When Medical Post staff writer Pippa Wysong called Dr. Vivian Rakoff’s secretary last August to try to talk to him about his controversial psychiatric profile of Lucien Bouchard, her editor didn’t actually expect Rakoff to cooperate. After all, dozens of reporters were desperate to talk to the high-profile psychiatrist. Surprisingly, Rakoff’s secretary called back, saying he wouldn’t do it for anyone else, but since it was The Medical Post…. While reports in the popular press often had to include a Rakoff-could-not-be-reached-for-comment statement, the Poststory quoted the doctor’s protest that, as a concerned citizen, “[I was] entitled to write what I like….I don’t think it [what I wrote about Bouchard] was that marvellous or significant.

Months later, Rakoff is still steamed about the coverage in the mainstream press. “I was totally misrepresented,” he complains. Magazines like Saturday Night and Maclean’s distorted the story to make it appear as if he had said Bouchard was absolutely crazy, Rakoff says. “After my experience with the media last fall, I am so suspicious of them. I want nothing to do with any of them.”

So why did he agree to do the interview with the Post? Because, he says matter-of-factly, the paper is “reliable.” And his trust was not misplaced; he was happy with the Post‘s handling of the piece. Dr. Ken Walker, who writes a widely syndicated medical column under the pseudonym W. Gifford-Jones, shares Rakoff’s confidence in the Post. He describes itas “an excellent medical journal-I think the best in Canada.”

And he may be right. Forty-two times a year, the Post offers doctors a way of quickly catching up with the enormous volume of breaking medical news. But the two doctors’ high opinion might also be due to the fact that no other paper goes head-to-head with the Post, the flagship publication of Maclean Hunter’s health-care division. That’s partly because the Post has a such a large, loyal following in the medical community that challenging it could be extremely difficult. In addition, the paper’s staff includes some of the best people in the industry. But it doesn’t hurt that Maclean Hunter uses its money and power to dig out any competition before its roots get too deep.

For more than three decades, TheMedical Post has been offering the nation’s doctors bulletins about the latest studies and newest therapies as well as changes in provincial health regulations. A typical issue contains approximately 60 stories as short as 100 and as long as 1,200 words (“Royal College to Change Foreign MD Policy?” and “Coming Soon: Cyber Charts” are typical). It also carries features on ethical issues and health trends as well as profiles of doctors. And every issue includes doctors’ letters; some correct past stories, others relate their own experiences to corroborate articles. Often the space becomes a forum for debates on such issues as health-care reform and abortion.

The tabloid is not only respected by doctors but has been recognized by its peers for superior content. The “wall of fame,” covered with 16 framed magazine awards, is the only indication that you’re entering the maze of staff writers’ cubicles that constitute the Post offices. The prizes include 11 Kenneth R. Wilson Awards for top trade magazine work, as well as two National Magazine Awards and a Science in Society Journalism Award that Pippa Wysong won in 1996.

Just metres away in the cream-coloured labyrinth are the Family Practice cubicles. They look much likeTheMedical Post‘s space, only less cluttered, since the magazine moved in much more recently. Until late last spring, the 10 Family Practice staff worked out of the Thomson Healthcare Communication offices in Scarborough, Ontario, and competed with TheMedical Post for stories, readers and advertising. Now the former rivals share a photocopier.

Some protest that the two magazines were never in serious competition. John Shaughnessy, editor of Family Practice until February, calls it a “quasi-competition.” Kristin Jenkins, who worked at the Post for more than 11 years, says, “I never felt that Family Practice ever really gave TheMedical Post a run for its money. It was never really a big threat. [We] sort of watched them with a mixture of contempt and amusement.”

Family Practice ‘s biweekly deadlines prevented it from ever scooping its weekly nemesis, meaning the magazine was forced to concentrate on analysis and interpretation. The papers have different audiences: thePost is for all doctors while Family Practice targets only general practitioners. However, over half of the Post‘s almost 42,000 readers are GPs and Family Practice does cover many of the same stories. The similarities in their appearance-the same glossy tabloid format-are undeniable. Understandable, too, considering their closely entwined history.

About 15 years ago, The Medicine Group, a U.K. firm, launched an Australian medical publication calledAustralian Doctor, which bought second rights to the Post‘s editorial. Several years later, the editor ofAustralian Doctor visited the Medical Post offices to see how the publication was run.

Not long after, The Medicine Group launched Family Practice, published out of Mississauga, Ontario. It did fairly well in readership surveys, but the company’s core business in Canada was continuing medical education. The magazine needed a more aggressive advertising sales team than The Medicine Group had the resources for. When Thomson came looking for a flagship publication for its health-care division in November 1991, the group sold.

