An interview with: Avinandan Mukherjee
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Health care is one of the most critical areas of today’s world, with almost every country experiencing a gap between need and available resources. Yet the scholarly output in the related field of marketing is small. For this reason, Emerald launched this year (2007) the International Journal of Pharmaceutical and Healthcare Marketing (IJPHM) as a double-blind peer-reviewed research journal dedicated to advancing our theoretical and empirical understanding of marketing pharmaceutical products and health care services. The journal has emerged to be a leading specialist reference resource of health care marketing information and analysis, highlighting cutting-edge research, new concepts and theories, and fresh practical ideas and initiatives. It includes empirical studies, conceptual papers, case studies, practitioner perspectives, and book reviews, and serves as an innovative practice reference for managers in the health care and pharmaceutical industries, offering insights, techniques and strategies.
Dr Avinandan Mukherjee is professor of marketing at the School of Business in Montclair State University, New Jersey, USA. He has previously taught at Pennsylvania State University (USA), University of Bradford (UK), Nanyang Technological University (Singapore) and Indian Institute of Management (India). He has delivered guest lectures at INSEAD (France), Strathclyde University (UK), Copenhagen Business School (Denmark), ESC Toulouse (France), and Kathmandu University (Nepal). His research interests include pharmaceutical and health care marketing, services marketing, retailing, and he has worked on research projects sponsored by MIT (USA), INSEAD (France), and the University of Sussex (UK). He strongly believes in interdisciplinary research, and has had several articles published in a wide range of leading international journals.
Journal mission and editorial focus
Congratulations on the launch of your journal this year, and on becoming editor. What are your main aspirations for the journal?
Our mission is to position IJPHM as the leading journal in the field of pharmaceutical and health care marketing. The idea for this journal came up because the erstwhile Journal of Healthcare Marketing was discontinued towards the end of the last decade. So, there was a discernible gap in good research outlets in this area: there were really no publishing outlets of real academic or scholarly repute, so that’s where we stepped in. We do have some competitors but most of the other journals in this area either address non-marketing issues (for example they may be management journals) or they are too applied, like a trade magazine. So our objective is to be the first choice for scholars in this area to publish their research.
Given the importance of health care for society, why is this such an under-researched area of marketing?
One reason why there has not been that much research in this area was the lack of specialist research outlets like this journal. Another reason has been the lack of interdisciplinary research between marketing and business scholars and pharmaceutical and health scholars. I guess this trend is now increasing and I can see a lot more collaborative work between nursing, pharmacy and medical schools on the one hand and business schools on the other. Also there’s more of a feeling within the health professions that they need to introduce business concepts. Increasingly the entire health care profession understands the need to go for more managerial type intervention; take, for example, the recent developments in the UK’s National Health Service or the US health care system. In both of these systems, we see more managed care, which is nothing but management applied to the health care service. These changes are adding to the research in the area; there are more cross-school collaborations. Health care management and marketing is seen as important to the economy – no wonder more research is beginning to happen and the area is taking off in a big way.
Do you think that covering both product and service marketing, which as general concepts both have rich theoretical areas, will enable you to fill the theoretical vacuum in this area more quickly?
We needed to have both angles because if we had included, say, just pharmaceuticals and not health care or vice versa in this journal, we would miss out on a very important part of the sector. I really see these as interconnected and inseparable parts of the broader health sector. It’s also true that the pharmaceutical industry is product based and therefore different from the service-based health care industry. And since marketing has always categorized itself into physical goods and services, I wanted to mention that explicitly in my introductory editorial and in the journal call for papers, because I wanted to appeal to anyone with an interest in the health sector. It’s still a very focused group and I wanted to make sure that any research in the health care and pharmaceutical area with some application for marketing and/or management was relevant to the journal. So the journal scope was kept broad within a specialized area.
You say that the journal is international, but many journals are international without real coverage in the USA. Yet you seem to have succeeded here, and you have a very impressive editorial board with people from such top institutions as Rutgers, Stern, Harvard and Columbia. How did you get such a top team together, and did it help the fact that you yourself were based in the USA?
The reason why we have a large number of US scholars on the editorial board of this journal is simple: at least 50 per cent of research in health care management and marketing right now is coming from the USA. So looking at the US health care market and including it in this journal was very critical. This US health care system is being constantly redefined in many ways, it’s also a very advanced but complex system and one around which there is a lot of discussion – for example, Michael Porter has recently written a book on health care marketing, which we shall be reviewing in the journal.
