Focus groups by telephone a way to research heatlh care

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Marketing News Aug. 29, 1988

Focus groups by telephone:
a way to research health care

BY MURRAY SIMON

Dr. Murray Simon is president of D/R/S HealthCare Consultants of Charlotte, North Carolina

FOCUS GROUPS with physicians and dentists are substantially different from all other types of groups.
When you weigh the underlying factors that are unique to the average focus group with health care providers, it's enough to make you decide not to do them. Consider the following:

Focus groups with health care providers are generally conducted in or near major cities to ensure a large enough recruitment pool.
Within any sizable metropolitan area there will invariably be a heavy concentration of graduates from nearby professional school. This can easily lead to philosophical biases in focus groups based on the teaching philosophies in these institutions.
In addition to regional similarities in educational background, recent research has shown that treatments rendered have definite regional consistencies.
There are noticeable similarities in the office environment and work ethic of practitioners from any give area. The dentist practicing in New York City tends to work differently than the dentist from Roanoke, Va. It can therefore be expected that focus groups with professionals in any given location will be similar in attitude by virtue of geographical professional "inbreeding."
It is very difficult to convene groups of providers without having some respondents who know each other or of each other within the group. All too often the people in the viewing room sit and watch groups of practitioners file into the conference room carrying on friendly conversations with each other as they take their seats.
Screening out colleague familiarity isn't easy, particularly when specialists have to be recruited, and often leads to the establishment of an immediate pecking order based on seniority and/or standing within the professional community.
After a day at the office or hospital, it is quite difficult to get practitioners to give up an evening to attend a focus group. The old concern about how typical is the "typical" respondent is especially apt with these groups. The problem becomes particularly acute when there is the need to recruit small incidence specialties of people with highly specialized knowledge.
It is frequently important in health care marketing research to get feedback from a variety of specialists or a mix of general practitioners and specialists on the same product or issue. Researchers tend to avoid developing mixed groups, often for good reason. Some general practitioners will be reluctant to offer opinions in the presence of specialists.
Some specialists will defer to the training or experience of other specialty groups. And lately there seems to be a rash of groups wherein GPs/FPs will take verbal "pot shots" at the specialists present, or one type of specialist will try to do a character assassination on another type of specialty.
The result is that if a number of specialists and/of GPs must be heard, there will be the tendency to run a larger series of groups to avoid mixing.
Recruitment costs and incentive payments are getting high for these groups. In part this is due to the extraordinary amount of time that must be spent in recruitment, and it is based partially on the belief that it takes a bigger carrot to get doctors to participate.
     If you add the standard focus group problems to the above list - inclement weather, geographic sampling limited by facility locations, reluctant participants, travel costs, the increasing difficulty of getting "virgin" respondents and trying to extract information from a sea of cross conversations on tape - what we wind up with is a problem very much in need of a solution.
     Despite all the difficulties, focus groups with providers are necessary to keep up with the rapid changes taking place within medicine and allied fields.
     Searching for a better way, D/R/S HealthCare Consultants has explored the telephone focus group, using teleconferencing techniques to link respondents, moderator and client in a focus group format. Initially our thought was that it might prove to be an acceptable substitute for some face-to-face group situations, particularly when time, convenience and/or budget are a factor.
     But in the time spent working with this technology, our thinking has changed dramatically. This is a solid marketing research tool that stands on its own and delivers valuable information when used properly. Not only that, there are certain advantages when compared to face-to-face groups.

1. Groups can have tremendous geographic diversity.
It is possible to reach every nook and cranny in the country. A number of respondents who may never have been heard from are now available to the researcher.
Respondents find it quite interesting to conference with colleagues in other parts of the country and this becomes an important adjunct to successful recruitment.

2. Travel costs can be virtually eliminated.
All participants - respondents, moderator, and clients - can participate from their homes or offices.

3. Recruitment is easier
You are not asking a respondent to spend the better part of an evening traveling to, sitting in, and returning from a facility.
Many practitioners not only appreciate the convenience but they are flattered by being asked to participate in a telephone conference. It is often possible to get them for a lower remuneration than that typically paid for a face-to-face focus group.

4. Mixed groups are less of a problem
Because of the tremendous geographic diversity that is possible, none of the respondents in a group tend to know each other, and they won't be running into each other the next day at the hospital and have to defend something they said at a focus group the previous night.
We also feel that allowing the respondent to participate while seated in comfortable, familiar surrounding tends to make them less defensive and protective of what they are saying. There is literally no one present to sit in judgment.

5. Weather is not a factor
Any moderator who has had to do mid-winter groups in the northeast or midwest knows what it's like to head for the airport with a silent prayer for good weather.
With the possible exception of blizzards, hurricanes or earthquakes, weather can not knock out a telephone focus group.

6. The information is generally clean, concise and to the point.
The problem with cross-conversations and visual distractions that often afflict the face-to-face group is virtually eliminated. Extracting information from the tapes for report writing is a moderator's dream. Everything is there and clear.

7. The problem respondent can more effectively be dealt with.
     In some groups you get the Dr. Tellitall who is determined to give the group the benefit of his/her experience. Assuming all attempts at neutralization fail, the moderator is tempted to remove this particular respondent.
     The removal of a health care practitioner can sometimes lead to a "circling of the wagons" by those who remain with a resultant loss of relevance from that group. On the other hand, keeping this character in place can prove to be a turnoff for the other respondents.
     Although we have not had to make use of it yet, it is possible through pre-arranged signals with the facilitator/operator to develop a "problem with one of the lines."

8. Concept testing is easy.
Materials can be sent to the respondents in sealed and numbered envelopes to be opened during the meeting. We have used this technique quite successfully for testing advertising concepts, packaging, product design, etc. If security or secrecy is of concern, this technique is not advisable.

9. It is easier to put together groups of low incidence specialties.
We have used this technique to talk to neonatologists, nuclear radiologists and implantologists. To reach a re-resentative sample with face-to-face groups, we would have had to travel to a large number of cities to do it.

10. Health care providers enjoy participating in these groups.
     It gives them an opportunity to tap into the thinking of their colleagues in other parts of the country. We have received many requests from participants to be included in future conferences.
     There are other applications for this technology that are being used now or suggest themselves for future use.
     Many manufacturers find professional panels helpful in developing marketing strategies. Unfortunately, too often these panels are expensive, difficult to recruit, regionalized in their thinking, often affected by absenteeism and sometimes difficult to manage.
     The telephone conference would appear to be the answer to many of these problems. Panels can be convened on a regular basis, generally in the evening with each of the panel members participating from the convenience of home or office.
     The panel can consist of members from all parts of the country. Practitioners representing smaller subsegments can be more easily recruited.
     Hard copy, ad/packaging/design concepts can be sent in advance for evaluation at the time of the meeting.
     The telephone focus group is not meant to be a replacement for the face-to-face group. D/R/S does face-to-face as well as telephone groups because there are times when it is necessary to go out and run videos, show concepts or demonstrate prototypes and observe the reaction. It is important to realize, however, that qualitative marketing research with providers can present some serious obstacles and the telephone focus group offers solutions.
     The telephone group should not be considered a panacea, but it does offer advantages and opportunities that should be given serious consideration by health care marketers and researchers. ¤