About the same time, Thomson recruited The Medical Post‘s publisher, Frank Lederer, who was later appointed publisher of its new acquisition. Lederer offered then-managing editor of the Post, John Shaughnessy, the editorship of Family Practice. Many people say Lederer is a leader in his field and largely responsible for the publication’s success. He gave Shaughnessy, a self-proclaimed “quasi-tightwad,” the power and money to bring the paper up to standard. Shaughnessy hired more photographers, illustrators and freelancers. He also stacked his editorial team with former coworkers. One by one, The Medical Post began to lose its managing editors to Family Practice. After Shaughnessy left, Kristin Jenkins recalls, there was a big party for him and Jenkins moved from features editor and senior staff writer to associate editor while Andy Monroe took over as managing editor. When Monroe left for Family Practice in late 1992, “they had a cake and some people standing around and a gift” and Jenkins moved up again. Then, after less than a year as managing editor, she left to start up Family Practice‘s clinical section. “They just about ran me out of that company on a rail,” she says. With all that borrowed talent, it’s small wonder that Family Practice took on the look and feel of The Medical Post.

After five years at Thomson, Family Practice was running smoothly and making money. Readership surveys showed a modest increase in the Family Practice numbers, while the Post‘s numbers were declining slightly. It seemed that Family Practice might be able to loosen the Post‘s hold on the GP community. Then, on Friday, February 7, 1997, Thomson Healthcare called a company-wide meeting. People who had the day off or were on assignment outside the office were summoned to attend. Downtown, a memo circulated regarding a similar meeting for the Healthcare staff at Maclean Hunter. Most of the morning was lost to speculation. There were rumours that Rogers Communications, Maclean Hunter’s parent company, was selling its publications. After lunch, both groups assembled in their respective meeting rooms. Frank Lederer, publisher of Thomson’s Healthcare group, and Jim Hall, president of Maclean Hunter Healthcare, announced that Maclean Hunter had purchased the Thomson health division.

The big story at that time had to do with two of the other six medical and pharmaceutical publications that Maclean Hunter had acquired. Thomson’s Pharmacy Post and its main competitor, Maclean Hunter’sPharmacist News, were merged under the title Pharmacy Post, and L’Omnipraticien was repositioned so that it was no longer competing head-to-head with Maclean Hunter’s L’Actualité médicale.

It’s not the first time that Maclean Hunter has effectively eliminated the competition. In the ’70s, a man named Frédéric Porte started up L’Actualité médicale for doctors in Quebec. It was very successful and Porte followed up by launching a similar, English-language paper called Ontario Medicine for doctors in the province. Ontario has the greatest concentration of doctors in Canada and, hence, represents a large portion of TheMedical Post‘s readership. In response to the success of L’Actualité médicale, Maclean Hunter launched L’Information médicale, which sources describe as a “disaster.” So Maclean Hunter did what it does so well: it bought the competition. Ontario Medicine came as part of the package in the acquisition ofL’Actualité médicale. Former Ontario Medicine staff say that, from the very beginning, no effort was put into the paper-they didn’t even have a dedicated salesperson, which meant that Ontario Medicine was merely an add-on, an afterthought to sell when someone had the time. Even so, the paper managed to hang on for just over a decade before a change in drug policy caused the advertising base to fall out from under it, and the paper to fold. However, L’Actualité médicale continues today as one of Maclean Hunter’s most successful papers.

So it was no wonder that many forecasted an early retirement for Family Practice, even though an article in the magazine industry’s trade publication, Masthead, on the Thomson acquisition reported that Family Practice was to “continue as usual.” The problem with that, says Derek Cassels, editor of the Post for 19 years until his retirement last June, was that Family Practice “was covering the same things. It was covering medical politics. It was covering medicine to perhaps a lesser degree than we were, but basically, it was doing the same thing we were.”

For example, the Post‘s November 4 and Family Practice‘s November 17 issues both carried headlines about new diabetes-testing guidelines. The dangerous fen-phen combination drug prescription story appeared onFamily Practice‘s September 15 cover and had prominent play on page two of the Post‘s October 7 issue.

Cassels wasn’t the only one to recognize that the two publications were looking a little too similar. Last fall, John Shaughnessy said plans were already in place to redesign the Post and Family Practice to “accentuate our differences.” The plan was to make Family Practice more of a community newspaper for GPs.

Apparently though, the top staff weren’t moving fast enough for Maclean Hunter. In February, Shaughnessy and managing editor Deborah Jones were let go and Vil Meere, also editor of Patient Care, another successful Maclean Hunter publication, took over as editor. He says that he wants Family Practice to put a greater emphasis on practice management with user-friendly information for GPs on how to deal with partners and other day-to-day duties, as well as service pieces and features that are “punchier.” “Quick hits in short, digestible pieces” is the paper’s new direction.

