Healthy Skepticism International News

April 2003

Healthy Skepticism 2003 Subscriber Survey: Report Part B

This is the second of a two part report on our January 2003 subscriber survey. The aim of the survey is to help inform our future planning.

In Part A we reported that we received responses from 27 of our 86 Paid Subscribers/Members = 31% and from 58 of our 808 Free Subscribers = 7% by the cut off date. (We appreciate and will take account of the responses that came in after we had written up our findings.) Part A covered demographics, how subscribers first heard about us, reasons for supporting Healthy Skepticism and subscription fees. This part will cover our website, our activities and links with other organisations.

As with Part A, regardless of whether you answered the survey, we invite you to comment on the findings and our conclusions.

4.  How often have you visited the Healthy Skepticism website before today?

Comments about our website from Paid Subscribers:

  Easy to use

  Given the limited resources the website is excellent

  Needs more work

  Not intuitive enough in terms of navigation

  Websites linked should appear in another window so that we can register them as favourites

Comments about our website from Free Subscribers:

  Alas I preferred the old paper style, even though not good re trees, but there was a clear letter to sign more regularly than now, especially in the early yrs.

  Just a lot of kudos out to the people who put it together!! it’s great and I appreciate the time and effort immensely! Too often we’re lead astray.

  Useful source of information but not always easy to find what you are looking for.

Conclusions:

Because we rely heavily on electronic communication it is important that we have an effective website and we appreciate feedback.  In response to the comments above, it would be good to give people the option of visiting external sites in a new window. This will be added to the list of jobs to do. If anyone would like to contribute to updating any part of the website including the Links page then please contact .(JavaScript must be enabled to view this email address) Just half an hour a week would make a big difference.

We now have a lot of material on the site so can be difficult for people to find what they want quickly. We have added a “Can’t find what you are looking for?” section to our home page which says: Please try our Site Map or our Search page. If that fails please contact .(JavaScript must be enabled to view this email address) There is a problem that many of the publications listed on our site are organised by publication date rather than topic. If we had the resources then we would put them in a database to enable searches by key word.

We will consider adding to our 2004 survey a question about whether our subscribers are visiting our site more or less frequently than the sites of other like minded organisations so as to find out how well we are doing by comparison. Nonetheless the information gained this year will provide a useful baseline for future comparison. 

Our new publication AdWatch will build on the strengths of the paper MaLAM letters that are remembered so fondly. AdWatch will be regular and will give subscribers ways to get involved. We are still deciding on the details. If you would like to get involved in the design or the ongoing production of AdWatch then your contribution will be most welcome. Please contact .(JavaScript must be enabled to view this email address)

5. Which of the following statements is most accurate about your plans for visiting the Healthy Skepticism website:
Number

Paid Subscribers

Free subscribers

I am unlikely to visit the Healthy Skepticism website again

0

1

I would only visit the Website in the future if notified of significant improvements to the site

0

5

I only visit the website when I am notified of new International editions

11

16

I don’t read International editions often but I do visit the website for other material

6

13

I read International editions often and also visit the website for other material

10

21

Conclusions
The site is now good enough that subscribers will return for new information. Brief E-mail messages are very important for bringing people to our website. Our recent trend towards communicating more frequently will continue.

6.  How would you rank each aspect of the Healthy Skepticism website?
    1 = excellent 5 = poor

Mean rank
Paid Subscribers Free subscribers
Relevant 1.5 1.9
Informative 1.6 1.8
Easy to find material 2.1 2.4
Up to date 2.1 2.2

Conclusions
We are struggling to keep the website up-to-date. If anyone with webmaster skills would like to help we would be delighted to hear from them. Just half an hour a week would make a big difference. Please contact .(JavaScript must be enabled to view this email address)

If you have any further comments on our website,  please make them in the box below:

7.  How would you rank each aspect of the Healthy Skepticism International News editions?
1 = excellent 5 = poor

Mean rank
Paid Subscribers Free subscribers
Relevant 1.7 1.8
Informative 1.6 1.8
Well written 1.8 1.9
Timely 1.9 2.2

Conclusions
It is encouraging that, on the whole, our subscribers and members rank the content of our International Editions favourably. We need to work on making the International News editions more timely.

If you have any further comments about Healthy Skepticism International News, please make them in the box below:

8.  How would you rank the importance of Healthy Skepticism’s many current activities?
(Most are listed below).  We asked subscribers to rank them separately according to the importance you place on them.
1 = high, 5 = low
Paid Subscribers Free subscribers
Mean rank Rank of ranks Mean rank Rank of ranks
International editions 1.52 1 1.67 5
Website 1.55 2 1.53 3
Information source for journalists 1.66 3 1.97 10
Information source for people and non-government organisations doing similar work 1.70 4 1.52 2
Publications in medical journals 1.74 5 1.79 7
Information source for government agencies 1.85 6 1.82 8
Information source for students 1.88 7 1.88 9
Information source for patients 1.9 8 2.09 12
Producing educational materials 1.96 9 1.74 6
Writing policy recommendations 2.11 10 1.56 4
Doing research ourselves 2.18 11 1.45 1
Supervising research by postgraduates 2.30 12 2.03 11
Supervising research by undergraduates 2.48 13 2.26 13
Lectures 2.74 14 2.46 14

Conclusions
This was a very difficult question to answer but the results are helpful for decisions about priorities. Responses indicated that our work on providing information is considered to be very important. However none of the activities were rejected by a majority of subscribers. The rankings by Paid vs Free Subscribers are little different except for Free subscribers giving a much higher rating for producing research, policy recommendations and educational materials and a lower rating for providing an information source for journalists.

