Health check: What can mainstream publishers learn from the world of medical journals?

“Consumer magazines and medical journals operate from different ends of the publishing spectrum, but they are both parts of the publishing mix,” argues Mark Allen, chairman of the Mark Allen Group, a business that has both elements in its portfolio of brands.

Yet, the Mark Allen Group is something of a rarity in publishing. Furthermore, it is surprising how little mainstream media executives generally know about journals and the way they operate.

Given that iHealthCareAnalyst recently concluded that the global market for medical education publishing is expected to reach $6.7 billion by 2029, expanding at a CAGR of 5.9% between 2022 and 2029, publishers are turning a blind eye to a lucrative and growing market segment.

One of the highlights of the recent FIPP Insider event Berlin in September was when Rachael Hansford, publisher of ACNR (Advances in Clinical Neuroscience & Rehabilitation) spoke with FIPP CEO James Hewes.

What emerged from the discussion and the informal conversations that followed, was that not only are medical journals something of a mystery to mainstream publishers but also that there is a significant amount that the medical journal world can teach the rest of the media about business models, reader retention and nurturing niches.

How then do you define a medical journal? Allen believes that the majority are clinically based and serve distinct medical specialties or niches. “It is the clinical element that separates most medical journals from mainstream magazines which are, generally, more broadly based and speak in a more universal language,” he says.

It is a view that is echoed by Hansford. “Medical journals provide information for medical professionals on the latest research in their area of expertise. Specialists need to keep up to date, so journals are a ‘must-read’ for their continuing professional development – they are a captive audience. The readership is very tightly targeted and publishers know exactly who the readers are. There’s very little reader churn.”

So medical journals are ultra-niche, highly targeted, and as we will discover, tend to operate using unique business models.

Yet surprisingly, in spite of these hallmarks, there are parallels between mainstream media and medical journals. It could be argued that in recent years, mainstream companies have adopted business models that increasingly resemble those of the medical press.

So, what then can mainstream media executives learn from the journals? Here are 10 points to ponder.

It is all about the niches

There are some bigger titles in the medical world, such as The Lancet, but in the main, the titles are very tightly focused. They go really deep in the way that they identify niches and produce high-quality content that inspires readers.

“Publishers need to know their distinct audience and promote to them accordingly,” says Allen. “Every medical specialty is different, and publishers will need to personalise their approach to satisfy their readers.”

There have been some very significant successes in recent years in both the b2b and b2c worlds of mainstream publishing focusing on small, tight niches, developing a community, and then monetising it. It is a strategy that has empowered entrepreneurs to start magazines and websites and is currently very popular with media investors.

Finding a community, immersing a media brand in it, and serving content that appeals to its participants is a strategy that medical journal publishers have excelled at for many years. Now it seems that the rest of the media world has realised they are on to something.

Starting small is an option

It is quite surprising how many medical journals were the result of individuals or small groups having a ‘eureka’ moment.

Rosaleen Shine of ENT & Audiology News, says her journal was “the brainchild of an Ear Nose & Throat surgeon who found he was too busy to read all the journals to which he subscribed.

“So over dinner one evening, he hatched a plan with colleagues that they would each read a different journal and synopsise the articles within, as well as adding a considered opinion.”

Similarly, ANCR began when Hansford and consultant neurologist Roger Barker realised that there was a knowledge gap in the neuroscience and rehabilitation niche they could potentially fill.

Both journals have grown from kitchen table startups to international, multi-channel, profitable businesses. They provide evidence that entrepreneurs don’t necessarily need big teams and significant investment war chests to start a business.

As The Rebooting’s Brian Morrissey told FIPP earlier this year: “There are many, many ways to build a sustainable media business so long as the cost basis is held in check. I think there’s always room for products with a clear point of view that is essential for a specific community. My advice is to always go narrow and deep.”

Authority is essential

One of the key characteristics of medical journals is the level of care they take over the content they publish.

“Because the subject matter is clinical and mistakes can lead to fatality, it is imperative that medical journals employ the right level of medical expertise, whether that is through its staff or the consultants who help advise,” Allen explains. “Clinical accuracy is absolutely paramount.”

In mainstream publishing too, media brands need to be trusted by their readers. Mistakes and poor-quality content can seriously undermine a magazine’s credibility.

“There is a significant amount the medical journal world can teach the rest of the media about business models, reader retention and nurturing niches”

Multi-channel is a given

Many medical journals have a print heritage and most still offer a paper version. For many medical journals, though, the mantra is to meet the reader where they are, so many have produced websites and then experimented with podcasts, email newsletters, and videos.

