Editor’s note: Dr. Murray Simon is president of DRS HealthCare Consultants, Charlotte, N.C.

To a moderator, good projection/imaging techniques are like a sophisticated sound system that can make a shower singer sound like Pavarotti . . . at least we’d like to think they can. And when we find techniques that consistently work, we take care of them like precious jewels and use them judiciously. A good projection technique can do wonders for focus groups or one-on-ones; among other things it can:

  • develop abstract input that reveals underlying thoughts and attitudes;
  • liven up an interview or group discussion; and
  • prompt the client to feel they have retained a creative moderator.

I specialize in health care market research; studies in this arena can be a bit pricey, particularly if they involve interviews with health care providers. Doctors put a high value on their time away from the office, even when it involves a relatively convenient telephone interview. If the study protocol dictates the use of focus groups or facility-based one-on-ones, the cost of putting together a study will be heavily impacted by significant recruiting and incentive costs. An experienced health care moderator often charges more than his or her consumer oriented counterparts.

These higher costs, coupled with the generalized perception of health care professionals being a difficult interview, can lead to a moderator who is dealing with concerned clients, i.e., they worry that their substantial investment of time and money will not provide sufficiently rewarding results. Sometimes these concerns are quite valid - physicians tend to be pragmatic (and guarded) in their responses and many are initially suspicious and wary of the marketing research process.

Many times the potential success of the study can be heavily influenced by the subject being discussed. If the physician or dentist thinks he/she might learn something about a new product or technology, the willingness to participate (and the success of the recruit) will usually be higher. Good luck trying to recruit gastroenterologists for a study involving the exciting subject of laxatives. But if the client has a new technology for performing colonoscopies, the recruit will probably be a breeze.

As a health care moderator with many years vested in interviewing providers, one of the few things in marketing research that still worries me is doing focus groups or one-on-ones in which the products or services involved are generally considered a low order of priority by the professional (dentists discussing toothbrushes, dermatologists comparing moisturizers, surgeons critiquing journal ad concepts, etc.). I do not mean to imply that these products or services are not of importance, but it is often difficult to prompt professionals to talk about them with any degree of enthusiasm or passion, either positive or negative. I would assume the same sort of potential problem exists in market research with other populations of highly educated, technically oriented respondents.

I’m always interested in learning about projection techniques that might be of value in invigorating interviews or discussion groups with professionals, but we keep coming back to the issue of rampant pragmatism. Asking a group of physicians, "If this drug were an animal, what kind of animal would it be?" runs the distinct risk of losing what can sometimes be a rather tenuous hold on their attention or cooperation. On those rare occasions when I do find a technique that works well with health care providers, it’s like finding a pearl in a mountain of oysters. And to create an original projection technique that works is somewhat akin to giving birth to a beautiful baby.

I’d like to tell you about my baby.

One of the hit movies of late 1997 was Face/Off with Nicholas Cage and John Travolta. For those who might not have seen it, the story involves an FBI agent and a vicious criminal who change faces, voices and identities. The movie was totally implausible, thoroughly entertaining and it will always rank among my favorites because of a thought it triggered one day in the midst of a marketing research project.

I had been doing several days of facility-based one-on-ones with primary care physicians and specialists. We would start at 7:00 a.m. and finish at about 9:00 p.m. The hours weren’t the problem, the subject was. We were testing concepts for journal advertising and physician educational/promotional materials for a new drug that was about nine months away from launch. Because this product represented a totally new drug category and would be going up against an established drug with a respected track record of 40+ years, we were not only trying to determine the best way to get the message across but were also trying to ascertain the relative potential for acceptance, e.g., would these doctors write prescriptions for it?

This type of interview can be very difficult because of the previously mentioned physician pragmatism coupled with intentional evasiveness. Perhaps due, in part, to the highly litigious times we live in, doctors have become understandably wary of passing judgment on a medical product or device they know little about. As a result, when you ask them questions about how they might hypothetically react to a new drug, you frequently get an evasive litany that typically includes one or more of the following comments:

- I can’t make judgments until I’ve read the clinical studies.

- I’m never the first doctor to try a new drug.

- What about all the "great new drugs" that have been pulled from the market?

- Send your rep around with samples and after I’ve used it we can talk.

Hour after hour of these responses can be frustrating for the client; there is also the potential of inducing mental anesthesia in the moderator. Late one afternoon a physician who was trying to be helpful started a sentence with the statement "Now if I was detailing a doctor on this new drug . . ." and a lightning bolt shot through my numbed brain. I asked him if he had seen the movie Face/Off; he had not. I briefly explained the story and asked if he would like to play Pharmaceutical Face/Off, i.e., I would assume his identity as a physician and he would assume mine as a detail rep calling on him to tell him about this new product. He sat upright in his chair, asked for a moment to gather his thoughts and soon launched into an impassioned sales presentation . . . and I quickly discovered a great projection technique.

Unless they happen to be practicing in Siberia, physicians are quite familiar with detail reps and their promotional efforts or pitches; the majority of doctors are convinced they can do it better. Although you are asking them to put themselves in the detail rep’s shoes, the thoughts and attitudes expressed are obviously based on their personal experiences as practitioners. Very few respondents were uncomfortable with Pharmaceutical Face/Off and the learning curve went up dramatically once we incorporated it into these interviews.

Using Pharmaceutical Face/Off we were able to learn the following:

  • The younger physicians would be less impressed with the long-term track record of the established therapy.
  • A significant subsegment of the patient population has strong emotional concerns about using this older drug.
  • The "design" of the new drug was very intriguing to those respondents who had listened carefully to the information presented.
  • The doc/reps found certain statements in the educational concepts particularly difficult to defend or justify; they would have to be revised.

The caliber of information was so much better in the interviews that followed the inclusion of Face/Off that my client asked to initiate it earlier in the process in order to allow more time to probe the issues raised by our "temporary detail reps."

Since its inception, I have used this technique several times with a number of clients; it seldom fails to elicit strong positive responses from them. Thus far it seems best suited to the one-on-one interview, but I’m anxious to work out a focus group version and would welcome thoughts and ideas from those of you reading this article.

I’m very much aware that the basic nuts and bolts of Pharmaceutical Face/Off aren’t anything new - what goes around comes around - but linking this projection technique with a well-known movie seems to provoke a challenging game instinct within highly educated respondents. I can easily envision a host of variations - CEO Face/Off, Banker Face/Off, Computer Nerd Face/Off, etc.

Give it a go . . . the worst case scenario is you wind up wasting a few interview minutes. But if you want to put more zip in those technical interviews while ratcheting up the potential return on investment, add Face/Off to your list of moderating (and movie) musts.