I knew that to get contributions from the USA it would be necessary to have a number of recognized US scholars on the editorial board. So I reached out to them, and I think that the fact that I’m based in the USA right now helped. I also went to few conferences within the USA on health care management, and met some of the leading scholars there. So now, submissions from the USA are very healthy – more than 50 per cent of the accepted papers. Of course I am now getting an increasing number of submissions from Europe and Asia. I try to keep the journal as international as possible in terms of authors, reviewers, and editorial board members, but you could never ignore the US element as that’s so important in this sector. There is also the existence of a big group of health economists in US universities, and I’m targeting them for the journal in the future. In short, you just can’t ignore the USA for scholarship in this area.
Do you think that the very complexity of health care in the USA and the fact that Hilary Clinton was unable to sort it out means that marketers and marketing academics are perhaps more inclined to research it than other sectors or has it been particularly popular?
I think there are reasons why health care is high on politicians’ agendas anywhere in the world. In the USA, it’s at the centre of the public debate, and almost every day there’s something on television about changing the health care system and making it more accessible, efficient, affordable, and so on. Health care is also much discussed in the UK and the rest of Europe. And the big emerging economies, like China and India, also need to look at their health care systems. These countries have seen a lot of industrialization and a lot of economic growth lately, but their health care systems pose the greatest challenge to their development. So, they need to modernize their health care systems.
Marketers and marketing academics are becoming more inclined to research this sector. On the one hand, it’s the sheer importance of the topic, with an ageing population in industrialized countries and poor health care systems in the developing countries. Another factor is the availability of research funding. The National Health Service has given out research grants, as have the National Institutes of Health in the USA. So there is a lot of research funding and research support for people who want to work in this area. I know that in several universities marketing scholars have been working on big funded projects which in turn have generated more research. For example, in the USA, the Center for Disease Control and also organizations like the Cancer Prevention Institute or the AIDS research institutes have sponsored research on changing patient and general consumer attitudes towards different diseases. There’s also been research support on direct-to-consumer communications, patient attitudes, compliance, interventions and prevention mechanisms, where there’s an overlap with psychology, social marketing and public policy. The health sector is interested in how marketing can help, and marketing scholars are increasingly applying their skills in this area, aided by generous funding. I don’t see that kind of funding in most other areas of marketing.
The third factor is again availability of publishing opportunities. Some other marketing journals, for example the Journal of Consumer Marketing and The International Journal of Research in Marketing have recently done special issues on this subject. It seems marketing academics are realizing the importance of pharmaceutical and health care marketing, which adds to the relevance of our journal because everybody’s talking about it.
You are determined to reach the publisher’s Holy Grail, the threefold market of researcher, faculty/student, and practitioner. You aim to include practitioner perspective articles but in principle are practitioners likely to read long research articles, or do they prefer, for example, executive summaries?
Yes, we definitely want to reach all three target markets. A prime objective of the journal is to appeal to both practitioner and academic audiences. Of course, we need to remember that IJPHM is a double blind peer reviewed scholarly journal. So we do look for academic contributions from every paper. But, there is a lot in the journal which will be of interest to practitioners. Emerald structured abstracts are absolutely fantastic resources for practitioners. But, I hope practitioners take more interest in the journal than just reading the abstracts.
The first way we appeal to practitioners is by publishing different types of papers. We have four or five pure research papers in each issue, but we also have some very interesting case studies, industry notes, or practitioner perspectives. The first issue had a case study on China’s supplements market, and the second issue published a practitioner perspective on ROI for pharmaceutical marketing. Emerald usage reports show that these articles are very popular. Second, we reach out to pharmaceutical and health care practitioners through a mailing list my editorial office has developed, which is updated regularly. With the help of my editorial assistant Kai-Li Weng, I send out an e-mail with the table of contents of each issue, so that practitioners get to know the topics that we are publishing. Third, and one which I find very satisfying, is that I am now getting a number of collaborative papers between practitioners and academics, in fact I think about a third of all submissions right now are in that category. This is helped by the fact that pharmaceutical companies recruit a lot of PhDs often in a scientific subject, but the fact that they have research experience helps them to write papers even if not on a directly scientific subject. I’ve received some really interesting papers submitted by managers of Pfizer, Bayer, Sanofi-Aventis and Daiichi Sankyo; I think that there are probably more highly educated professionals in the pharmaceutical sector than in any other. Many have both scientific PhDs and MBAs.
