First came the specialist medical magazine 15 years ago when revenue was tighter than a packed A&E and operating in the highly competitive health sector was fraught with fear. What reaction could two former journalists, with no previous experience of running their own publishing houses, expect from the most sympathetic bank manager?

After sitting and listening, perhaps a recommendation that the would-be publishers visit their GP for referral to a psychiatrist. But madcap schemes were not part of any plans John Gibbons and Geraldine Meagan had in mind when they launched MedMedia Group (MMG) in 1991. Experience told them that a new magazine was the correct prognosis.

For Gibbons, it started in 1987 when he joined Irish Medical News as editor and then managing editor. Three and a half years later he and Meagan, who had worked on the journalistic and production sides of the business and had brought in desk top publishing for INM in 1980, jumped ship “to do their own thing”.

Two people in a rented office in Monkstown, Co Dublin and with their holiday pay. At first, Gibbons was living upstairs to keep overheads down and commuting time to a minimum. The first edition of general practice title, Forum, was launched in October 1991 with enthusiasm, contacts but without a clue about advertising and marketing.

Meagan admitted it was all rather daunting, but as Gibbons said they brought a lot of their old relationships from INM with their reputation acted as credit in the short term. By December they had come to within two weeks of completely running out of cash, but they weathered the storm and made it safely through to the spring.

Meagan said they thought long and hard about who would be the first person they would employ. Would it be a credit controller? They decided on a graphic designer and that put down a marker on the future of the business. At the tail end of 1994, the wind dropped out of their sails as there were regulatory changes which impacted on drugs budgets.

“We had been booming all through 1992 and 1993,” Gibbons said, “then suddenly were were facing into 1994 with an order book down 40 per cent. There was a huge reflex cut back in advertising and it was the most serious threat we'd faced since our launch – and it hit overnight. We relied on advertising for 95 per cent of our income.”

Bruised by the experience, they launched a creative division in 1995 which was become known as MedMedia Campaign (MMC). MMC was a way of avoiding similar reliance on ad revenue only and being proactive by producing ads in-house. MMC services the likes of Pfizer Healthcare and Eli Lilly and three of the top four pharma brands.

“From watching our flagship practically disappear beneath the waves overnight, we decided we'd diversify,” Gibbons said. “The vagaries of advertising revenue only publishing were not for us. So we decided to split our effort between ad sales and direct contracts for creative services. We knew there was a huge gap.
“The standard in medical creativity in the mid-nineties wasn't great and it was widely acknowledged as such. Most stuff was being brought in from the UK. There was no specialist Irish agency. It was our clients coming to us asking could we do this, that and the other… At first, we said no and then we thought, hang on, there's a business here.”

'Health in Ireland has become the new weather' – John Gibbons

Over the past 15 years, MMG has grown from a two-person start up to a company employing 30 staff and a host of freelance writers and specialist contributors across three divisions in Dun Laoghaire. The core business has moved from Forum, to 11 healthcare publications covering medical, nursing and allied health issues.

Forum is the published in association with the Irish College of General Practitioners (ICGP). Next came the World of Irish Nursing for the Irish Nurses Organisation (INO), an A4 magazine for Irish nurses, which initially had a run of 16,000 and ten issues a year. WIN was re-launched in 1995 and as INO membership grew the run jumped to 33,000.

MMG took on Diabetes Ireland for the Diabetes Federation of Ireland and Diabetes Professional for healthcare workers. Last year, the Asthma Society awarded the group Asthma News. Other magazines, which are self-explanatory by their titles, include Nursing in the Community and the Irish Journal of Psychological Medicine.

Meagan heads up the publications division at MMG. She works to a panel of medical experts they call on – doctors, nurses, physios et cetera. The journals are structured to the organisations' needs and having a mailing of 33,000 gives them commercial options.
Recruitment ads for nurses is an area which MMG has finally managed to exploit.

“Other media outlets have had an absolute lock on nurse recruitment,” Gibbons said. “We've gradually broken that headlock over the last ten years. We would now have a decent chuck of the nurse recruitment business in print in Ireland. But it took ten years to persuade certain ad agencies there was more to life than certain Sunday newspapers.”

Meagan stressed the importance of the tenor of the advertising for the magazines targeted at professionals. To keep with its professional tone, MMG has avoided health and beauty advertising and knows the line that should not be crossed. Gibbons said all the journals they have developed are profitable in their own right and cross selling is a no-no.

“We possibly have a reputation for being a little bit inflexible at times and we actually take as a compliment,” Gibbons said. “You can produce more journals, more pages and cut your prices, sell your space if you're willing to slash quality but maybe it's because we have a background in journalism, we don't want to produce dross.

“Advertising is important – of course it is. But it has a secondary position to the editorial. There's a tendency for highly commercially-driven publishers to put advertising first and editorial is seen as an overhead. In the longer term, people will come back for quality. It's a harder sell and we're still standing and we're respected… we've a market niche.”

The launch of irishhealth.com in 2000 really put MMG on the consumer map. The site has proved a major success and gained wide mention in more mainstream media at a time when online faced problems, largely due to the hype and over-promise indulged in by those who swore the internet was the panacea for all commercial ills.

If you type in the word 'health' into Google.ie, out of 4.5 million hits, irishhealth.com ranks second only to the Department of Health. “Health in Ireland has become the new weather – everywhere you go people talk about it,” Gibbons said. “There's huge interest in issues….obesity, diabetes, asthma, erectile dysfunction to plastic surgery.”

Apart from the articles on health-related topics and conditions, irishhealth.com features about 50,000 user postings, on everything from blushing and anxiety to marital rape. Gibbons said the discussions are the site's lifeblood, allowing vigorous dialogue between users of the health system and the people who work in it.
“You're likely to find a doctor going toe-to-toe with half a dozen patients. More long-suffering relatives and perhaps a few nurses joining in,” Gibbons said. The site has searches of all the country's GPs, pharmacists and physiotherapists and 02 subscribers can access all the content on i-Mode mobile phones.

Earlier this year, MMG launched the Health Update, a syndicated column developed from irishhealth.com. The column features in 35 local newspapers, from the Kerryman, to the Evening Echo to the Irish Farmers Journal. The column is produced by MMG and syndicated to the various publications as a pdf ready to print.

The combined circulation of participating titles in Health Update is put at 750,000, with two million readers. Irishhealth.com recently achieved a landmark 100,000 registered members – some achievement for a specialist site in a market the size of Ireland. The site averages 600,000 visits, the equivalent of 20,000 visits a day.

Parents and carers could find the child vaccination tracker (CVT) a godsend as it helps manage vaccination needs, from birth to leaving school. Anyone registered with the system is sent out an automatic email reminder of when the next vaccination is due.

The online video section allows questions and answer sessions with top medical experts on issues like heart disease to alzheimer's. There are video interviews with key healthcare experts in Ireland and new resources are added regularly.

Gibbons said that while the government is spending upwards of €11 billion a year on running the health service, little or nothing has gone into using the internet as a tool to provide services to people that may help reduce unnecessary doctor and hospital visits.

In January this year, irishhealth.com was rated as the world's ninth most popular health news and media website and as indicated by alexa.com it was up there with such sites as the New England Journal of Medicine, the BBC and CNN Health.