Lectures were given a low rating but Part A of this report confirmed our impression that they are one the most effective ways we have of gaining Paid Subscribers without whom it would very difficult to do any of the other activities.

We asked subscribers: Is there anything not on that list that you would like us to do?

Paid subscribers wrote:

  I think all these activities are important, because they all reach different people, so not one is more important than another.

  I would have to say I think all of these activities are important, the time allocated to each may depend on current demands and may be difficult to anticipate

  List very long - did not further try to sort out.

  More than enough

  They are all important! Given our limited resources we should be concentrating on the areas that have the most impact - reaching the most people, influencing policy makers and influencing the way doctors are trained.

Free subscribers wrote:

  Drawing immediate attention to critical alerts on drugs.

  Enter into a dialogue with the many doctors, pharmacists and others working in the industry whose job is to maintain promotional standards. Talking with us could further the cause of improved promotional standards - if the mutual distrust can be overcome.

  Guidelines on critical assessment of websites and webpages; Assessing and evaluating complementary and alternative medicine claims (especially herbal medicines)

  I haven’t reviewed any of the above sections

  If you want busy people like me to interact with you then please try to make it quicker, easier and more simple

  Increased consciousness raising for medical students! - ?target medical students publications / conferences?

  It may look as though I didn’t chose rankings but all of those I ranked a # 1 as important.

  It’s great that you help people internationally. I don’t know how limited your resources are. I find your website invaluable and would like you to keep that updated.

  Vaccine safety and effectiveness

Conclusions
There are a range of views about priorities. Some want more focus whilst others want us to take on even more. Given our limited resources anyone who wants to influence our priorities may have greater impact than they might expect just by offering to help us work on the topic that they care about. Please contact .(JavaScript must be enabled to view this email address) That invitation also includes the drug company staffer who wants us to enter into “dialogue”. We think we have been in dialogue with drug company staff for most of the last 20 years but understand that he or she could be referring to a different type of dialogue. We are open to new ideas for pursuing Our Aims.

If you have any further comments about our priorities, please make them in the box below:

9.  Please list any other philanthropic or cause related organisations that you support.

Conclusions
Our subscribers tend to be “part of the solution” by joining cause related organisations. Almost all mentioned at least one other organisation and many mentioned three or more. The most frequently mentioned were Amnesty International, Médecins Sans Frontières and Oxfam. We are keen to investigate ways of forging links with any of other organisations supported by our subscribers so as to advance shared aims and increase our membership.  Your suggestions would be appreciated. Please use the comment box below section 10 or contact .(JavaScript must be enabled to view this email address)

10. Please list any professional associations that you are a member of:     

Conclusions
Not surprisingly our Paid Subscribers/Members and Free Subscribers are also members of Professional Associations appropriate to their profession.  As with the cause related organisations we are keen to investigate ways of forging links with any of these associations to promote our aims and increase our membership and value your suggestions.

If you have any further comments about links with other organisations, please make them in the box below:

Finally we asked subscribers if they had any comments, suggestions or questions about Healthy Skepticism.

Paid Subscribers wrote:

  Although not an “active” member, I enjoy Peter Mansfield’s comments.

  I do like the trend towards including more research in Healthy Skepticism’s work. But I must confess I miss the old days when we saw direct letters to pharmaceutical companies challenging their advertising. Are these absent because the MaLAM Australia newsletter could no longer be published? Are these still being written but not finding a venue for publication?

  I wonder if the range of activities is over-ambitious, so that there is not enough time to do the core activities. What are the core activities? I would suggest international editions and website, and many of the other functions are then fulfilled by this, eg journalists, govt and public can look at website. Academic activities (publishing, supervising) are worthy, but not necessarily what paid subscribers should support (because academic institutions should do this). Providing information through website is fine, but maybe if staff time is involved in doing searches etc, a fee should be charged?

  Just needs more work.

  Thank you and keep up the good work

  Whilst there is certainly a great need for Skepticism about many health issues and promotions in the “West” there is an even greater need for a viable and informed an vigorous “watchdog” on issues in the developing world. It is important to keep a good balance

Free Subscribers wrote:

  A very useful site - if it can be kept free for those unable to afford hard currency rates that would be great. Particularly like the theory bits - very useful for teaching purposes.

  Best wishes!

  Cant afford any of those subs even when I will be working.