New Jersey, where I’m based now, is a pharmaceutical hub of this country, with the headquarters of close to 50 per cent of the pharmaceutical companies in the world – Pfizer, Merck, Johnson & Johnson, etc. all within one hour driving distance from Montclair State University. That helps a lot, and I have tried to reach out to the local industry by involving their managers, inviting them to give guest lectures in our pharmaceutical and health care courses at both undergraduate and postgraduate levels, and by organizing pharmaceutical events. I’m also hoping to increase the number of practitioners on the editorial board.
You have a very multidisciplinary focus, while insisting that your articles have marketing content. How do you achieve the balance, and from what sorts of disciplines do your authors come?
Authors come from marketing, management, strategy, finance and other business disciplines, as well as from pharmacy, medicine, health administration, and public health departments. We know that we have to reach out to these multiple audiences and make the journal readable to all of them. Marketing papers are easier to read for other disciplines, but sometimes I get very scientific papers with a lot of medical terms – I have to go back to the authors and ask them to water down to a level that marketing people can understand. Scientific matters have to be explained very clearly and frequently the paper has to be re-written in a way which is more comprehensible to the general reader. When I go to conferences and participate in meet the editor sessions, I make it very clear that this is not a scientific journal and therefore scientific information must be discussed in a non-scientific language; we are talking purely about management applications and implications. Once that’s clear, scientific authors will re-write in a way that’s understandable to business academics. On the other hand, business academics frequently ask for even greater quantitative and statistical analysis from health care and medical authors. Then a dialogue between science and business goes on, which is one of the journal’s purposes, and I hope that can continue so that we can get more interest from the health care and pharmaceutical professions.
So, that’s how you ensure that you will not have too strong a medical content but how do you, when you decide to include something, ensure that it is of interest to marketers and business academics or are you also looking for some sort of theoretical constructs from the marketing literature or whatever?
The first part is definitely yes as I just discussed, the paper clearly has to be of interest to the marketing audience; but as for the second part, it depends. In many cases even papers written by people on the health care side have some theoretical constructs from marketing, communications or psychology. Occasionally I have had papers which don’t use marketing type theory, but the theories or applications that they’re using are very well established in the health care literature and have been used in several journals. So, I’m not saying that we are only interested in theories that marketing people currently use; we would be open to new theories from the health care side. I am sure marketing academics appreciate knowing the health care perspectives to research, just as the health care researchers are getting to read things which are new to them from the marketing people. But the theories should not be purely scientific and I have to be convinced that business people will be able to appreciate the material – for example, does it include something from a related discipline like communications, economics or psychology? The dialogue is really critical here, and we are hoping that the marketing and business people learn as much from the health care profession through this journal as the other way around.
You are quite specific in what you require your reviewers to look for – importance of the topic; originality of work; literature review and references; problem formulation; theoretical/conceptual framework; research design and methodology; data analysis; results obtained and implications; legitimacy of conclusions; practical significance; clarity of presentation, organization and writing style; relevance to pharmaceutical and health care industries; relevance to marketing and management; overall contribution of the paper; and likelihood of passing the "test of time". This is quite a lot to cover in a relatively short article – 4,000-6,000 words: how can authors be succinct while still covering quite a large area?
It is a long list, and I have deliberately made this long list public because I think that authors should know the criteria by which their work is being judged. We are often asked by authors, what they should be thinking about when they write a paper. These criteria could coexist in one submission because these are the sort of things reviewers would expect from a good marketing or business paper. However, we would not expect every paper to have every criterion; we leave the list long because we would not want to penalize a paper which was particularly strong in a certain area. Generally, we rate the papers out of five for each criterion, and we are not looking for a five in everything, merely more than an average. For example, a paper may be very strong on the theoretical side but not have much data, or vice versa. It’s a bit like the list of topics on the web page, which is exhaustive, but not mandatory. At the end of the day, acceptance into the journal is a matter of overall reviewer judgement beyond the total of the score card.
What are your future plans? How many issues a year, and do you intend to have special issues?
