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Congress is back in session, but many members are anxious to get home to campaign in this election year. We'd suggest they forget healthcare legislation if they're looking to speed things up in Washington this fall. While the administration is pressing for healthcare reform, the healthcare industry is steadily reforming itself-and the impact on healthcare marketing has been great.

Like the grocery industry of several decades ago, healthcare providers are moving toward group purchasing organizations. Individual doctors, like individual grocers, have less and less to say about buying decisions. The purchasing groups act as gatekeepers, authorizing products for consideration by their members only after scrutinizing product quality and price. And these committees are also favoring drugs and medical devices that can cut costs.

The shift has had a major impact on medical marketing, since buying decisions are becoming much more concentrated; fully 45% of prescription drugs are now sold to managed-care groups.

Notable is the downward spiral in medical journal advertising (down one-third in one year). Medical journals once led the parade of business and specialized publications. Many were as bulky as today's fat-cats, the computer industry publications.

Medical marketing agencies have had to shift from concentrating on ads to advising clients on how to operate in this new environment; where to put their marketing dollars. Mergers in the pharmaceutical field have also shifted the competitive balance, promising further economies.

We can only hope Congress takes note of all these changes. While it still faces the issue of universal healthcare coverage, the need to help rein in costs by putting healthcare providers and suppliers under some massive government tent seems to be fading. Working its way into the body politic is a familiar old remedy: the competitive pressures of the marketplace.

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