Physician respondents are not a limitless resource
This cover story first appeared in the Quirks Special Healthcare Issue (January/February 2020).
Building a health care-focused data collection company over the past two decades has been an interesting, rewarding and oftentimes frustrating process for me. The challenge of executing research with geographic constraints of an earlier era has been replaced by more recent concerns of adequate sample supply, vendor transparency and the quality of respondents and data.
Before diving deeper into the issues of today and tomorrow, it's worth a trip back in time to remember the early days of recruiting physicians for market research surveys. While this article may have some characteristics of a "remember when" story, it is rooted less in nostalgia and more in an effort to draw on some of the best practices of the "good ol' days."
The Internet has certainly made it easier to accumulate and reach healthcare professionals, but these gains have not been made without significant sacrifices. As many sample suppliers have invested in expanding the size of their healthcare panels, the quality of the relationship between the healthcare professional and the sample supplier has deteriorated. The lack of focus on providing a great, personal experience to panelists has manifested in a number of ways over the years and will continue to be a growing problem for the industry in the years to come. As an optimist, I reject the notion of “doom and gloom” and believe that we get to shape the industry we want to have; however, it will take a significant mind shift in how we approach panels and the experience respondents have with companies in our industry. The future belongs to those who can learn how to marry the best practices of the past with the technological advancement of today and tomorrow.
A lot more fragmented
It was only a short two decades ago when I was introduced to the world of medical market research. I had just started college when I found a job at a local company specializing in conducting telephone surveys with patients, physicians and other healthcare professionals. Sharon Ricca founded Ricca Research in the late 1970s after a couple of years as an independent contractor for some of the local market research agencies. Having stumbled onto a few healthcare projects amongst other consumer work, Sharon took to interviewing local physicians and decided to focus all of her efforts on building a healthcare-focused data collection company. The healthcare market research industry was a lot more fragmented in those days: almost all of the research was conducted locally and in person. If the rare need to survey physicians in a different region arose, you would have to make a call to one of the companies in that local market and hire them to recruit and survey physicians, fill out the paper questionnaires and ship them to you for processing.
It’s disorienting to remember a time when calling phone numbers outside of your local area was unusual and, often times, cost prohibitive. Ricca enjoyed visiting the physicians in the area and interviewing them on a range of healthcare topics. She researched the topics beforehand and came prepared to have a substantive discussion with plenty of follow-up questions. The physicians also seemed to enjoy the conversations, as they always made time for her, even going so far as to invite her to their homes for interviews following a family breakfast.
The insights they provided were always detailed and thoughtful and there was never a concern about the identity of the participants or the quality of their responses. Even as the business evolved to more telephone interviewing and expanded its reach to a national audience over the next two decades, there was always a confidence in the quality of the respondent and the information they provided.
When I joined Ricca Research in 2001, the company maintained a database of friendly physicians who had participated in past surveys. Email had just started to emerge as a mass communication tool, so most of the recruiting was still being done by telephone and fax. We continued to grow the database of “friendlies” by calling new physicians in markets across the country, using phone books from cities across the United States, which diligent employees had brought back after vacationing with their families. It may seem silly now, but there was no way to just find a phone number for a physician in a different city other than by calling the directory service with specific information, or by consulting a phone book.
As I think back to the thousands of conversations I’ve had with physicians all around the country in those years, each call felt personal and engaging. We were trained to respect their time, prepare for discussions, engage them in a dialogue on the topic at hand, and provide “wow” customer service at every turn, before it was the cool thing to do.
There was a clear sense of how important each and every respondent was to our ability to get projects done and for the company to be a success. It also wasn’t uncommon for physicians to ask for us by name, and for us to know some personal details of some of their lives. The first few minutes of a conversation could sound like friends catching up. Our friendly physicians didn’t number in the hundreds of thousands, but the ones we had were consistently engaged and provided great feedback to our clients.
Surprising and disappointing
It’s not surprising that the proliferation of the Internet and the emergence of new technologies over the past two decades substantially changed the way in which healthcare professionals are recruited. What has been surprising and disappointing, however, is seeing new (and some old) healthcare sample suppliers mistreat physicians and other healthcare professionals as if they were a limitless resource. The barriers to entry for operating as a healthcare sample provider have all but disappeared with the emergence of purchasable physician lists and mass communication services. For someone who has been in the industry for some time and understands the value of each respondent relationship, it’s been frustrating to watch fly-by-night companies purchase questionable marketing lists of physicians and use them to spam potential respondents. While the effort has yielded some results, it has cheapened the relationships built over prior decades and has done real damage to the industry as a whole.
As response rates started to decline, it became more and more important for these companies to build large panels so that they could achieve the desired sample sizes. This also had the added benefit of marketing the “impressive” panel counts to customers, although proving to be useless in predicting project success. Building and maintaining large panels has a significant drawback: the bigger the panel, the harder it is to create a positive experience for each member within the panel. To maintain an excellent level of support for the hundreds of thousands-- and sometimes millions-- of panelists these companies claimed to have would have taken a significant investment, which was rarely made. Normally, this would create an opportunity for good companies to separate themselves from the competition and become the go-to survey brands for healthcare professionals.
