Methodology Decisions:

When to Use (or Not Use) In Person Focus Groups

By Mike Karchner

Ive always been taught that focus groups are used to leverage the group dynamic generated by
individuals working together. In other words, respondents build upon what is said by other
respondents, hopefully coming at a topic from a variety of angles to uncover and explore all of
the themes surrounding the topic. Today, this remains sage advice, and is a guiding principle
when we recommend a particular study design.
However, reflecting on the qualitative research studies weve done over the past year, Im hard
pressed to come up with more than five different studies that included focus groups of some
kind whether traditionally sized (eight to 10 respondents) or smaller (four to six respondents),
which are often referred to as mini-groups. This often seems to have
been the case with our work over the past decade as independent
qualitative research consultants. Of the 40 to 50 assignments we
work on each year, why do so few feature a group discussion
methodology?
After analyzing our study history, it seems the use of focus groups
may largely be due to client requirements or the fact that 75 percent
to 90 percent of our work occurs in the healthcare/pharma sector.
Because we often collaborate with other, larger marketing research
firms, the methodology is often already in place before we became
involved. Some clients simply dont have the time to sit in the dark for entire days at a time while
hour after hour of individual depth-interviews (IDIs) tick by. Thus, the focus group or mini-group
is a tantalizing option, hearing from more respondents in a span of about one fourth of the
amount of time, but admittedly in less depth. While the research experience for clients is just as
important as the respondent experience, ensuring study objectives are met is the key reason
focus group methodology is often not selected when a deep level of discussion is required.
In healthcare/pharma work, it is not uncommon to include physician specialists such as
oncologists, endocrinologists or psychiatrists, depending on the therapeutic area. However,
because of their specialization within the medical community, many physicians may already
know one another, which can create a restrictive and uncomfortable dynamic within a session
where the participants do not feel able to share their experiences and input freely.

Focus groups in some cultures are less effective because older

respondents are perceived as having more wisdom and experience.
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Several years ago, I was conducting groups among neurologists discussing the treatment of
multiple sclerosis. Upon posing a question to the group sitting around me, all turned and pointed
their finger to one physician at the far end of the table, and said in unison: Ask him! Hes the
one who just published an article on this! While I tried my best to assure all of the doctors that
their thoughts and opinions on the matter would be of value to me, clearly, an expert among
experts was perceived to be in the room, and other physicians didnt want to say something
wrong and be thought of as less knowledgeable in front of their esteemed colleague. Similarly,
focus groups in some cultures are less effective because older respondents are perceived as
having more wisdom and experience, and the same type of deference can occur.
I also recall a couple of focus group studies where physician specialists seemed to gang up on
the product or advertising concept versus carefully weighing and discussing perceived benefits
and shortcomings, more so than when IDIs were used. A couple of things may have been going
on in these scenarios. From hundreds of sessions with physicians and research we have
conducted on the respondent experience, weve learned that many doctors participate in
marketing research to learn about whats new or to contribute to the advancement and
development of cutting edge therapies. However, if posed with a me-too drug that is, a
medication that offers no advantages or benefits over current therapies some doctors will balk
and conversations can become cynical and non-productive because of this or a lack of interest.
Physicians might be more likely to feel
they are wasting their time.

Focus groups work well if the

When it comes to communication or

advertising research, we typically
group is later divided into teams
recommend including screening criteria
pairs to complete an exercise, in
so participants are aware of the topic so
that marketing and promotion haters
which case an adequate number
can opt out. Usually it is of greater use
to the study sponsor to exclude these
respondents are needed.
respondents versus spending precious
time listening to such an individual
belabor the point or attempt to get them to set aside their strong beliefs.

or
of

From a practical standpoint, the type of doctor, patient, or condition is sometimes so obscure
that it is not possible to locate enough respondents within a particular city to attend a focus
group, much less two or three. An example is work we have conducted among Dupuytrens
Contracture patients. Dupuytrens is a rare condition that affects the hands, where a cordlike
thickening of tissue beneath the skin can eventually draw one or more fingers downward into
the palm. Similarly, some conditions are too debilitating for patients to attend a focus group
session in-person, such as those with Stage IV lung cancer who are likely bedbound and facing
end of life issues and concerns.
So, at least in the healthcare/pharma, sector, there are several additional reasons why inperson focus groups might not be the best approach.
When focus groups are a part of the design, our work generally supports the overarching trend
of including fewer respondents per session. There are a number of reasons for this, including
cost, and providing each individual with more air-time. With larger groups, its too easy for
some respondents to hide and not respond unless called-upon. It can also be challenging for
moderators to not then fall into the trap of polling respondents versus facilitating group
discussion. This seems more challenging today as more objectives and questions find their way
into discussion guides. Many clients are under pressure to cover more and more ground in any

single research study, while continuing to yield deep insights. This can be a tall order and may
not only contribute to greater usage of smaller sessions, but also IDIs.
To this point, Ive spoken more about when the use of focus groups should be reconsidered
then when they seem to really fit the bill. However, looking back at the several different studies
weve conducted this year using focus or mini-groups, none were conducted with physicians for
the reasons previously mentioned. The purpose of those sessions is also similar, in that they
each involved the exploration of processes, such as patient/consumer journeys, the
development/optimization of products, or of promotional/marketing concepts, where the building
of ideas seems to mesh well with the dynamics of a group conversation.
Perhaps it is far less likely that consumers or patients (when properly recruited), know one
another, or have anything in particular to gain or lose from advancing or thwarting a particular
idea compared to a relatively small community of physicians. Some of these physicians may be
concerned about impressing whoever is observing behind the mirror for speaking or consulting
assignments, or to convince other respondent physicians that they may be better suited than
others in the group for patient referrals.
Focus groups also work well if the group is later divided into teams or pairs to complete an
exercise in which case an adequate number of respondents are needed. An example might
include setting up an in-session debate where respondents take opposing sides of an issue and
attempt to convince the other side of their argument.
So whats the bottom line or sweet spot for the use of focus groups? Below are a few
guidelines that may prove helpful.
x

x
x
x

Focus groups may be more appropriate for consumers/patients than audiences who
know each other, such as physicians, especially specialists, and may defer to those
perceived to be an expert. Respondents who may also be competitors to one
another, such as business owners, of which some doctors are, may also be less
appropriate for focus groups.
Provided that a focus group methodology is appropriate to meet study objectives, group
sessions may be of higher consideration for clients who do not have the time to view 2436 hour-long IDIs.
Similarly, client marketing research departments may use focus groups to create an
engaging, yet streamlined means of including internal clients in a study in order to view
first-hand how results unfold spoken in the language of the customer.
When looking to better understand processes or journey experiences of
consumers/patients, focus groups can be naturally used to fully flush out the ideas
offered by each respondent to fully map their experiences. Examples might include what
are the steps consumers take in purchasing a new cell phone, or how patients with a
certain condition care for themselves and manage their disease.
Focus groups may be somewhat more insightful to aid the development and optimization
of non-pharma/healthcare products or marketing/promotional materials among
consumers/patients versus physician specialists who seem to think more deeply in an
IDI setting.

As a RIVA-certified master moderator, member of the Qualitative Research Consultants

Association and president of Karchner Marketing Research, LLC, Mike Karchner runs the
qualitative research consultancy with vice president and spouse Helen Karchner. The Karchners
collectively have more than 40 years of marketing and market research experience across a
wide variety of industries.
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