I think we shall have the same number of issues (four per year) in the near future, since this is a very specialized area, with a finite number of people working in it. On the other hand, I would want the journal to be more selective and reduce the acceptance rate. Right now we have a 30-40 per cent acceptance rate, which is quite good for a new journal. But, this can certainly be improved particularly when you consider that some submissions are not even directly relevant to the journal. Selectivity is critical as it is the prime determinant of journal quality and is an important criterion for inclusion in Thomson Scientific (formerly ISI) citation index and listing in the Cabell directory.
As far as having special issues is concerned, this is a specialized journal anyway so we probably won’t have too many special issues as these will make it even more specialized. I do have a couple of special issue proposals at the moment and we may go forward with one on health care in emerging markets in the not-too-distant future.
General publishing issues
One list of academic marketing journals lists 116 refereed journals in marketing. Do you think that the way forward in the discipline is to look for a greater degree of segmentation, and do you see it as a problem that many of the top rated marketing journals are very general in their focus?
Most of the top marketing journals will always remain very general in their focus. Exceptions are very prestigious journals like the Journal of Retailing and Marketing Science . The top journals will continue to have the greatest impact on research in the discipline. At the moment, marketing remains a fairly general discipline without very strong specializations. For example, a marketing professor is still expected to teach courses in different areas of marketing, which is difficult to fathom in more mature disciplines like chemistry or biology. Can you think of a physics professor being expected to teach across the whole area of physics? But, as marketing matures further as a discipline, we will see more stronger specialisms.
I do think there is a definite opportunity for high-quality segmented journals in marketing. The current trend in academic marketing is the acceptance of some more specialized journals as among the top in the discipline – journals covering a particular context or sector such as the European Journal of Marketing or the Journal of Services Marketing, for both of which, incidentally, I have guest-edited special issues. I think Emerald is going in the right direction, producing some of the best specialized journals in the field and many of them are doing extremely well, and I see this as more of a trend in the future.
You seem to have a very broad definition of research, welcoming both qualitative and quantitative studies, post-modernist research etc. Yet it’s often thought that US scholars prefer to follow a more conventional research path through quantitative research etc. Do you agree?
I think there is a need for both types of research approaches and both types of studies. It is true that US scholars prefer a more conventional quantitative research methodology, at least in marketing, compared to UK scholars, for instance. Interestingly, I don’t see that trend in medicine. If you look at a medical journal you will see that US scholars and European and UK scholars are doing exactly the same type of quantitative or qualitative work. But somehow in business, US researchers tend to use more quantitative analysis.
My experience is that most of the new ideas in marketing are first published in the British journals, for example in the European Journal of Marketing . And eventually over time US scholars will test out those ideas with data and write a more quantitative paper. So I don’t see US researchers in marketing necessarily coming up with a lot of totally new ideas because of their research paradigm. In the UK research tradition, there is more scope for saying something new and getting it published. So I do see both approaches as very important and almost complementary. I welcome quantitative papers with good data and strong analysis. But, I also welcome papers which don’t have much data but which are thought-provoking, which have new ideas. I have accepted a lot of US submissions which have advanced models and data analysis, so to me both are very important, but the new ideas have to come first. In marketing, it’s only in the last decade or two that the top marketing journals have become extremely quantitative.
For example, in the 1970s and 1980s you would see conceptual, ideas-based papers in the Journal of Marketing. I think that our discipline is following the scientific approach in the same way that economics has gone through changes and is now like a pure science – in many ways it’s extreme pontification.
How can a new journal attract sufficient attention to ensure it receives adequate submissions?
Right, that is indeed the greatest challenge! Any new journal has to make sure that it gets a lot of support from its publisher, and Emerald has been great, working very closely with its editors, and I must always thank them for that. The first major task is to form a renowned editorial board, the second to get good reviewers, and the third to get quality submissions. Without a healthy flow of submissions, no journal can exist! Many journals come up and die out within a few years.
The journals market is highly competitive. So, sustaining the new journal’s frequency and quality is quite a challenge. Perhaps, the most important way of doing that is by sustained targeted marketing. We did a lot of research finding out who was working in the area, not only in the USA and the UK, but also in other countries and continents, Hong Kong, Singapore, India, China, Africa, looking at faculty databases and faculty publications. Thus we developed a targeted list which resulted in a flow of submissions. Advertising on relevant listservs proved very helpful. We have to keep up this dialogue, otherwise within six months the flow of manuscripts will dry up. For example, as I said earlier, we e-mail the table of contents of every new issue to about 1,000 academic scholars and about 500 practitioners.
