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China 101: Case StudyAmerican College of Chest Physicians/CHEST
Stephen J. Welch
Executive Editor, CHEST
Vice President, Communications
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China 101: Case StudyAKA: Swim With the Sharks but Don’t Get Bit;
In fact it’s quite possible to Thrive
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Objectives
• Background on ACCP (Publisher)
• Vital Statistics of CHEST
• Discuss International Development
• Why China?
• What were/are our goals?
• How are we doing?
• Lessons learned
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ACCP and CHEST Vital Statistics
• Self-published since 1935 by ACCP
• Circulation: ~20,000
– ~16,000 ACCP members (20% Int’l)
– ~4,000 subscribers (50% Int’l)
• Distributed into 100+ countries
• Heavily clinical -- lots of asthma, COPD, respiratory infections, lung cancer, etc
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CHEST Overview
•• Submissions: Submissions: 32003200 manuscripts per yearmanuscripts per year
•• Impact Factor: Impact Factor: 3rd out of 333rd out of 33 Respiratory JournalsRespiratory Journals
•• 2nd2nd in # of total citationsin # of total citations
•• Ok Ok for a clinical journalfor a clinical journal
•• Advertising is strongAdvertising is strong
•• CHEST is tops in its field CHEST is tops in its field in Market Sharein Market Share
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Manuscript submission statistics
Current Submissions:
• 31% from USA
• 3% from Canada
• 66% from Int’l– 1.5% to 2% from China
Accepted/Published papers:• 37% US, 4% Canada, 59% Int’l
These numbers have reversed since 2003 (online submission)
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CHEST % of Manuscripts PUBLISHED by Region
Accepted Manuscripts, %
4%
37%
59%International
US
Canada
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CHEST International Editions
CHEST Had International Translated Editions in These Countries:– Spain (regular edition and pediatric edition)
– Mexico (regular and pediatric edition)
– Italy
– Turkey
– India (English language)
– So in 2003 we started looking at China
– Investigating others (sorry that info is classified)
– Failed editions: Russian, Portuguese
• These things don’t always work the way we’d like…
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Starting an International Edition:Steps Involved
1. Identify Region(s) where you want to develop editions• Part of an international business plan
2. Select a translation partner• Must be reliable, professional (your reputation is at stake!)
3. Develop a contract• Who is responsible for what -- all the legal fun stuff
• Disclaimers, length of term, # of pages published, etc
• Financing (Industry sponsored vs subscription based)
• Royalties to your organization
• Other (house ads?, who will receive it, etc)
4. Identify the Editor (must be a CHAMPION!)• Our Editor (and board members) are MEMBERS of ACCP
5. Appoint Editorial Board (select articles to translate)• Articles should be for the readers, not the sponsors
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China Development: Why China?
Why focus on China for society publishing business development?
– WORLD DOMINATION!!!!
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China Development: Why China?
Why focus on China for society business development?
• Growtha) Financial (we’re a not-for-profit, but a greedy one!)
b) Organizational (studies show a US specialist workforce shortage is imminent; that means fewer US members)
c) Sales and distribution (reach) of products and services
• Missiona) Get CHEST into the hands of population with health problems
b) Help promote humanitarian awards of our Foundation
• Member Needs -- 2003 visit resulted in requests for:a) Chinese language edition
b) Help with translation and getting published
c) Educational programs
d) More robust membership (HK chapter was very successful)
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China Development: Why Now??
Q: Why Focus on China now? Why not wait?
A: Because it takes TIME
Be Prepared to spend:
– a lot of time
– a lot of money
Be prepared to wait a while for any ROI
Be prepared to face your critics
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China Development: Why Now??
