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Healthy Skepticism International News

December 2005

Report on consultation with Healthy Skepticism subscribers and members

Caroline has spent 3 months liaising with members, subscribers and the management committee to gauge opinion about future directions for Healthy Skepticism. This is the short version of her report. A more detailed account will be posted on this website soon.

1. Purpose
The purpose of this report is to identify key issues from the consultation with subscribers, members, management group and others. Proposed actions will be highlighted for consideration by the management group.

2. Background
Why did HS undertake a consultation? HS wanted to seek the views of stakeholders in the organisation, particularly looking at differences in motivations for paying or not paying subscription; increasing involvement of subscribers and areas for priority and suggestions for improving the organisation.

3. Key Issues
This report will look at the following key issues:

• How could HS encourage free subscribers to pay?
• How could HS encourage paid subscribers to become members?
• Should HS be differentiating services for paying and non-paying?
• How could HS increase involvement of subscribers?
• What is HS’s product or strategy?
• What suggestions have been gathered as a result of this consultation?

4. Summary
The following is a list of suggestions and/or key themes that arose:
• Communicate the difference between paid subscriber and member
• Consider just having member category (rather than paid subscriber in addition)
• More communication about what being a member means (i.e. dispel assumptions that members have to live in Australia; have to be known within the organisation; that membership is onerous with greater involvement; that membership costs more money, etc)
• Free subscribers want benefits to upgrade; paid subscribers and members want to show their support for the organisation (should/can HS provide more benefits to paying or is paying more of an expression of support?)
• Ask free subscribers to upgrade
• Ask paid subscribers to become members
• Ask subscribers to become more involved, provide opportunities for involvement (in particular need to find people to initiate HS branches)
• Re-introduce AdWatch- HS needs to have a promotional focus to work it does
• Suggestion of being more visible, greater publicity/ awareness (NB could make use of word of mouth)
• Need to share details so people can network more within the organisation
• Need to keep people informed of activities (could this also be a way of involving people- with a calendar of events and asking people if they are interested in helping us- links into issue of proactive vs reactive strategy)

5. Key Issues: Discussion and Comment
This section will look at the 6 key issues outlined in section 3 above, drawing from both questionnaire and interview data where appropriate.

5.1 How could HS encourage free subscribers to pay?
In order to answer this question, HS needed to firstly ask why our free subscribers are free subscribers rather than paid subscribers and members.

The majority of responses indicated that free subscribers did not know what the benefits of upgrading are; the second greatest response was that they could obtain all the information they wanted for free (therefore presumably why would they want to pay?). Other responses included that they thought the subscription price was too high; that the benefits are not worth the subscription price; that there is an assumption that upgrading equates to an obligation to be more involved with the organisation. However, a minority did state that they had intended to upgrade, but had not found the time to do so.

There was an opportunity for free subscribers to state any other reasons why they were not paying subscribers or members. Several themes were identified:

• A lack of financial resources to pay the subscription
• Desire to consider the organisation first before deciding on upgrading
• Unsure how Australian currency converts into their own currency (i.e. queries over affordability if own currency is weaker than AUS dollar)
• A lack of trust over internet transactions method of payment
• HS is not seen as local (i.e. if it were, they would be more encouraged to pay)
• A lack of time to read additional information (i.e. they did not want to pay for information that they have no time to read)

We also wanted to ask the reverse, i.e. why our paid subscribers were not free subscribers. This could potentially show motivators for upgrading for our free subscribers.

The responses to this question are grouped into themes:

• Paid subscribers can afford to pay
• They want to express their support for the organisation
• They want to contribute economically
• They understand the sustainability of the organisation ultimately rests on paid subscriptions

We then asked specifically what changes HS could make that might encourage our free subscribers to consider upgrading to paid subscribers and members. By far the greatest number of responses was a trial period to see the benefits (NB this fits into the first question responses well- as free subscribers said they did not know what the benefits are). The next greatest response was that people were unsure what changes HS could make; followed by that HS could abolish the free subscriber option. There were also a few responses that free subscribers would like to see more benefits or have more opportunities to participate.

