Only the most far-out futurists could have predicted the changes that have taken place in the medical advertising world since the start of the final decade of the 20th century. Promotion was still firmly rooted in the traditional triad—detailing, direct mail, and professional advertising in journals—with the dawning of the digital age, DTC, and the world of the Web just breaking. All of that was soon to change at a breathtaking pace. Savvy marketing communications executives kept one eye on the past, grounding their communications in traditional medical and professional media and the tried-and-true organization and methods of the 20th century. At the same time they eagerly approached the exciting new consumer-oriented media of the 21st. To provide a unique context for the narratives that follow, John Corcoran captures the essence of the era in his expansive overview of “Professional Advertising Today." Tom Domanico and Don Martiny detail the changes that have occurred in the creative development and production processes over the last two decades in their essay on "The Impact of Technology." As important as the creation of content is, the delivery and dissemination of breakthrough ideas does not occur in a vacuum. Tim Pantello and Mark Bard describe the sea changes that have occurred throughout the new media environments. In "Digital Communications Emerge," they outline how rapid growth has highlighted the tensions between consumer demand for more healthcare information, and the legal and regulatory constraints on industry providers. One of the most controversial aspects of the new information flow is the advertising of products and services directly from the regulated industries to patient- consumers. "A History of DTC," by Frank Hone, not only tracks direct-to-consumer advertising as it evolved from print to the broadcast media, but also describes the growing trends of Internet/Web use and the direct-to-patient movement that has resulted. No medical communications medium has been left unchanged by shifts in societal values and new technologic advances. Publishing industry veteran Carroll Dowden chronicles the effects of these shifts on traditional professional literature in "Medical Publishing," a perceptive overview of the current state of that industry. Harry Sweeney 83
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