Events are also a way to not just nurture a community but also to broaden the reach of the brand. For most mainstream media brands single-channel publishing is no longer an option.

It’s all about the subs

Way before subscriptions became a top priority for mainstream media brands, medical journals were curating and maintaining their list of subscribers.

There is a split in medical journals with some being available free and largely funded by advertising while others have a fee. The key for all medical journal publishers is to ensure that the people they need to read the content actually subscribe.

“In order to maintain your subscription base, it is imperative that you have the appropriate database, whether that is promoting to cardiologists in a medical journal or to woodworkers in a craft magazine.”

There might be ways to keep editorial costs low

Another way that medical journals diverge from mainstream media is in how they handle the editorial budget.

“Some medical journals don’t pay their contributors, but the payback for authors has historically been the recognition they gain from peers, and the possibility of influencing medical practice,” Hansford explains.

The past couple of decades have seen a move towards open-access publishing. In this model, readers don’t pay to access journal content. However, doctors and scientists are charged fees to publish their papers. These fees vary but are in the region of £1500 per article – with the money often coming out of their research budget.”

For smaller media titles, content from enthusiastic amateur writers has long been a tactic to keep editorials costs down. At the same time more and more b2b titles are now accepting thought leadership content from executives from brands as a way of adding comment and expertise without having to pay for it. The content is bylined for the executives by journalists working for PR companies or content marketing agencies.

Sponsored content is possible – but handle with care

If mainstream media brands do accept thought leadership articles for brand executives or sponsored content from brands, they need to be very wary of labelling the content in an appropriate way to ensure that they don’t undermine editorial integrity.

This is even more of an acute issue in the world of medical journals.

“We also publish sponsored articles and supplements, and have worked with several pharma companies over the years,” Hansford explains.

“Pharma advertising is tightly regulated in the UK, and the ABPI (Association of the British Pharmaceutical Industry) has a Code of Practice that sets out the requirements they have to comply with.

“Anything which is sponsored must be clearly identified as such, but we take that one step further – sponsored content must add value to our readers too. I don’t want to insult their intelligence!”

“In order to maintain your subscription base, it is imperative that you have the appropriate database, whether that is promoting to cardiologists in a medical journal or to wood workers in a craft magazine”

Learn from mainstream media

Perhaps a little surprisingly, medical journals are not shy of taking their inspiration from mainstream media.

For Hansford, the main way that the big titles influence her journal is through design. “Medical journals traditionally had plain covers and just text on the front. Having a picture on the cover was a bit radical when we were starting out.

“We aim for something that is visually striking, so I’m always looking out for interesting images. For example, the next issue will have a picture by a 13-year-old, expressing how they feel about having Tourette Syndrome.”

For Rosaleen Shine of ENT & Audiology News, inspiration came from an unlikely source.

“Don’t scream when I say ‘Hello’ magazine was an influence! In the early days of the magazine, I noticed at a congress that younger doctors would gather around a ‘superstar’ surgeon and get them to autograph a book, etc.

“It suddenly struck me that surgeons are like the rest of us and they have their heroes, so I thought why not interview these stars and put questions to them in a more personal way? Prior to this these characters were ‘named authors’ in journals but we did interviews with colour photos showing them at leisure or with their families and this was a big hit. Now, this is commonplace.”

b2b/corporate sales are the backbone of the business

At the recent Media Makers Meet Di5rupt event in there was a significant amount of discussion about how media brands can increase subscription sales by focusing on dealing with corporations and trade organisations.

These areas have long been fruitful grounds for medical journals too. “I found myself spending lots of time processing subscriptions until I came up with the idea of asking a company to ‘sponsor’ circulation of the magazine within a particular country or region,” Shine explains.

“In those days companies used to offer corporate ‘gifts’ to doctors at meetings – pens, diaries, wall planners, etc. With this novel-sponsored distribution scheme, they had the opportunity to supply something worthwhile to their customers.”

“They were perceived as the good guys, displaying their credentials in supporting education. The scheme allowed them to keep their mailing lists up-to-date, as readers didn’t want to miss a copy, and grow their mailing lists as new colleagues were introduced to the free scheme.”

Care about your product

It might sound obvious but the passion the publishers of medical journals have for their products, especially the smaller independent ones, really ought to inspire mainstream media brands.

Hansford concludes: “I’m lucky that I’ve had years to gain the trust of contributors, advertisers, and readers and have built up some great relationships. My favourite feedback recently was from one of our editors who said, ‘That meeting was so feel good. I love being part of this’. I think you’ve got to genuinely care about your product and your people and surround yourself with others who feel the same.”

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