Few themes emerged from the additional comments free subscribers made, one was that the free subscriber option should definitely not be abolished (i.e. that people support HS as a free resource). Other comments included that there should be the possibility of paying by some other means; that no changes can be made if people cannot afford the subscription fee; that there should be specific student and senior rates (which there are already but it seems that some subscribers are not aware of this) and finally that the subscription fee should be lowered.

As lack of financial resources was anticipated as a potential barrier for free subscribers to pay, we asked some questions around whether free subscribers thought that the subscription fees were too high. The majority of free subscribers(66 of 125) thought that the ordinary subscription fee of $100 was too high, with 22 people thinking it was not too high and 30 people unsure either way. Again comments reflected that free subscribers wanted to know what the benefits are; that the subscription cost should be advertised in different currencies and that the fee should be reduced.

We also asked if free subscribers thought the concession subscription fee ($25) was too high. The vast majority of respondents thought no (79), only a small minority said yes (12), with a reasonable number being unsure (27).

Some free subscribers commented that $25 was too high for some people, for instance for people in developing countries, or with low incomes.

We then asked specifically if our free subscribers were willing to upgrade (to either paid subscriber or member). Small numbers were willing to upgrade (13 to paid subscriber and 6 to member); 51 responses indicated that they were not willing to upgrade and an almost equal number (48) were unsure.

5.1.1 Comment
It appears that free subscribers would like to know what the benefits of paying are before considering upgrading. Perhaps this means that free subscribers actually want more benefits out of a subscription fee than the current paid subscribers (whose motivations are in part supporting the organisation).

One possibility would be to reduce the subscription cost, however if this was done across the board then it would significantly reduce HS’s income (for instance if it was reduced to $80 it may encourage more of our free subscribers to pay, but would loose $20 from every current paid subscriber).

HS could investigate other methods of payment as some comments indicated that they subscribers not want to pay over the internet. (There is already an option to pay by fax or post but it seems some subscribers are not aware of this.) There is already a link on the website to convert Australian dollars into other currencies, so if people are not finding this information the layout of the website could be altered.

An obvious response to how HS could encourage free subscribers to pay is to ask them. A total of 19 people said they were willing to upgrade to either paid subscriber or member. Seven people became paid subscribers within a few days from the commencement of the free subscriber questionnaire which suggests that it prompted some of the respondents to become paid subscribers.

5.2 How could HS encourage paid subscribers to become members?
For this we first asked why our paid subscribers were paid subscribers rather than members. By far the most common response for this was that paid subscribers were not aware of the difference between the categories of paid subscriber and member.

Orders of frequency of the other responses are ranked in the following table:

Paid Subscribers
1) Unsure of difference between the two categories
2) Lacking expertise
2) Unsure/ no particular reason
3) Unsure if anything to offer HS
3) Living outside Australia
3) Intention to become a member
3) Lacking time
3) Not known within HS
4) Members have to contribute more
4) Too expensive

In addition, we asked why our members are members rather than simply paid subscribers, again this could show motivators for paid subscribers to become members.

The two most common themes were that members wished to indicate their support for the organisation and that they wanted to contribute financially. Again, members stated that even they were unsure of the difference between the two categories, although this was not the top response it is interesting that this appeared in the member responses.

1) Indicate support for HS
1) Financially contribute to HS
2) To be more involved
3) Unsure of difference between two categories
3) As above
3) Unsure

We then asked what changes could be made for paid subscribers to consider upgrading to member.

The most common themes from this were that paid subscribers would like to be informed of the differences between the two categories.

Paid Subscriber
1) Inform me of differences
2) Will check this myself
2) None
3) Clarify my status
3) Desire to upgrade
3) Assumption categories were the same

A hypothetical question was asked of the members, along similar lines to the above question.