  Guidance on setting up a similar organisation in South Africa would be welcome.

  I am sure that in earlier years there were more letters to send to companies etc than now? Am I wrong??

  I became a paying subscriber so that you can continue your work.

  I guess I never have subscribed because as a part-time GP there are so many organisations wanting money from me, and so much free information (OVERLOAD), it’s hard to know where to start. On the other hand, this is where the pharm. companies have the advantage, because their info is ‘free’, and it’s hard to compete with that. I rely on government sponsored mailouts to get most of my info (eg; Australian National Prescribing Service, Australian Drug Reaction Advisory Committee), so healthyskepticism lobbying them is a good way to get info across to info-burdened GPs like me.

  I have supported you since nearly the beginning and have over the years tried to persuade others in my circle to do so also with scant success.
  Have tried to get my workplace to subscribe but have been knocked back so I’m quite a failure!
  The various organisations I support are becoming a burden but I guess I should be shamed into coughing up the subscription fee again soon.
  As I do not own a computer & my only access is at work & I am not yet very computer literate I am unable to answer all the questions properly. Sorry about this but I feel strongly that like minded people CAN make a difference & I think you have been doing a great job over the years & the website should make a big difference to your coverage.
  Keep UP the GOOD WORK !!

  Keep up the good work!

  Keep up the great work!!!!

  Nowadays I worry about HS’s independence particularly from Government pressures, 15 years or more ago I worried about independence from Pharmaceutical Industry Pressures. It is a fine line to tread and HS has to be forever vigilant.

Conclusions
We will keep up the good work but we do need to focus in on the highest priorities. We also need to improve communication with our subscribers because much of our current situation has not been understood. We need to remember that many supporters do not find computers easy to use and many more suffer information overload.

Subscribers miss the MaLAM letters. We do too. The main reasons why we had to stop them were given in December 2000 see Changes MaLAM International News 2000;18:11/12. As mentioned before we are developing a new publication: AdWatch which is being designed to fill the gap. One issue on the design agenda is the balance of focus on wealthier vs poorer countries.

As we understand it the Australian Government’s current policy regarding funding any work on improving prescribing is to only fund the National Prescribing Service. The NPS prefer us to work for it for free on projects it controls but it has given us some small contracts. We have offered to help the NPS to improve the quality of their work but we have not received a positive response.  That has lead us to move to academic activities as a way to gain funding for advancing Our Aims. Currently the main funding for Healthy Skepticism’s work is Peter Mansfield’s PhD scholarship.

However we remain open to working with any government funded agency in any country as long as the work will advance Our Aims. We have shown that we are willing to shrink to whatever size is determined by our subscriber support base rather than compromise Our Aims so as to get funding.

Overview
The survey has provided useful information about our most supportive subscribers. The response rate is too low to enable us to make generalisations about subscribers who did not respond.  Overall we received mostly positive feedback, particularly in light of the fact that our paid subscriber numbers (and hence our income) are currently very low.  Where questions asked respondents to rank aspects of Healthy Skepticism, paid subscribers responded slightly more positively than free subscribers.

We are pleased that the responses to our questions on the website were generally positive because it is our primary means of providing information. 

What next?
Healthy Skepticism is run almost entirely by volunteers and most of our funding comes from subscriptions. We are far more likely to make a difference if we have a larger membership, not the least because with more income we can be more active.  Thus knowing more about the views of our members/subscribers is essential.

In devising strategies to increase our membership we need to think particularly about how to attract subscribers from countries other than Australia. We need to continue to find ways for non Australian residents to be involved, both in running the organisation and in supporting and contributing to our activities.

The median age of the subscribers who responded is 46.  Our future success depends on us earning the support of younger members and our membership strategies will need to take account of this.  Consequently we are very keen to listen to ideas from younger people, including medical and pharmacy students.

Subscribers found out about us from a variety of sources, the most frequent being through colleagues and the website.  From time to time we will ask our subscribers to help us promote Healthy Skepticism.  We will do our best to keep the website ‘fresh’ and endeavour to make it more effective for promoting membership of Healthy Skepticism.

A number of people first read about us in a journal article and we will continue to do all we can to maintain our presence in a range of journals.  We were particularly pleased by the very positive unsolicited endorsement we received in the Lancet late last year.

We were interested in the response to our question on membership fees.  As an organisation we have to juggle the problem of relying on subscription fees as our main source of income on the one hand, with wanting membership to be accessible on the other.  The survey has shown that at least some people would be prepared to pay a higher subscription fee.  We will not lose sight of the importance of being accessible - one solution might be to enable our paying supporters to elect a fee level that they consider appropriate and can afford.  We will get back to you on this.

The Healthy Skepticism Management Group is currently developing a business plan, we are in the process of establishing two new publications, Adwatch and a Subscribers’ Update and we are about to embark on a membership drive.  The responses to this survey have been most informative and will shape our planning.

Thank you for your feedback.  We will continue to keep you informed of our plans and invite you to provide feedback at any time.

HS Int News index

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