Meere’s newspaper background (he was at the Ottawa Journal for 12 years and was later editor of The NapaneeBeaver) along with the knowledge of medical practice he brings from Patient Care and four years atThe Medical Post makes him a strong choice for the job. His appointment is a good omen. Although Family Practice was part of a package deal, Maclean Hunter is obviously putting resources into the paper. And whileFamily Practice doesn’t generate close to the Post‘s estimated $8 million in annual revenue, it did reach about $3 million in 1997. Family Practice doesn’t seem destined to die the slow, wasting death that Ontario Medicine suffered.

Meanwhile, the Post has brought in a new editor as well. With the retirement of Derek Cassels, Pat Rich, previously the Post‘s managing editor, moved up to the editorship in May 1997. Rich, 40, has been with thePost for 16 years and many consider him an excellent writer and editor. He has increased the Post‘s coverage of medical politics and prefers features on subjects like medical ethics issues. He is described as a more personable, laid-back character than the gruff “curmudgeon” Cassels.

“Pat is more conciliatory and accessible,” says Kristin Jenkins, who has moved on to Multi-Vision Publishing, where she edits both Healthwatch and Owl Canadian Family Magazine. “He’s more sympathetic. He would be personally distressed if someone were upset. For Derek, you’d have to be dead in your chair before he felt it was something he should tackle.”

Still, Cassels’ confrontational style had its advantages. He was known to have frequent showdowns with publisher John Milne over editorial issues, including the encroachment of advertising on editorial. This has yet to happen between Rich and Milne. Some wonder whether Nice Guy Rich will be able to fight off an advertising invasion or whether his gift for compromise will ultimately, though inadvertently, compromise the paper’s editorial integrity. Pat Rich agrees that this is a perfectly valid concern. “It’s something that I’ve wrestled with myself. My personal management style being nonconfrontational, it may also be seen as wimpy. But I think I have enough commitment to the editorial mandate that I can withstand the pressure of sales.”

Of course, both the publisher and editors insist that there is a clear line between advertising and editorial. But Q&A, a special section for GPs that has been part of the Post since 1996, suggests otherwise. The section takes a subject that GPs frequently deal with in their practices, such as asthma or migraines, and asks a qualified specialist questions that would help GPs diagnose and treat the problem.

But each four- to eight-page section has a single advertising sponsor; the advertiser proposes a subject to cover and sometimes provides the sources and questions to ask. The January 20 Q&A on urinary incontinence even mentions the advertiser’s product, Elmiron. The section is printed on thicker, glossier stock and is free from advertising aside from the sponsor’s ad, positioned within the segment. However, nothing flags the item as being single-sponsored or essentially advertorial.Dr. Ian Gray, a 53-year-old GP from Alliston, Ontario, says that this kind of trick makes him worry that the story is biased. Still, he finds Q&A one of the best parts in an otherwise “gossipy” paper-he calls The Medical Post “TheNational Enquirer of medical news.”

“It makes lots of money,” says Rich of the section, “and it’s very popular among our readers.” However, he says it’s raised the question about “whether it was fish or fowl. And it’s taken a while to figure out whether it was an editorial-driven product or an advertising-driven product. But I think we’ve got editorial control over Q&A sufficiently that I’m quite happy with it.”

Family Practice has had its own problems with advertising-editorial adjacency. In its August 4, 1997 issue, for example, the Arthritis Alert section is preceded by an ad for Arthrotec and followed by a Cytotec ad, both of which call themselves a “powerful anti-arthritic.”

The advertising problems may be only a symptom of the larger problem: complacency. The repositioning-making a complementary paper out of a competitor-means that The Medical Post is left without direct competition. When the information you’re offering is important and you’re the only one offering it, there’s no real threat of losing those readers.

Maclean Hunter might have done itself a favour, financially, by picking up Family Practice, but ultimately it might have done the Post a disservice. Without the impetus to improve or at least retain the standards that made it successful in the past, the Post may go the way of many trade magazines-a necessary evil for their readers, a “spinach read.” The Medical Post is well regarded by many doctors and it certainly has many friends in the industry, including ex-staffers who loved and miss working at the paper. But there are those who are concerned by its lack of urgency.

Kristin Jenkins recalls a factory atmosphere when she was writing for the Post. “It was very rare that anything was questioned in the material. As long as the lead was sharp enough, the information flowed and you wrote a headline, it was like, ‘Next!’ ” she says. “You get complacent and stop questioning whether you’re doing the best job you can. Being the only job in town, they can do that…. If you can do it in your sleep, there’s something wrong.”