‘What changes, if any, could HS make that might lead others to consider upgrading from a paid subscriber to a member?’

There was no identifiable theme from the responses here, although there were many suggestions as to what changes HS could make that might lead paid subscribers to consider upgrading to members.

Suggestions included:

• HS should market this option more actively
• HS need to clearly explain what the benefits of membership are
• HS needs to make face-to-face meetings possible via linkages outside of Australia
• HS should continue to improve communication; raise awareness of the types of activities it undertakes and summarise costs involved to members and possibly paid subscribers
• HS should emphasis the need for support from a as wide a range of people as possible
• HS needs to indicate that membership may not be onerous in terms of commitments

Other comments included that there is probably a group who just support HS but do not want any other involvement. On person felt that the MaLAM strategy gave a sense “that there was something informed and effective happening on a regular basis. It is a bit more episodic and ‘hit and miss’ at present, to my perception, and this could put off those looking for something that was solid, steady, educational and value-based”.

A further comment was that, “Local groups sense of being able to be effective and involved in the process of going about the core business of HS, getting to know the local people so there is the positive social interaction”.

In addition, several people answered that they were unsure of what changes HS could make that might lead others to consider upgrading to becoming a member.

5.2.1 Comment
Members want to indicate their support for the organisation and contribute financially. There is nothing to suggest that paid subscribers do not also want to indicate their support for the organisation (in fact this was one of the main reasons why they decided to pay rather than be free subscribers). Members want to contribute economically, as do paid subscribers and there is absolutely no difference in cost for being a member as compared to a paid subscriber.

However paid subscribers did not know what the differences between the categories of paid subscriber and member meant (and even some members did not know the difference). Clearly, this need to be communicated more effectively.

The other possibility to consider is why there are the two categories of paid subscriber and member, the distinction is causing some confusion and perhaps HS need to question why there needs to be these separate categories. Certainly there is an assumption amongst some paid subscribers that if they are paying this automatically means they are members of the organisation and want to express their support.

In addition, there appear to be other assumptions, such as that members need to be known within the organisation, that they must be within Australia, etc and these incorrect assumptions have to be rectified. If a paid subscriber wants to become a member, two other members must nominate them. If however, they are not known within the organisation, they can send in their CV and the management group will decide their membership status.

5.3 Should HS be differentiating services for paying and non-paying subscribers?
There were differing opinions on this question. Responses for this section will be split into management and others responses.

5.3.1 Management Group

One opinion was that if HS are to maintain the funding stream through subscriptions, then the organisation must try and differentiate services for those that pay and those that do not.

However, in some ways, the philosophy of HS is about ‘getting as many people as possible interested’ and this is the reason behind having the free subscriber option. Subscriptions are HS’s core source of income; however it was questioned whether this option gives people the incentive to pay if they can obtain basically the same information for free.

Perhaps HS do not maximise bringing people off the free list, yet this is linked into the idea of whether HS should be offering benefits for paid subscriptions or not.

However, it was questioned whether there in fact needs to be anything ‘in it for them’; the fact that subscribers are joining HS means that they are backing the organisation financially and may not expect anything back?

Other thoughts included that it perhaps ‘would be nice to offer the paid subscribers something’, for example extra publications, however the important part of HS is ‘getting the message across’.

If HS is to differentiate service for non-paying and paying subscribers, the organisation needs to know what would incentivise free subscribers to want to become paid subscribers. This is about knowing what our subscribers want and offering something discrete to paying subscribers (which could also encourage more free subscribers to upgrade).

5.3.2 Other interviews
Non-management group members did not talk about differentiating services, however there were comments that ‘it’s good that people can get information from HS without ‘signing up’’, showing that there is value in having HS as a free resource.

5.3.3 Comment
If we look back at the previous questions, this also shows insight into this question of whether HS should be differentiating services for paying and non-paying subscribers.

