The Empowered Patient A diagnosis triggers a hunt for information from television, Websites, family, and friends. Once a prescription is written, relationshipmarketing programs build loyalty while direct mail can erode loyalty. The impact of all this on the physician is signif icant.The physician is now part of a negotiation rather than the decisionmaker. An understanding of the patient’s position and the basis for that position is essential for a successful dialogue. It is important for physicians to have an awareness of these direct topatient communications and for sponsors to realize that the quality of these communications may have an impact on the physician’s attitude toward the sponsor and its products. Managed Markets, Financial Stakeholders, and Healthcare Consumerism Managed care has had an impact on the physicianprescriber. But it is clear that the impact has been less severe than expect ed. Influence is moving from these intermediaries to their cus tomers — the financial stakeholders, employers, employer groups, and governments. As these customers increase their healthcare knowledge, they accelerate cost shifting to patients to inject market forces into the prescription moment. By moving financial risk to the patient, a true patientconsumer is created. Interactions with patients will increasingly include discussions about cost effectiveness. Information will be made available to patients and physicians by financial stakeholders to ensure that options are discussed. Patients will expect physicians to help them manage their health and healthcare budgets. Time, the Ultimate Change Agent Educating physicians and counseling patients takes time; no one has enough of it. Details are measured in seconds, and low turnout at symposia and dinner meetings is common. In the clinic, dialogue is limited and the use of physician extenders is increasing. Getting information to physicians is problematic, the assimilation of information into practice is haphazard, and discussions with patients are harried.New channels,such as edetailing,and new tar gets, such as nurse practitioners, are included in marketing plans with varying results. Increasingly, the solution to this time crunch involves understanding grouppractice dynamics and deploying intrapractice viral marketing activities that maximize the value of every contact.The value of every interaction is increased by under standing how individual physicians respond to various changes.Pro filing, segmentation, and regionalization analyses are used to con struct relationshipbased communications and tailored messages. A New Prescription Moment The physician’s role is changing,but it is possible to draw con clusions and arrive at new marketing decisions. Financial stake holders, patientconsumers, time pressures, and altered practice dynamics affect a single common denominator — the physician patient relationship.Together, these change agents define a new prescription moment and can guide the development of a bal anced marketing plan. As the role of the physician continues to evolve, what can agencies do to ensure success? Maintain focus. At the end of the day, success is measured by prescriptions and it is almost always the physician who takes pen to prescription pad. Resist the temptation to dabble in tactical abstractions. Resources are scarce. Study change and act on influence. Change agents have vary ing levels of influence in different therapeutic categories. Study best practices when evaluating innovative approaches to the market. This is how an agency can avoid tactical distractions and zero in on influential disruptions that create market advantages. Seek experi enced partners with proven track records of developing balanced communications plans that include relevant tactics that bring target audiences together. Make the physicianpatient relationship a primarytarget audience. The most significant change agents influence this relation ship,and the best way to compete for the new prescription moment is to understand these change agents better than the competition. Remember, changes bring opportunity. AGENCY SERVICES SUDLER & HENNESSEY,NewYork, has specialized divisions in medical education (IntraMed Educational Group and Precept Medical Communications), market research and strategic planning (Primary Source), publication strategies (Imprint Publication Science), and digital solutions (Avenuee Health Strategies) to respond to changing market needs.All of these divisions include M.D.s and/or Ph.D.s on staff, many of whom have experience in clinical practice, including Dr. Metropoulos. For more information, call 212 6144100 or visit www.sudler.com. The Changing Role of the Physician The goal is to balance innovative approaches that address significant influences on the prescription moment with fundamental practices that form the foundation of pharmaceutical marketing. Sudler & Hennessey Jim Metropoulos, M.D. CoPresident

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