8 October 1998 Rev 8 August 1999
1,550 words

McMahon needs clinical and business stories for gastroenterologists and pharmacists

NEW YORK--Over the last decade, lots of writers wrote their first medical story for the McMahon Publishing Group. During that time, the rates have gone up and the quality has improved.

While individual editors set their own pay scales, said David Bronstein, Editor-in-Chief of Retail Pharmacy News (RPN), it usually works out to about 50 cents a word, for news stories of 500-600 words, cover stories of 1,200 to 2,000 words, and pharmaceutical company-sponsored special reports on symposia of 15,000 words or more. There is a base rate plus an extra fee for each additional interview, and most stories require at least 2 sources.

Gastroenterology & Endoscopy News (GEN) uses a "growing number of freelance writers," said Kirell Lakhman, editor since June after the retirement of Tatiana Chilrud. GEN is read by 11,000 gastroenterologists and endoscopists, colorectal surgeons, GI nurses, and related professionals, with a few European and Asian readers, some of whom read it in Japanese translation, explained Lakhman. GEN covers 2 to 4 annual meetings around the country.

Bronstein and Lakhman addressed the monthly meeting of the Editorial Freelancers Association medical group on W. 23 St. here on 8 October 1998.

Clinical, patient-oriented

Most of GEN's stories are clinical reports, and Lakhman can use writers with clinical specialties. For example, there are 2 "very new, very hot" areas in gastroenterology, he said. One is endosonography, an imaging technique that uses ultrasound probes on catheters that can be inserted into the gastrointestinal system. Another is neurogastroenterology and GI motility. During GI surgery, peristalsis stops, and it is a great concern of surgeons to start peristalsis again quickly. These new techniques can get very complicated.

Most of the gastroenterology research is presented at 2 huge annual conferences. One is Digestive Disease Week, sponsored by several medical organizations, whose next meeting is 15-21 May 1999, in Orlando, FL. The other is the annual meeting of the American College of Gastroenterology whose next meeting is 10-14 October 1998 in Boston. Both web sites have the annual meeting program, and DDW posts the abstracts as well. So you can just surf through the abstracts, on-line or on paper, looking for story ideas. Writers who cover the field try to attend these meetings, for a saturation course in gastroenterology and an abstract book that can provide a year's stories.

But Lakhman is trying to broaden his approach, to add a patient focus and an economic focus. He's trying to help doctors understand the patient's perspective, and be prepared for the questions patients will ask. For example, an upcoming story will deal with the patient reaction to a new drug for Crohn's disease. Crohn's disease is a chronic inflammation of the intestinal wall, with an immune component and no curative treatment. In August, the FDA approved infliximab (Remicade, Centocor), a monoclonal antibody to tumor necrosis factor, which helped patients with advanced Crohn's. Infliximab wasn't appropriate for patients with milder forms of Crohn's, and yet, said Lakhman, those patients were begging for the new drug. These days, doctors have to know what kind of questions to expect from their patients, he said.

Lakhman is trying to help doctors through a "paradigm change" in medicine, he said, from seeing patients as "things that have to be fixed" to individuals.

Need financial, computer writers

RPN is a relatively new publication, 5 years old, in a field of established publications, said Bronstein, who was an editor at Medical Tribune before then.

"I never seem to have enough freelancers," said Bronstein. He uses 8 to 10 freelancers on a regular basis, "and I find that it's not enough."

"Our niche is that we are a source of a full spectrum of information, not just clinical," a mix of clinical pharmacy and practice management, information that helps pharmacists become more profitable, said Bronstein. They cover promotion and display, for example. They help pharmacists "choose among thousands of products that come out every month." They provide practical clinical information that pharmacists can use to counsel patients.

"Pharmacists are under a lot of pressure," said Bronstein. They make little or no money in the prescription counter, or "back end" of the store," so they have to be more profitable in the "front end," or merchandising side.

You can find clinical stores in the medical journals or pharmacy meetings, said Bronstein, but merchandising stories are harder to find. So he works with consultants.

Bronstein is also focusing on financial stories, of two kinds. About 75% of it is personal finances, he said. It's modeled on the Wall Street Journal or Fortune, "filtered towards my readers, who tend to be wealthy CEOs," he said. "They don't have enough time to read 10-15 financial publications." The other 25% is financial stories about running a pharmacy.

RPN runs a lot of business stories, said Bronstein. For example, pharmacies can put their own names on generic products, and get a 40% markup. These private label brands can become number 1 or 2 in their category.

"I'm a medical editor, not a financial editor," said Bronstein. "I really have a need for business and financial writers."

He also needs writers who understand pharmacy computer systems, which are "really complicated," said Bronstein. Insurance claims are filed electronically, and move through an adjudication process, where many different standards have to be reconciled. Some systems can switch a prescription from a branded drug to a generic, although they must then get approval by the prescribing physician. Pharmacists are paid a certain fee to handle the computerized claims. There are ethical issues in switching prescriptions. One of the benefits of computerized prescription systems is that they can warn doctors and pharmacists of dangerous drug interactions. However, the systems give false warnings so often--pregnancy warnings for male patients, for example--that pharmacists switch them off.

Working with new writers

Lakhman and Bronstein said that they typically assign a new writer to interview sources who are relatively easy to work with, and are easy to reach. That's one of the obligations of the editorial advisory board, said Lakhman. If Bronstein is using a writer for the first time, who doesn't know the industry well, "I'll give them a lot of direction," he said. "But I have a couple of writers who used to be the editors of a competing pharmacy journal, and I just tell them, 'Do a story on X.'"

Deadlines depend on the story. RPN and GEN are monthlies, and if you hit the right part of the cycle, you might have 2 weeks. But if you're near closing, and a story is already on the Reuters wire, the deadline could be a day. "I have people who can turn a story out overnight," said Lakhman. Other writers, who specialize in science, are slower. "I have writers who are very good," said Bronstein, "but I have to give them feature stories that are not time sensitive, trend stores needing lots of research."

"The best writers are the ones who work with you rather than for you," said Lakhman, who likes to "brainstorm" with writers. "We're in communication all the time by e-mail, fax, and phone, and bouncing ideas off them all the time," he said. "I like to cultivate a relationship with a writer so he can think with me."

Lakhman sometimes meets other writers at symposia and meetings, and those writers usually work out well, he noted.

Reporting skill is more important than medical knowledge. "If somebody has really good reporting skills and really good writing skills they tend to do a good job the first time, either on a clinical or practice management story," said Bronstein. "The harder job is somebody who has a really good medical background and wants to become a writer." He doesn't have time to rewrite a story extensively.

"If somebody has really good clips, I would give them a shot," said Bronstein.

Placement and disclosure

Some freelance writers are paid by drug companies to cover medical meetings, and place stories about their products. "One of my pet peeves," said Bronstein, is writers who do that without telling him. "It's fine as long as I know," he said. "Full disclosure is the best way to go." Bronstein would then make sure that the writer would get a comment from an independent investigator, and write a balanced story. But if he finds out after the fact that a writer was pitching a story for a drug company, he won't work with them again.

"There are editors who won't work with people who are trying to place stories," said Bronstein. "That's the editor's prerogative."

McMahon also buys all rights, but the editors, who used to freelance themselves, enforce that policy flexibly. The McMahon group also includes Anesthesiology News, General Surgery News, and Pharmacy Practice News. General Surgery News reprints stories from GEN, and the author doesn't get the same fee again, but does get a bonus.

McMahon doesn't want the same stories to appear in competitive publications, and demands exclusivity for 30 days, but the author can interview somebody else on the same subject for another publication. --Norman Bauman