One of the main functions of HS is raising awareness, therefore the free subscriber option is very important, as there are considerable numbers of people who want access to the information HS provides but are not able or willing to pay. To encourage free subscribers to upgrade, it appears that they want tangible benefits. Paid subscribers and members do have greater access to material on the website (and members can vote and elect the management committee). Given current resources within HS, it may not be possible to further differentiate services for paying and non-paying subscribers.

It also appears that primary reasons for wanting to become paid subscribers and members is a desire to support the organisation, not because there is anything ‘in it’ for them.

In conclusion, perhaps services do not need to be differentiated as such, as if subscribers pay this means they want to support the organisation. HS management group need to consider whether they can and whether they want to differentiate services.

5.4 How could HS increase involvement of subscribers?
For this section, there was a specific question in the questionnaire relating to subscriber involvement, it was also a topic which arose in the interviews. This section has been split into questionnaire and interview (management group and others) for ease of reference.

5.4.1 Questionnaires
In the questionnaire, we specifically asked whether people would be interested in doing any particular tasks and listed some tasks they could get involved with if they wished. The below shows numbers of free subscribers, paid subscriber and members interested in particular areas with totals of the two and the numbers in brackets show the actual numbers willing to have their details for this question passed onto the management group. For example, 56 free subscribers and 35 paid subscribers and members would be happy to tell others about HS. However, 78 out of the 91 responses for this indicated they would be willing for their details to be shared with the management group. Unfortunately a coding error was made when the free subscriber website questionnaire was set up, so that answers to special interest group option were not recorded.

Free + Paid/member
Telling others about Healthy Skepticism 56 + 35 = 91 (78)
Contributing to email discussions 32 + 19 = 51 (46)
Providing comments on our written work before publication 32 +13 = 45 (42)
Providing feedback on our activities 31 + 13 = 44 (40)
Involvement with a local branch of Healthy Skepticism 29 + 11 = 40 (38)
Involvement in a special interest group 0 + 13 = 13 (12)
Assisting with specific projects 22 + 18 = 40 (38)
Adding articles to the website library 17 + 11 = 28 (25)
Writing articles 12 + 9 = 21 (18)
Providing expertise 12 +19= 31 (28)
Other (please specify below) 6 + 1 = 7 (5)
Unsure 24 + 4 = 28 (16)

No free subscribers comments were recorded because of another coding error. There were, however, some main themes within the paid subscriber and member comments (in order of frequency): lack of time; unsure of what can contribute/expertise; unsure what is required; other commitments. Other comments included a general willingness to help, with some suggested specific areas they could help with. Another suggestion was that HS should publish a membership directory, as “we can do a lot of networking ourselves”.

We also asked the management group and others about the issue of getting subscribers involved.

5.4.2 Management group
It was suggested that what HS needs is someone from the management group to work out how to involve members and subscribers and that there were enough ideas of how to engage with subscribers but not enough time to follow these ideas through. In addition, there was a query over whether HS needs to firstly increase its subscriber base, if it wants to increase involvement. The idea behind this was that HS needs a bigger ‘core’ of people, so that it isn’t the ‘same people who end up doing everything’.

However, if HS does not have anyone to engage with subscribers then the organisation has to inspire subscribers to become involved and give them what resources we can give and control over what they do.

The most significant efforts to get people involved have arisen from when people have been physically able to interact. It is difficult to get people involved when they aren’t ‘face-to-face’, as ‘those types of meetings tend to gather enthusiasm better than an email will’. HS have been able to get people involved in Adelaide ‘probably to a large extent because of the face-to-face stuff’.

However, one comment was that HS can only expect a small number of subscribers to have the energy to give the organisation; the rest will just want to express solidarity for HS’s position. A comment was that perhaps HS is getting as much out of members and subscribers as can be expected? In other words should HS expect a lot of involvement?

If HS wants to involve members and subscribers then the organisation need to know how to enthuse them; is this about making things meaningful and local?

