In the ideal free market, entrepreneurs create the businesses needed for society’s economy to function. They are rewarded with a compensating share of the wealth they generate and are venerated for their financial success. But the philosophy of laissez-faire enterprise, at its best, carries with it the caveat that the rights of free commerce ought to include more than making money but also producing something of public value. The career of Lewis A. Miller shows that social benefit can spring from the entrepreneurial spirit and even be its animating force.
Miller graduated early from Princeton at 20 and began a career in journalism with stints at The Princeton Herald, and The Schenectady Union Star. At the age of 22, he showed his entrepreneurial bent by founding a small town paper in Glastonbury, Connecticut, The Glastonbury Citizen, which he later sold. He went on to editorial positions at The Newark Star Ledger and The New York Telegram & Sun. From there in 1960, he made a move that would greatly influence his future career when he entered the healthcare industry becoming executive editor of Medical Economics (ME). He left his mark on ME by instituting the hard-nosed newspaper discipline of firm deadlines and rapid editorial review, and establishing news bureaus in four cities. He also presided over the magazines transition from digest format to an A-sized magazine.
At ME, he met Gus Fink, who was research director (elected to the MAHF in 2006), and they teamed up to found Patient Care in 1966. Patient Care was a truly innovative medical journal. Its editorial premise rested on Fink’s experience in readership research of medical journals and Miller’s journalistic background and was written for primary care physicians. Its circulation of 100,000 was also different from the established mass-circulation publications (JAMA, ME, and Modern Medicine) that went to audiences approaching 200,000. Although limited to MDs who comprised just 50 percent of the medical audience, this group wrote 70 percent of pharmaceutical prescriptions. These two innovations established Patient Care as the first “mini-mass” medical journal, and advertisers immediately appreciated the efficiency of its circulation.
Important to Patient Care’s success was its new editorial approach. Carroll Dowden, who has worked with Miller for many years, describes Patient Care as “the first publication to be produced by lay editors taking material from physicians and making it clear, understandable, and actionable to GPs, internists, and DOs, in contrast to the scientific publications of the day…but bringing [scientific information] down to the everyday needs of the practicing physician.”
Patient Care’s approach has been described as the first shift in medical journal publishing from subjective clinical content to an objective view of treatment based on multiple, informed sources.
Patient Care editorial was fact driven, audience sensitive, employed an “easy-to-read” style, and was based on reporting the thinking of opinion leaders—elements that strongly reflected Miller’s journalistic background. It relied on such features as pro-and-con discussions at roundtables among specialists and generalists, 50-word “Express Stops” (every 700 words in bold text to move the reader through an article), treatment plans diagramed with algorithms, and flow charts on lab tests, diagnostic signs, etc. Response from MDs was enthusiastic. The publication became hugely successful and a fixture on journal advertising schedules.
Miller & Fink publishing went international with Patient Care and expanded into the new areas of continuing medical education (CME) and medical record systems. Patient Care eventually was purchased by the Medical Economics Company.
Having helped create a medical journal designed to encourage up-to-date patient treatment, it was logical for Miller to become more extensively involved in CME programs. Following a conference of medical, governmental, and pharmaceutical companies, sponsored by Miller & Fink in 1975, Miller was instrumental in organizing the Alliance for Continuing Medical Education. He went on to form the Global Alliance for Continuing Medical Education.
In 1988, Miller joined with Carroll Dowden to set up Dowden Health Media, which now consists of the medical journals OBG Management, The Journal of Family Practice, Current Psychiatry, and Mayo Clinic Proceedings; medical education companies; and a division that publishes newsletters for hospitals.
Miller is a respected figure in healthcare communications, greatly admired for his vision. Jon Bigelow, group vice president/general manager CMP Media, who was an intern at Patient Care says, “What is important to him is accomplishing the next new thing and bringing people along for the ride.”
He is known for his mentoring and development of young talent and his ability to put big ideas into practice. Warren Ross, a founder of KPR and a member of the MAHF, says, “Lew was one of the first to realize the potential of CME, both as a contribution to good medicine and a way for industry to enhance its reputation by sponsoring CME programs. He was the statesman of CME.”
Miller is also admired for what is perceived as the motivation behind his entrepreneurial drive. Dennis Wentz, who worked with him on CME, says of Miller, “He is so involved with life that he embraces it and his commitment is really to better care of patients. He published a book in 1979 called The Life You Save that has as its premise the patient has the right to know and the patient has the right to say no. It demonstrates his commitment to patient care and to helping doctors achieve the best patient care.”
Reinforcing this view of Miller, Warren Ross adds, “My perspective on him would be innovator and public citizen. There are lots of people who start commercial things with the sole objective of making money. Lew always had not only a high ethical standard of doing the right thing, but asking himself how they could best be made to serve public health.”
Carroll Dowden adds, “He is quite committed to healthcare. Its important to him for what it does for society, what it does for patients. He is proud of the work he has done…the good that has come from his editorial work and from his work as a business man in the field of medicine.”
Further, Dowden says of Miller, “When you think about Lew Miller and what makes him go, the first thing that comes to my mind is something he has said to me from time to time. What he wants to do is celebrate life. That attitude permeates Lew…defines him. He finds that he is able to celebrate life through his work.”