Considerations and arguments for doing it sooner not later:
– Huge population (physicians and consumer public)
• This = potential customers
– Large number of institutions
• More potential customers
• 2 major consortia: CALIS and NSTL
– Pharma development and involvement is increasing quickly
– Great desire for Western medical information
– Great pressure to publish in English language journals
– Language barrier is improving (slowly)
– Economic barriers are improving (slowly)
• Note: Financial transactions can be problematic; must go through a government approved company that can handle money
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China Development: Goals
1. Promote Brand Identity & Awareness of CHEST
and ACCP– Awareness: Get CHEST into the hands of people who may
not be familiar with it -- and deliver key articles in their native languages
– Increase ACCP membership
• Lower cost e-membership
• Low-cost membership for physicians in training
– Increase meeting attendance
• Target submission of abstracts
– Marketing: ACCP products (books, CDs, etc) and educational courses
– Increase manuscript submissions of key regional researchers
– Involve local members in projects
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China Development: Goals
2. Financial
– Generate royalty revenue from licensing the content
– Increase subscriptions to CHEST
• Individuals (via membership)
• Institutions
– Develop relationships with international pharmaceutical companies
• Grants
• Sponsorships
• Other projects
– Grow society revenues from membership dues, meeting attendance fees, product sales
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China Development: Goals
3. Develop Key Personal Relationships– Give leaders and members in other
countries a sense of ownership through journal projects and other participation
– Identify key leaders and future leaders for ACCP
– Leverage relationships for other future projects
• Membership development
• International courses
– Woo potential authors to submit research to CHEST
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China Strategy: A Step-Wise Approach
• Develop Translated Edition of CHEST in China– Identified Everwell as Publisher
– Named highly respected, famous local leader as Editor in Chief, appointed local editorial board (serendipity is good!)
– Launched in 2004
– Published monthly (8-10 articles), advertising based, breaking even
• Use Translated Edition as Marketing Vehicle– Ads for membership
– Ads for products
– Ads for meetings
– Potential mailing list
• Hold Writing/Publishing Workshops Branded to CHEST
• Begin Targeting Subscriptions and Product Sales– Hired Charlesworth in January 2007 as sales agent in China
– Plan to utilize Beijing Book Fair to promote books, products
• Offer a low-cost print-only reprint through XWPC
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CHEST Results
How have our
China efforts
done so far?
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China Outcomes
• China Edition Circulation: 8,000+
• Institutional Subscriptions: 40+• Working on consortia deals
• Managing current China subscriptions much better
• Membership 2003 vs 2007– China: 8 →→→→ 59 (+51 = +600%)
– Hong Kong: 81 →→→→ 130 (+49 = +60%)
• Meeting Attendance 2003 vs 2006– China: 3 →→→→ 5 (+2)
– Hong Kong: 9 →→→→ 9 (no change, although this varies)
• Meeting Abstract Submission– Fluctuating, no clear pattern yet
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China Outcomes
54
11
8
23
3
13
1
0
5
10
15
20
25
2004 2005 2006 2007
Abstract Submission 2004-2007
China
Hong Kong
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CHEST Results
• Financial– Too early to have detailed results but membership $$ are
up
• Manuscript Submissions– # of Chinese submissions are increasing
– Quality is increasing
• Involving Local ACCP Members– EIC of China Edition, Ed Board are Members
– May involve members as faculty in future workshops or courses
– Have developed strong personal relationships withleaders (just invited to attend conference organized by a China Ed Board member)
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China Strategy: Other Considerations
• Politics
– Hierarchy of current medical system
• Old guard and young turks
• Traditions (Negotiations take TIME)
• Cost of Building Relationships
– Face-to-Face is important but cost $$$$
• Publishing: CN Code
– If you don’t go through CMA, getting one can be very problematic
• Can China Model Be Replicated and Applied to Other Countries?
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Summary and Lessons Learned
• Be Patient
• Prepare to have to spend money to make money
• Have a business plan and a budget
• Choose your partners wisely
• Financial transactions must go through proper channels
• Make visits -- face-to-face time is VERY important
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CHEST International Edition ReportTHANK YOU!
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