Several members of the management group expressed that the ‘vision’ to some extent was that HS will eventually be a truly international organisation, with HS branches, or groups all over the world. This is a key way in which HS could involve more subscribers.

However, the fact that HS is voluntary-based and run means that it is not so straightforward to have HS groups all over the world, as it would require a significant commitment and time input from those concerned setting up the new groups. There would also be the issue of resources; perhaps HS would need small amounts of ‘seed’ money to establish these groups?

For a local group to be establish would require a couple of people in each area who are very interested in this area to act as the catalyst. These key individuals would need to then identify other people in their area to participate. They would also need to feel they had the authority to act independently although the issue was raised over consistency of theme and ensuring that all potential groups follow the identity statement of HS.

The belief was expressed that HS in Adelaide works simply because of Peter Mansfield and Jon Jureidini to a significant extent; getting subscribers involved in other areas in terms of setting up other groups is difficult because ‘you’re just not going to have those types of people in every place’.

Lastly the issue of expertise was raised, i.e. perhaps some people are inactive because they feel they lack the expertise.

5.4.3 Other Interviews
There was a question as to whether HS should target specific areas where members have an interest/ and or expertise in order to increase involvement

There was another suggestion that perhaps members could be more active in terms of sending information somewhere central.

Subscriber involvement is a difficult issue, information sharing is an activity that people can become involved in and it would be good to have a type of email discussion group going, one subscriber commented.

In terms of involvement, the letter writing strategy of MaLAM did provide the opportunity for subscribers to feel involved in the organisation. ‘With MaLAM there was a clear role where people could participate’. However, the effectiveness of this strategy was diluted after a period of time and it was commented that it was not feasible to continue along similar lines.
One person expressed that part of what subscribers get for paying is the newsletter but this tends to be fairly ‘Peter centric’ and that in some ways this might be self propagating (i.e. if it’s always Peter doing things how do you involve more people?)

There are other barriers to becoming more involved, such as a feeling that subscribers lack the expertise or do not have the depth of knowledge in this field and so are limited in terms of what they feel they can offer. There were additional difficulties expressed over getting subscribers more involved, with a lack of time an issue for most.

One person suggested that getting subscribers involved is partly about enthusing people to take the initiative, but partly it’s about saying HS has the structure in place to say ‘we’ve got x, y, z on offer’. Although there was another suggestion that perhaps what needs to be done is identify what are the gaps or what tasks are time consuming that could be shared out.

If the question is how to increase subscriber involvement, one way of doing this is for HS to be more local and to have HS branches, as face-to-face meetings gather more enthusiasm than an email will

The idea of local groups would mean that it would be easier for people to collaborate on pieces of work. It’s essential that these groups be connected to the centre, however one person questioned that if HS did remain centralised then perhaps the issue is of how the organisation makes communication easier so that other people can work and participate in HS.

Details would need to be shared for the formation of local groups to be possible; members need to know who the other members are in order to be able to network by themselves. In addition, the goals and aims of this network of potential HS branches would need to be clear (i.e. what is the purpose of HS branches?).

There was a further suggestion that the supporter base of HS needs to be bigger before the idea of local groups can be possible and sustainable.

5.4.4 Comment
How could HS increase involvement of subscribers- the obvious answer is by asking and providing opportunities for involvement. The first step is compiling a list of potentially interested parties for various areas. One specific part of the questionnaire asked whether people would be interested in participating in local HS groups, approximately 40 said they would be interested. In order for local branches to take off, details would need to be shared (requiring permission) and interested people brought together. The purpose of these branches would need to be explicit, for instance should one branch concentrate on one specific area of interest? There should be the freedom for branches to decide their own agenda so long as it fits within HS’s identity statement.