While this may be true in some cases, it is also true that busy health professionals have a hard time distinguishing between good and bad actors in market research. After all, these respondents already have very demanding day jobs that have become increasingly more time-consuming and stressful in recent years. Having spoken to many physicians and published previous white papers on the topic, we have found that physicians find their inboxes flooded with survey opportunities that often do not provide incentives in accordance with fair market value, that questionnaires are becoming unbearably long and complex, and that there is frequent disqualification due to broad targeting criteria and the increasingly specific requirements of each study.
When respondents complete a survey, they often do not see the compensation for a long time and are not provided with a direct line of contact to customer service at the survey company. It’s typical in the industry that respondents are provided with a generic email address with an unreasonable response time to follow up on their incentive status. In more frustrating cases, respondents experience a technical issue, report it, and receive a response several days later notifying them that the survey had already closed and that their participation is no longer needed.
Take a moment to process this experience and ask yourself whether you would continue to participate under the same set of circumstances. As the industry churns physicians and other healthcare professionals every year, many companies fail to understand the true impact of this loss. Because respondents generate a recurring stream of revenue for the company as they participate in survey opportunities, it would be appropriate to apply some common e-commerce metrics to understand the value of each respondent. Having done the exercise with our team, I can report that the potential lifetime revenue for each survey respondent is in the high 5 figures. If you consider that many respondents are members of multiple panels and may get turned off from all market research after a bad experience with a single company, the potential loss of revenue to the industry is in the hundreds of thousands of dollars.
Unlike in the world of consumer research, the universe of healthcare professionals is extremely limited, and their ability to participate in any given study is further reduced by their busy schedules and increasingly strict project criteria. We’ve highlighted this trend in a recent white paper, asking a random sample of physicians about the likelihood of participating in market research surveys in one year and in five years from today. Across all specialties, physicians indicated that they would be less likely to participate in 5 years compared to a year from now. As an industry, we simply cannot afford the churn if we want to continue delivering on client sample requests.
Reverse the damage
Considering how valuable each respondent is to the future of our industry, what can be done to reverse some of the damage done in recent years? Thinking back to my start in the industry and the way Sharon Ricca trained us to care about each and every healthcare professional, there would have to be a major mind shift in how sample companies relate to their panelists.
For one, it’s healthy to question the need for a very large panel. This may seem counterintuitive, but if you really stop and think about it, is it all that crazy? Before writing the idea off, it’s worth running diagnostics on your current panel to understand whether there are panelists who never receive survey invitations because their specialty or job function is not in demand for market research. If those people exist, why bother maintaining the overhead that comes with having to service those members? Why not build a smaller, more engaged panel with a renewed commitment to properly servicing the membership in the same way we did 20 years ago, but with all the benefits of modern technology?
How do we convince sample companies with a customer service email address to move to an exceptional customer service model found in today’s most successful e-commerce operations? Sure, it becomes a bigger cost center to the company, but there is a tangible value in retention and engagement that will be reflected in company revenue. After all, healthcare sample companies are unique in that they are effectively a marketplace that serves to connect brands with the experts who provide experience and opinions.
Without a healthy supply of respondents, the model starts to break down. In the best-case scenario, the project completes at the expense of the gross margin, and in the worst-case scenario, the project falls short and the customer walks.
Many panel companies operating in the healthcare sample space today behave more like mass marketing agencies, sending email campaign after email campaign of survey invitations until there is no more respondent engagement. That may work for projects with few restrictions and audiences that have a large universe size, but for the majority of healthcare projects, it presents a challenge in getting to the desired sample size.
When recruiting hard-to-reach healthcare professionals, for quantitative or qualitative efforts, it is more effective for sample companies to think and act like a specialized recruiter and not an email marketing company. It may require an investment, but in the long run it is more sustainable than tanking the project gross margin or churning customers.
Perhaps there may be a time in the future when asking people for their opinions may be replaced with machine-generated insights from tracked data. Until that day comes, we’re at the mercy of extremely busy individuals whom we are asking to provide those opinions at the expense of spending their limited free time on other things. As a physician friend told me once when I asked him what sample companies could do to entice him to take more surveys, “It's simple - create a better experience for the survey respondent.”
Of course, we can roll our eyes at this overly simple and broad statement but if we take a moment to think about it, is he all that wrong? If you were a busy professional and a member of your company’s panel, would you participate? Would you tolerate 10 minutes of screening questions just to be told you do not qualify and will not be compensated? Would you tolerate waiting more than a year for your incentive without any response from customer service? Would you be able to spend 60 minutes of your time taking a poorly designed survey on your mobile device? The success of tomorrow's healthcare sample providers lies in the honesty with which we answer these questions.