the Most out of Your Agency—The Agencies Weigh In

I arrived in time for the final pre-lunch segment, moderated by Med Ad News Editor-in-Chief Christiane Truelove, who directed questions to Joe Shields, product director, Enbrel, Wyeth, and Dave Paragamian, partner, Euro RSCG Life LM&P. The two industry veterans tag-teamed issues about the client and agency relationship, inciting inquiries from the audience about how agencies can truly improve their existing methods or evolve their business models to benefit collaborative efforts in changing times.

Mr. Shields admits that while marketers want their agencies to play more of a consultant role, the flip side is that marketers do not always want to pay for it. Mr. Paragamian agrees that marketers are looking for more, with less money to spend. In addition, the two wrestled with the definition of an ‘integrated’ agency, grappled with how to deftly manage social networking and digital trends, and tackled the various stages of brand campaigns.

12:30: Lunch

Opting for the big salad, I lent an ear to Stan Bernard, president, Bernard Associates L.L.C., who continued his discussion about ‘winning’ in a competitive era with Patricia Spinner, group publisher, Canon Communications, and Ms. Truelove. It was refreshing to hear such a wakeful voice engaging us with an unrelenting mindset toward competitive intensity.

2 p.m: Achieving Sales, Brand, and Managed Markets Alignment in Today’s Fundamentally Altered Environment for SFE

The first post-lunch presentation, led by John Moran, leader, commercial effectiveness, IMS Health Management Consulting, discussed tools and tactics that could be used to coordinate sales, brand, and managed markets more effectively.

Mr. Moran spoke about how brands fall into three categories — commodity, transitional, and differentiated. The differentiated classes are characterized by significant product innovation, no generic equivalents, and little payer influence on prescribing decisions; commodity are classes where the main differentiator is price, with considerable payer influence over prescribing decisions; and the transitional class comprises those products that fall between the two extremes and are likely to undergo significant change.

IMS states that companies are overspending within the commodity segment, where the share of voice paradigm is largely obsolete and return on investment well below par. By improving promotional productivity the industry could save $15 billion, money that could be better allocated elsewhere. Other thoughts touched on payer-driven value development plans, patient-centric brand message development, and the use of anonymous patient-level data.

In closing, Mr. Moran outlined the steps to adopt a more patient-centered strategy, such as value diagnostics to assess brand strengths vs. marketing positioning, comparing call plans that use patient data and access information to current plans, and tracking brand performance by patient segment and corresponding physician segments. Mr. Moran closed with the hypothetical question of whether ‘promotion channels are being optimized for the highest potential patient segments?’

2:45 p.m. Resource Allocation: Finding The Right Mix

Speaker Dorothy Gemmell, VP, WebMD, and guest panelist John Furness, associate director, oncology marketing, Bayer discussed resource allocation and the marketing mix. According to Ms. Gemmell, from 2002 to 2008 the Internet has increased in use and satisfaction among information-seeking consumers. Access to physicians was another topic of discussion.

Mr. Furness delved into details of Bayer’s oncology brand Nexavar, citing salesforce dynamics and minor references to the company’s partnership with Onyx Pharmaceuticals Inc.

3:45 p.m. Pharmaceutical, Biotech, and Medical Device Video Marketing Strategies

The final presentation, by Raj Amin, CEO and co-founder, HealthiNation, focused on how to effectively manage fair balance in video programs. Mr. Amin entertained the lasting crowd with a lively “Slap Chop” video segment with Vince Shlomi, better known as the ShamWow pitchman, as well as with snippets from the Nuvaring portion of the ‘Girl Talk’ series.

Mr. Amin stresses that video should become the center of a broader strategy, adding that when investing in video marketers should create programs and series to use in a wide variety of outlets. In measuring performance, he believes it is ‘not about the click.’ The focus should be about whether the video is driving people to the physician and if it is driving the ‘right’ people to the physician.

4:30 p.m: Closing comments

As Ms. Truelove bid us adieu and safe travels, I sensed something in the remaining amphitheater audience. Like pupils in lecture hall, there was a hunger for knowledge. As time abruptly pummeled toward supper, there was no conference-door rush. Instead, an honest cross section of the industry came into focus as industry reps and vendors propped their weary heads — a meridian of leveled minds famished on the even playing field of pharma.

Industry tenets projected like prism reflections on the wall as marketers, ad agencies, and vendors alike homed in on the future identity of the pharmaceutical marketing industry. I have to say, unicorn symbolism aside, Integration was definitely in the building.

“Now I will believe that there are unicorns.” — William Shakespeare, The Tempest