Starting HS branches is easier said than done however, as this idea has been around for some time, HS needs to identify key people to initiate these branches. Of the people who said they would be interested in becoming involved in a local branch of HS, there may be a small handful who would be interested in initiating these branches. However, this is a much bigger commitment and expectation to have of our subscribers. In addition, there would need to be support structures in place for any branches, for advice and communication (also for things like avoiding duplication of effort).

Having branches may encourage some free subscribers to upgrade and increase paid subscription numbers and would certainly increase involvement.

In terms of strategies for involving subscribers, some reference was made to MaLAM however although it involved subscribers this strategy should probably not be re-introduced.

5.5 What is HS’s product or strategy?
This question involves looking at many areas, for instance referring to HS’s previous incarnation, MaLAM; discussing the importance of AdWatch and also directions for the organisation. There were no specific questions around this area in the questionnaire, however some comments showed an awareness of these issues.

5.5.1 Management group
A comment from the management group suggested that the main thing that HS can control is the product it can deliver. However, in some sense HS appears to be questioning which approach is best to take at the moment. There are a mixture of activities HS is involved in, for instance education, advocacy, research, etc.

HS seems to have a different style for a different name, and there were some comments around MaLAM being more a descriptor of activity, whereas HS has more of a ‘brand’ name than MaLAM, which in some sense was ‘a paper chase’.

The AdWatch campaign was really quite effective because medical professionals could look at it and identify what HS was about. In addition, it was a useful device to educate people and get people on side. However HS has not been able to continue with AdWatch due to lack of resources. If HS does something like AdWatch it shows that the organisation is doing something on a regular basis, with new additions of AdWatch, there was a constant generation of something happening and it is engaging and pulls people in. Academic articles written are interesting but possibly do not have the same appeal as the de-construction of ads, so perhaps other material that HS produces does not portray the same message as AdWatch did?

The feedback from AdWatch was positive; it was popular and has the potential to draw more people into the organisation. HS should be producing things that are of interest to people, like AdWatch.

5.5.2 Other Interviews
Comments from non management group people included that HS does good work and there is value in what it does but it is difficult to tell what HS is doing. In addition that HS has evolved past the letter writing strategy of MaLAM and there is a more sophisticated approach now.

Comments were that HS should restart AdWatch and that it was a useful and interesting campaign. AdWatch was useful for looking at the before and after thoughts people would have about ads (i.e. before they know what misleading techniques are being used). There were also questions about where has HS’s focus on promotion gone, with one person saying that ‘HS without AdWatch was like Mercedes not making cars anymore’.

5.5.3 Questionnaires
HS’s product in some ways could be viewed as the information it provides its subscribers and members, but no response specifically talked about strategy/ direction from the questionnaires as there were no questions directed towards this theme.

One area that paid subscribers and members were interested in receiving information about was pharma behaviour and HS highlighting problems, which could in part be interpreted as an approach comparable to AdWatch. A similar theme emerged from the free subscribers questionnaire, with comments such as ‘critiques of current adverts for drugs’ as a topic they would like to receive information about. One comment from a free subscriber particularly highlights the importance of AdWatch:

‘I learnt about HS from a reference…to an analysis of an advertisement. It achieved a level of sophistication and penetration, and an intellectual approach that was far removed from anything I have encountered’.

In some sense, comments from the management group and others seem to suggest that HS is questioning which approach it should take currently, there have been several comments concerning MaLAM and the strategy the organisation took previously however HS should probably not go down this route again.

The transition from MaLAM to HS links into the issue of what is HS’s product/strategy. AdWatch seems to be a very important part of HS’s identity and all comments from the management group and others are favourable concerning the benefits of AdWatch. However, re-introducing AdWatch depends on resources (particularly having the time to do the in-depth analysis). A meeting held in Adelaide on the 7th of November 2005 suggested whether it would be possible to do a type of ‘mini AdWatch’, which would not be as in-depth but would concentrate on perhaps one or two aspects of misleading promotion of the advert. Healthy Skepticism’s slogan: ‘reducing harm from misleading drug promotion’ suggests that the organisation should have promotion as its focus and many have referred to AdWatch as a core activity of HS that needs to be re-instated. Again this comes down to resources however.

