Members of the Medical Advertising Hall of Fame have left their imprints on medical advertising as founders of advertising agencies, innovators of new marketing approaches, and as creators of memorable advertising. August “Gus” Fink brought 2 important ideas to the business that were not agency-oriented, but related to the principal media for reaching physicians—medical journals.
Both ideas are so fundamental to journal publishing that it is hard to imagine the field without them. First, Fink was a leader in journal readership research. Secondly, he was one of the creators of a new kind of medical journal that brought practitioner-based information to physicians. Both ideas came out of Fink’s background in psychological research.
Fink obtained a PhD at Columbia University, where he studied under the famous B.F. Skinner. His academic studies at Columbia included behavioral research on animals. (During his career in medical marketing, Fink would often jokingly refer to himself as a “rat psychologist.”) Most importantly, he approached medical marketing from the high standard established in an academic setting, where proof based on the collection of credible data was required before making judgments. He was working at Klemtner Advertising when his thinking on readership research of medical journals attracted interest at Medical Economics (ME) and he was hired as its research director. At ME, he put into practice techniques to study advertising readership in medical journals that Alfred Politz had used in consumer print media.
The first of Fink’s research techniques was to write MDs’ names on ads in medical journals and then, in follow-up calls to assess MDs’ familiarity with those issues of the publications, to see how many had noticed their names on ads. Through this approach, the “ad page exposure” in publications could be determined. This direction was taken further by Fink and others, using what came to be called the “perfect coupon.”
With this approach, instead of MDs’ names, checks made out to the doctors for $10.00 were bound into issues of publications. From the rate of redemption of the checks, even better readings on ad page exposure were gained. A refinement on this approach was to place a short questionnaire on the back of the check to verify that the MDs, and not their nurses or family members, had found the check.
The “perfect coupon” brought major changes to the use of medical journals in pharmaceutical advertising. It lead to comparative ad exposure studies among publications, appreciation of the placement of ads, front and back, in journals, and, eventually, use of computer analysis to determine the efficiency of spending levels in journal advertising and the best mix of publications for a campaign. Gus Fink’s initiation and advocacy of “perfect coupon” research—the production of hard, ad exposure data—was the moving force behind truly revolutionary changes in selling of medical journal space and in medical publishing.
Gus Fink and Lew Miller met at ME in 1960—Fink as research director and Miller as executive editor. They became close friends and over the next few years considered going into business together. At that time, pharmaceutical advertising was funneling sizable sums through a limited number of medical journals. There was a market for new publications, and given Fink and Miller’s experience with journals, it was logical that they think about creating a new one. In 1966, they launched Patient Care (PC), which departed in editorial content from the conventional journals. Most journals then were devoted to original studies authored by researchers to report on scientific findings. The practice of medicine resulted from an assimilation of these research findings as taught at medical schools, teaching hospitals, and medical education programs. No journal was written to help general practitioners deal with the every-day treatment problems they saw in their waiting rooms. This became the mission of Patient Care, and in keeping with Fink’s research background, it based its editorial, circulation, and advertising sales on investigations of how MDs treated patients and how manufacturers marketed pharmaceuticals.
The publication’s content was markedly innovative. Its editorial board was not made up of noted names in research, but practicing MDs who often were PC readers. In covering a treatment problem, PC would convene a roundtable of specialists and generalists and report on their discussions pro and con as to therapy. Its text was colloquial, not academic, and, to help busy MDs get what they wanted to know quickly, it was interspersed every 700 words with 50-word summaries (“Express Stops”) in bold text. Treatment plans were diagramed with algorithms—flow charts on lab tests, diagnostic signs, etc, to guide practitioners. Topics for articles were researched in advances and issues were studied in the field after publication to test their success with readers.
PC’s circulation was also a departure from the norm. Rather than cover a broad MD audience of all practicing physicians—approaching 200,000—as was done by “mass circulation” journals like JAMA, Medical Economics, and Modern Medicine, PC concentrated on the GP, FP, Internist, and DO audiences, totaling some 100,000—the generalists of medicine. Significantly, although this audience consisted of roughly 50% of physicians, it accounted for 65%-70% of the prescriptions written.
The efficiency of this coverage came to be appreciated by pharmaceutical marketers. Patient Care started slowly. It ran 441 ad pages in 1967. Lew Miller recalls, “Today, patient care is a well accepted term that doctors are supposed to render. But back in the ’60s, when we told people that we were starting a journal called Patient Care, the reaction was that it must be for nurses.” Fink ran check studies every quarter in PC documenting to advertisers that the publication was delivering on its promise of gaining an audience of high prescribers. In 1970, PC carried 1,699 ad pages and was recognized as a breakthrough idea. Its success created the “mini-mass” class of medical journals.
In the midst of his career as a highly respected researcher and a recognized creative thinker on medical practice and pharmaceutical marketing, Fink suddenly suffered a fatal heart attack in 1985. His loss was mourned by the industry and by his friends who remember him as a striking, brilliant, down-to-earth, and fun-loving person who brought great analytical ability to medical media coupled with a practical drive that turned insights into tangible action.