Best Medicine
CONSUMERS increasingly view doctors as less-than-trustworthy technicians, chosen more for their location or managed care affiliation than their bedside manner. In the business-to-business healthcare arena, however, physician lists are as useful and responsive as they ever were. The stalwart provider of that physician data is an organization that has as much of an old-fashioned ring of reliability as Marcus Welby, M.D.: the American Medical Association.
The Chicago-based nonprofit file is “the Cadillac of the industry,” says Norman Swanson, a business development leader at Acxiom Health in Skokie, IL. The healthcare business unit of Acxiom Corp. is one of 10 licensed to use the data from AMA physician lists.
But it’s not the only file. There are several others, each of which has special strengths.
Acxiom Health’s list features 700,000 doctors’ names. The company represents more than 50 healthcare lists, which were bolstered by the acquisition of Buckley Dement LP in 1997.
Other major lists include a 575,000-name Physicians & Surgeons file from American Medical Information Inc., a division of InfoUSA in Omaha, NE, and a 1.2-million-name healthcare professionals’ file from SK&A Information Services Inc., headquartered in Irvine, CA.
For its part, the AMA has the goods on every doctor in the country. In fact, you can’t be a doctor in the United States without being in the AMA’s database. Even physicians who do not belong to the organization (and nearly half of U.S. doctors do not belong) are in the file.
The list is a must-use for primary medical marketers who want to reach doctors by mail-medical equipment companies, biotechnology firms, continuing medical education providers, medical publications and pharmaceutical businesses.
Medical schools automatically turn over information on each student who is matriculated. Then, the AMA issues each a Medical Education Number, analogous to a professional Social Security number, which allows the association to track doctors for the rest of their lives, according to Mark Frankel, director of database products and licensing at the AMA.
The file contains 827,900 total names, of which 685,000 are actively practicing medicine in the U.S.
Some 17,000 doctors are on the no-contact list. They aren’t offered a chance to opt out when they enter medical school, but “they can call or write us anytime,” insists Frankel. “Most of them want to be on our list, because they want the information that’s being sent them.”
There are numerous selects to choose from, but not all are available for the entire file. They include name, preferred mailing address, type of practice, practice organization (whether the physician practices with others, or is self-employed), gender, birth date, whether he or she has been board-certified, licensure data, hospital data, medical school attended, graduation date and where the residency was done.
The AMA buys area-of-specialty data from the American Board of Medical Specialties. A physician’s area of concentration is important to marketers selling luxury goods in particular, say some brokers, because there can be such a disparity in income among specialists. “Surgeons make three times what psychiatrists make,” David Nelson, senior vice president at Walter Karl, Greenwich, CT, points out.
The AMA file is clean, too. “It’s always being updated. It’s constant,” Frankel says. The number of entrants to medical school fluctuates very little-about 2% to 2.5% a year. “It’s going to grow pretty much at a constant rate,” he says, adding that medical schools “are not going to double their enrollment.” Of course, all the medical files on the market boast the same cleanliness, especially SK&A’s. “We turn the file three times a year, every site and contact is verified,” says Tim Hinds, SK&A’s Western regional manager.
Better still for the AMA, its sources for gathering and updating the data are numerous, reliable and (mostly) free. “There are probably 200 ways to update data” with the help of professional societies, educational groups and the physicians themselves, Frankel says. Also, as the largest medical publisher, the AMA even gets a return address back from the post office when someone moves.
Not surprisingly, the AMA lists are-like the old-style way of practicing medicine-expensive but efficient. The companies licensed to use the AMA data pay royalties on each group of one thousand names in addition to licensing fees.
Licensees make deals with sub-licensees, such as SK&A. Because of the royalty charge, sub-licensees “have to be people who are in a position to do volume on the files. [So] they have to be squarely in the list business with related products. The AMA files for us are ancillary and complementary to our own products,” says Henry DiSciullo, Eastern regional manager at SK&A.
There’s a slew of sub-licensees-the largest healthcare B-to-B compilers such as SK&A among them-who hew to AMA specifications on how data can be used. Much of the data remains proprietary to the AMA.
“No one can get our data without our approval. We don’t have a contract with [the sub-licensee or other end-users], but we see all the contracts,” Frankel says.
Not everyone agrees that the AMA list is the best. “No list is the Cadillac of lists. If it’s right for the mailer, it’s good,” says Nelson, echoing other brokers’ advice to couple the AMA list with others to cover the universe.
Another big reason direct marketers seek out additional physician lists is that managed care has transformed doctoring from a focus on the art of healing to the science of business administration. Health maintenance organizations have driven doctors to form physician practice groups as a means of economic survival. “Doctors are putting their resources together and going to vendors and demanding better prices because there are so many of them,” says Tade Farmer, vice president of the pharmaceutical business unit at SK&A.
DM vendors, in turn, are targeting these physician groups with products such as computers, billing software, office supplies, human resources training and all the materials it takes to run a business.
The crunch of managed care has reduced physicians’ former affluence from 20 years ago when “consumer marketers always wanted doctors, lawyers and the American Express list,” according to Nelson.
Physicians are still good responders. “Because of the nature of their work, they respond to informative mailings, journal offers, etc., because it keeps them abreast of products and services they need,” observes Acxiom’s Swanson, who is a 20-year veteran of the B-to-B healthcare business.
But the growing, secondary physician-as-businessperson market signals a solid future for DMers. “Any market squeeze we might be seeing is really being offset by the physician’s office becoming more like a business,” asserts H.L. DeVore, vice president of business-to-business list brokerage at Acxiom/Direct Media, Greenwich, CT. “All of a sudden, that nice old lady who used to go to the backroom to get your medical records now needs Internet access [or] a computer training course. There’s going to be a complete reinvention of the doctor’s business office. Even when the economy goes south, doctors are not suddenly going to turn in their computers.”
And it’s the nice old lady direct marketers want to reach. SK&A’s Group Medical Practice & Surgicenter Management Decision Makers list is an attempt to meet that need. The file contains the names of 174,563 professionals with titles such as CEO, president or business manager-but no doctors. In addition to titles, selects include telephone and fax numbers, site type, gender, ethnicity, physician specialty, number of physicians and geographic data.
The AMA has a physician-group file, too, but it is limited to 120,000 doctors, and doesn’t identify non-medical staff. “If you wanted to reach a doctor with a credit card offer, you would probably do very well reaching him through the AMA file. If you wanted to sell a computer, you would want to use my file because you could reach the person at the group medical practice who is the decision maker,” says SK&A’s DiSciullo.
Nice data, but what many direct marketers want to know is which managed care plans each physician is associated with. So far, they are out of luck.
“There are companies trying to collect that information, but the problem is it changes overnight,” says the AMA’s Frankel. “And that’s why we haven’t gone after it yet. If we can’t do a good job, why do it?”
It would be helpful to know the HMO affiliation for some mailers, “but that’s never going to be an issue for the Staples or Reliable Office Supply people, [or] for the magazines,” DeVore maintains.
More important, he says, is understanding the business environment in which physicians practice. Increasingly, they work from multiple locations: an office, a hospital, a public clinic and, possibly, a medical college where they teach.
The AMA list features all those addresses. “But the question is what address is best [for a given offer],” DeVore adds. “That’s the art form of being a mailer.”
