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.”

Crucial conclusion for the eyes of pharma marketers: nearly half of the physicians surveyed say they require or prefer appointments to be made by reps prior to one-on-one meetings, while about 23% of doctors refuse to see sales reps at any time at any of their practice locations.

According to the SK&A survey, the percentage of doctors who will not allow access unless an appointment is scheduled increases measurably when their practices are owned by hospitals or health systems. In many cases, the appointment must be made through a headquarters location rather than the practice site itself.

Some other important findings:

• 98% of respondents report that their offices are visited by up to 20 industry reps per week or one rep an average of every two hours.
• Specialty physicians are less likely to grant sales reps access than general practitioners. The top-three most accessible physician areas are allergists/immunologists (4.2% no-see rate), orthopedic specialists (5.1%), and diabetes specialists (7.6%). The least accessible physicians are diagnostic radiologists (92.1% no-see rate), pathologists (91.8%), and neuroradiologists (90.6%).The access rates for these specialists have remained constant for the last two bi-yearly reporting periods.
• Offices with fewer patients seen daily are less likely to see sales reps. Sites with a daily patient volume of one to 10 have a no-access rate of 28.9%, while those with a daily patient volume of 31 to 40 have a 13.4% no-access rate. Sites that are less busy are often staffed by one physician who is not able to take a break from patient appointments to visit with industry sales reps.
• Health system- and hospital-owned offices are less likely to grant sales reps access. Health system- and hospital-owned offices have no-access rates of 30.8% and 29.6%, respectively. Non-health system and hospital-owned offices have no-access rates of 21.4% and 21.7%, respectively.
• Larger practices are less likely to grant sales reps access. Offices with one to two physicians have a no-access rate of 13.3%, while offices with 10 or more physicians have a no-access rate of 42.2%.
• Physician offices in the Western United States are least likely to allow sales reps access. The South had the lowest no-access rate of 19.4%, and the West had a 28.4% no-access rate.

“Entering the second decade of the 21st century, the imperative to take a human-centered approach in everything rings loud,” Ms. Hoenig-Carlson says. “This means getting inspired by people; especially those who share the condition which we seek to improve, and adopting a more collaborative and engaging orientation. Excelling in a patient-centered world requires that we observe and dialogue with customers in their real-life environments.”

Six key themes emerged in the book:

1) e-Patients are at the center and critical to learning and design;

2) Authenticity isn’t a “nice to do”, but a “must have”;

3) Don’t get distracted by social media bells and whistles – remember the basics (especially SEO) and keep your brand core strong;

4) The marketing cycle of life is going through unprecedented change requiring the industry to unlearn much – movement from paid marketing to earned marketing requires a different mindset and skills;

5) New marketing requires new ROI thinking…the ROI of connection, authenticity and compassion; and

6) Effective marketing and engagement requires new kinds of leadership skills.

According to Ms. Hoenig-Carlson, the early response to the book has been positive. “We’re seeing continued interest as healthcare marketers dig into complex change,” she says. “Social media, e-patients, consumers, and healthcare organizations continue to converge online, and brands are challenged to find a new voice and new online roles.”

The e-book is posted on the AdvanceMarketWoRx site at: http://bit.ly/5kuxO5.