For the more than 75% of Americans now enrolled in some form of managed health care, the key word is "managed" -- and that means managed not just by insurance companies and HMOs, but by consumers and their families. Americans are increasingly demanding that they become partners in decisions regarding their medical care. To do this, the patient/medical consumer (who has, on average, less than 30 seconds to explain his or her symptoms to a doctor) must be able to find the information needed to evaluate health-care options.

This October, Simon & Schuster and Harvard Medical School join forces in what they promise will be the ultimate consumer tool in the age of managed care -- Harvard Medical School Family Health Guide. "There already exist good family medical guides," S&S president Carolyn Reidy acknowledged, "so in creating this book we sought to create a work that was different -- that provided the essential, comprehensive information today's consumer needs as well as the tools to help that consumer navigate the shoals of managed care to keep themselves and their families healthy."

Harvard Medical School, which initially contacted S&S in the fall of 1995, was looking to establish a long-term publishing partnership. At the same time, S&S was looking for a medical school to partner with for an all-inclusive family health guide. Harvard envisioned a book that would touch on all areas of medical care with a heavy emphasis on prevention. "We wanted to not only tell people about illness," said Dr. Anthony Komaroff, the book's editor-in-chief, "but provide the means for understanding what can be a confusing and sometimes threatening health-care system." Komaroff, who is a professor of medicine at Harvard Medical School and editor-in-chief of Harvard Health Publications, says, "there are several other books that tell how the body is built, but we felt the need for a book that would tell how the body works."

The joint publishing agreement was finalized in September 1996. Harvard Medical School provided 162 members of its faculty (all practicing physicians, not just researchers) to write various sections of the book, as well as, said Komaroff, "the expertise of the faculty's 7000 doctors and researchers at 17 affiliated hospitals and research centers."

Features such as "When You Visit Your Doctor" (Q&A pages that suggest questions patients should ask their physician and lists of what tests might be performed), Symptom Charts, Alternative Medicine sidebars and Risk Assessment graphics interpret medical data in a way that is designed to be both accurate and easy to understand.

Focus Groups Provide Input

Focus groups, said executive editor Bill Rosen, were a key part of assessing what should be included in the book. Beginning in the summer of 1998, focus groups and a 2400-person national phone survey were asked what they wanted to see in a medical guide. These groups later looked at everything from jackets to sample pages and advertising. The response, Rosen recalled, "was overwhelmingly positive to the graphics and sidebars."

Perhaps the most important information to come out of the focus groups was the growing importance of the Internet in consumer health-care research. "The possibility of a Web site was not presented as a question to the groups," said Rosen. "It came as a response from them. There is still the myth that Internet users are young and male, but the focus groups showed us that most everyone, male and female, had used the Internet as a source of medical information."

The result is a Web page that will constantly update the information in the book. In Reidy's words, "This will be the first family health guide that will never go out of date." The site will be maintained by Harvard and will, in addition to supplementing and updating specific pages in the book, provide information about new research, diagnostic tests, treatments and drug interactions. It will also include additional images, q&a checklists and first-aid charts that can be downloaded and printed.

Finally, weighing in at a hefty 1192 pages and one million words, the Harvard Medical School Family Health Guide ($40) is ready to be positioned for what promises to be a mega marketing and publicity campaign. "We met for over a year on our PR and marketing strategy," said Reidy. "The greatest challenge was to create a plan that would cover the enormous breadth of the target audience." First printing has been set at 150,000 copies.

Spreading the Word

The initial phase of a print and radio advertising campaign will begin in October. It will include repeat advertising in the New York Times and USA Today and a series of 60-second radio spots that will run through December.

Harvard Medical School will supervise the editorial content of a 16-page advertorial, "Women's Healthlink -- A Guide to Wellness over 40," which will run in Good Housekeeping, Harper's Bazaar, House Beautiful, Town & Country, Victoria, Country Living Gardens and Colonial Homes. Hearst will also be running a consumer sweepstakes with 500 copies of the new book offered as prizes.

"The campaign for this book will be ongoing," explained Beth Wareham, director of the S&S lifestyle publicity department. "We're using the model that worked so successfully for The Joy of Cooking. The launch will take about a year. Initially, the focus will be on the 'core' press -- medical health, women's, golden age, etc. Then we begin pitching broader stories based on the seasons: how to make it through the cold season without getting sick, how to keep your kids healthy at summer camp."

A national publicity campaign, featuring key physicians who have contributed to the book, will include a TV satellite tour, intensive regional media and interviews on national, syndicated and local radio. Plans also call for targeted coverage aimed at magazines, newspaper lifestyle pages, and columnists that cover women's, health, parenting and consumer issues. "We have an embarrassment of riches," Wareham observed. "We can pitch the world's best doctors on virtually any topic that has to do with the human body."

A grassroots publicity push will include campaigns to reach the 7000 physicians who are graduates of Harvard Medical School, a direct-mail campaign to the Hearst mailing list of three million names, and a blow-in card inserted into the regular mailings of the Harvard Medical School family of newsletters (circulation 900,000).

Online Promotion

In addition to the online site maintained by Harvard (, will contain basic information on the guide, as well as excerpts, charts, interviews with contributors and a link to the Harvard site. Online booksellers will be able to feature the cover, excerpts targeted to their sites and cover quotes.

Subsidiary rights have already been sold to Family Circle (first serial), QPB (main selection), Book-of-the-Month Club (alternate selection) and One Spirit Book Club (alternate selection). All this has led executive marketing director Michael Selleck to speculate that "between advertising, publicity, sub rights and on-line marketing we could generate upwards of 60 million impressions."

"For Simon & Schuster," Selleck added, "the challenge of this book was to create something that would redefine the usefulness and accessibility of a family health guide. Let's face it, this is a crowded field. But we worked hard to ask consumers what they needed and then to give it to them. This is a guide worthy of today's golden age of medicine, and with the continuously updated Web site, the book can keep up with science. For Harvard, well, they get to make house calls."