Another good way of getting the journal known is by promoting it at conferences – we are helped here by the fact that there are very focused conferences in this area, for example the health care marketing conferences and the pharmaceutical marketing conferences. We conduct "meet the editor" sessions there. A third way is to tie in with a particular conference and get papers submitted to the conference to be submitted to the journal, although most conference papers would not be published in the journal as they are, since the reviewing procedure for the journal is far more stringent. Finally, we need to promote the journal through an excellent website, and I must thank Emerald for developing the website content collaboratively with me on a continuous basis.
Also, my editorial board members have come forward with useful suggestions from time to time, which helped me to shape the direction of the journal. Tapping into the shared experience of the editorial board is necessary for the editor of any new journal.
About yourself
How did you become interested in this sector?
I don’t have a formal background in biology, I am an electrical engineer and then of course a marketing academic. I became interested in this sector through the interactions I had with health care and pharmaceutical companies when teaching in Singapore and then Bradford. Then, when I came to Montclair here in New Jersey I realized that with pharmaceuticals being such a big industry, there was a lot more scope for research. I was in any case an expert in services marketing, but I liked the health care sector because I could see its relevance. As marketers we tend to discuss a lot on Coke vs Pepsi or McDonald’s vs Burger King, but health care is the need of the hour. If we as marketing professionals can help improve the health care system, then that helps the society at large like nothing else. That’s what drives me, and I look at this sector and see that it is such a big part of the economy, set to reach 15-20 per cent of GDP, so we definitely need more research in this area. We need to make health care more professional, and the way to do this is to conduct more research on health care management and marketing. When I talk to hospitals, health care clinics, and insurance companies, I see a lot of interest in understanding and applying marketing and business principles. These trends are not going to go away – they will grow and grow, so it’s a good area to be in.
What do you most, and least, like about being an editor?
I think that the best part of being an editor is to help others achieve their goals of publishing their research. I see the editor’s role not as someone who is trying to judge which paper is good or bad, or who’s trying to stop papers from getting published, but as someone who is constructive and enables others to publish their research, while improving quality through a constructive review process.
That is the best part of it. The other side to it is the time it takes. That’s true for any editor, it’s something that we choose to do, but it’s the way the academic profession runs which makes it sometimes a little harder on editors because universities rarely make allowances for faculty’s editorial duties. It’s something which you decide to do of your own accord, but it’s an additional job on top of everything else. It’s a really critical service to the profession through which the editor and his/her university gains in academic stature. Of course, Montclair State University has been exceptionally supportive of my role as the editor of IJPHM . I have been provided an editorial assistant to work exclusively on the journal. Both dean Alan Oppenheim and marketing department chair John McGinnis have recognized the contribution of this editorial work to strengthening the research image of the school. The editorial responsibility is very challenging with its deadlines and deliverables, but it’s also very, very satisfying. There is so much that one can learn from the sorts of papers that come in, just getting the opportunity to read so many interesting papers is in itself a big motivating factor for an academic. So, there are many, many invaluable plus points of being an editor which cannot be quantified.
And finally...
Can you give examples of ways in which developments in marketing in this sector, new product development being an obvious example, can increase the health and wellbeing of society as a whole?
Marketing can improve the health and wellbeing of the society as a whole. One can think of examples from several areas of marketing, new product development being, of course, one of them. The pharmaceutical industry conducts significant trials and marketing tells us how to bring the product to market – products that help to combat disease and ill health. Then there is social marketing and the marketing of non-profit organizations, which can help in improving the health of millions across the world, for example, distributing pharmaceutical products to the rural poor selling subsidized AIDS drugs in Africa, or providing health education to consumers.
The next thing of course is marketing communication – we all understand that direct-to-consumer communication is a very important part of health promotions – which can help to inform and empower patients. Then there’s distribution – efficient drug supply chain, locating health care providers, hospital networks, etc. Services marketing research can help improve service quality in hospitals, and help in service designs and blueprinting. And then there’s the whole area of patient compliance – if patients don’t take their medications properly, their own health deteriorates and the health care costs of insurance companies, employers and societies escalate. So, marketing can do many things for the wellbeing of health and society, it’s not just about profits.
Publisher's note
Dr Avinandan Mukherjee was interviewed in September 2007.
Visit the information page for: International Journal of Pharmaceutical and Healthcare Marketing