5.6 What suggestions have we gathered as a result of this consultation?
The last area detailed in this summary report is that of suggestions of improvement from our subscribers. This has been divided into free subscriber, paid subscriber and member responses and summarises the main themes from the suggestions.

5.6.1 Free subscribers
When we asked if free subscribers had any views on how we can improve HS, the main themes of suggestions were as follows:

Doing a good job/satisfied with HS- “I feel that you do a good job”; “I think it is a wonderful facility up front and behind the scenes. I have no idea on how it could be improved”.

Development of local groups-“I understand this is an Australian organisation – there is a need for the development of local groups”; “Be more ‘international’”.

Increase visibility, disseminate message more- “Have a very clear message to give to those people who may not have ever heard of healthy scepticism before”; “Let me hear more from you”.

We also asked what topics free subscribers were interested in receiving information from Healthy Skepticism. These can be seen as suggestions of the type of information free subscribers would like from HS.

There were a varied number of responses here; the main themes are as follows (in order of frequency):

Drug related issues- this covers a number of areas- “New drugs”; “problems with prescription drugs”; “Alerting us to drug dangers”; “Objective drug data”; “info on new drugs and their supposed benefits over those they are replacing”; “drugs and products currently being pushed”.

Unethical Pharma behaviour- “avoiding being unduly influenced by Pharma”; “Selling methods of pharm companies and related ethical problems”; “illegal or unethical drug company behaviour”.

New information/news on current issues- “Important news”; “New issues and current topics”; “Latest news about relevant issues”; “Current topics”.

Any/all relevant information- “Everything”, “All”; “Anything relevant”.

Updates, newsletter- keeping informed of HS’s activities- “HS news”; “Publication of new material by HS on website”; “Informations on activities of HS”; “What new with HS, and what events have been happening or are on in the near future”.

5.6.2 Paid subscribers and members
The most common of the themes of suggestions from the paid subscribers and members were as follows:

Increase visibility, disseminate message more-“Higher profile of activities”; “The message need to get out there more, many doctors have no idea about the danger of seeing drug reps…would be great to raise HS’s profile…”; “Anything that would increase visibility”.

Increase funding to be more sustainable- “Most improvements would be predicated on being better funded…”; “Getting funding to become more sustainable”.

Improve networking- “more networking”; “Improved networking with other members”.

The most common was that HS needs to increase its visibility and disseminate its message more; the other two themes had an equal number of responses.

There were many varied responses to what topics paid subscribers and members would like to receive information on. However there were some general themes seen in the responses (in order of frequency):

New information/ news on current issues- “New important information”; “Current issues”; “hot ‘news’”.

Updates, newsletter- keeping informed of HS activities-“Information about current events – perhaps via a calendar each year”; “I’d just like to be kept informed of what the organisation is doing”; “Being kept informed of your activities”.

Pharma behaviour: HS highlighting problems- “Pharma industry practice…”; “Pharmaceutical company behaviour and the ways in which Healthy Skepticism is highlighting problems”.

Promotion and regulation- “What is happening on the promotion and regulation side both nationally and internationally”.

6. Action Points
There are many important areas of action from the questionnaire and interview results.

6.1 Paid subscriber and member: differences
The difference between paid subscriber and member categories needs to be communicated, as currently there is much confusion as to what the differences are and an assumption that these categories are the same. Both paid subscribers and members were unsure as to what the differences between the categories are.

One possible solution is that HS considers just having the member category and abolishing the paid subscriber category. This would simplify the situation and avoid further confusion. There are pros and cons to this however. Some paid subscribers may not wish to be members due to conflict of interest. Currently the ‘default’ option when subscribers decide they want to pay is paid subscriber; HS could change this so that the default is member.

Another issue related to member status is what being a member involves. There are some assumptions that being a member (as opposed to a paid subscriber) is more expensive, that membership is onerous with greater involvement, that members have to be known within the organisation and that members live in Australia).

Being a member is no more expensive than being a paid subscriber; it simply means a declaration of support for the organisation’s aims. Members do not necessarily have to be more involved, although if they wish to they are able to. Members are more involved in the sense that they are able to vote and elect members of the management group who run the organisation. To become a member does not mean that the person must already be known to other members within the organisation. Paid subscribers need simply to send in their CV and declare that they support the aims of HS. The management group then looks at the applications for membership and makes a decision based on the information presented to them. Lastly, members do not need to come from or live in Australia, the majority of the management group are based in South Australia but there is no reason to limit membership by geographical locality, in fact HS would wish to promote the opposite and have as many international members as possible.

6.2 Differentiating services
In general, it appears that free subscribers want to see the benefits in order to consider upgrading, whereas paid subscribers and members want to show their support for the organisation and this is why they pay (in addition to the fact that they can afford to pay).

Reducing the subscription fee may make it more affordable for some free subscribers to upgrade, however this has the potential to reduce the income of the organisation overall, if all current paid subscribers had their fees reduced.

The questions for the management group to consider are does HS want to provide more benefits to paying and is HS able to do so (i.e. have the resources)? One way to view this is that paying is an expression of support for the organisation’s aims, therefore there does not need to be anything ‘in it’ for paying subscribers.

6.3 Increasing paid subscriber and member numbers
The obvious solution to this is to ask free subscribers to upgrade and ask paid subscribers to upgrade to members. The results from the questionnaires show that at least some free subscribers would consider becoming either paid subscribers or members. In addition that many paid subscribers already believe themselves to be members. In both instances, HS should be able to increase its paid subscribers and members as a result of the questionnaires.

6.4 Subscriber involvement
Again, this comes down to asking people to become involved and providing the opportunity to do so, whether this is a list of specific projects or tasks that HS would like to involve its subscribers in. The questionnaire results showed that many people were interested in helping out in one activity or another, with the most responses being that people are willing to tell others about the organisation. This is very significant as word of mouth can be a powerful tool.

Subscribers can be more involved if they are doing something on a local level, therefore the idea of local HS is very appealing. Approximately 40 people said they would be interested in being involved in a local branch of HS however the next stage would be to identify people according to which geographical area they live in and identify those willing to help initiate these groups (as this stage will be the most time and effort consuming).

6.5 Suggestions
There were many suggestions from the questionnaires and interviews, perhaps the most important of these are as follows.

HS should reintroduce AdWatch as it is critical for the organisation to have a promotional focus to the work it undertakes. Although it may not be possible to have a fully fledged AdWatch currently due to lack of resources, one suggestion was for there to be a smaller version of this. Perhaps this is another area where subscribers could get involved?

There were many comments about increasing the visibility of the organisation, one possible way of doing this is to make better use of word of mouth. Currently subscribers may tell others about the organisation such as colleagues and friends, but is this done in a structured way and could it be done in a structured way? Could HS provide PowerPoint presentations and information packs so that subscribers can tell others about the organisation in a more formal way perhaps?

Another area where comments showed HS could improve is by increasing networking. It is vital that details can be shared amongst members and subscribers, so that networking amongst these groups can take place. HS needs to gain permission for these details to be shared and posted on the website. It could be a stipulation of membership that details will be shared and a type of membership directory published. Without this, it is very difficult for a new subscriber or member to know who is who in the organisation and to make their own links with others.

Another area is that subscribers need to be kept aware of HS activities and this could also be a way of involving people (see section 6.4). If HS could publish a type of calendar of events and list future areas of work, this may encourage subscribers to become involved in these areas, if asked. However this idea depends on HS being more proactive in the way it operates, rather than reactive.

7. Further action
HS management group to consider this report and the suggestions outlined in sections 6.1-6.5



HS Int News index

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