This article first appeared on Insights Association Website.

As Director of Client Services for MedSurvey, a medical market research company, I'm not generally in the habit of publicizing scathing online reviews of my own company. In fact, I think it’s fair to say that as a general rule, circulating a review that states “MedSurvey IS A SCAM” is not sound business practice. And yet here I am, announcing to the world, “One of our survey respondents filed a one-star review with the Better Business Bureau accusing us of being a scam.” And yes, a review like this is alarming to us at MedSurvey. But to our fellow sample companies and clients, I cannot emphasize enough: This review should be alarming to all of us.

Despite our best efforts to maintain relationships, more and more frustrated respondents are walking away from market research for good.

At MedSurvey, I both develop relationships with clients and oversee all aspects of fielding a project, including project managers, programming, and our customer service center, where we field calls from survey respondents. Prior to stepping into my current role, I ran our call center for 16 years. Through countless conversations with healthcare providers, I was able to keep a finger on the pulse of the industry from the perspective of our respondents. I have personally observed the industry grow and change over the past decade and a half in such a way that the respondent experience has deteriorated. As research has become more targeted and the screening process more arduous, healthcare providers are asked to complete longer screener sections requesting more data at the same time that they are less likely to qualify for the surveys. In addition, as more players have entered the medical market research space, these same healthcare professionals are now likely to receive dozens of survey invites simultaneously, often disqualifying from multiple companies’ surveys in a row. It has always been the case that the greatest uphill battle we face in the call center is the perception that market research is a scam; however, today the slope is far steeper than in the past.  Despite our best efforts to maintain relationships, more and more frustrated respondents are walking away from market research for good.

Of course, all of us in the industry acknowledge that we need to address respondent attrition in our industry. Because we work with a limited universe of specialized professionals, our respondents are neither expendable nor replaceable, and if the well runs dry, research will become impossible. Yet I have seen very few steps taken toward tangible change. Now that I work closely with clients, I believe that I’ve gained insight into some of the reasons for this inertia. One of the things I’ve been most struck by is the stark disconnect between our clients’ perspectives and our survey respondents’ experiences. Whereas clients see respondents disqualifying from surveys in terms of numbers and incidence rates, our respondents see this as a personal and professional rejection. Recently we came to a client with concerning news: After several days in field, the incidence rate of a project was far lower than we expected—only 25%. To our surprise, our client didn’t view this as problematic. And it is true that if you cast a wide enough net, you can hit a quota simply by rolling the dice. But if you shift your perspective to see the people behind the numbers, the flip side of that 25% incidence rate is a 75% rejection rate. We can only hope that not all of those respondents who feel rejected are clicking the unsubscribe button.

I’ve come to realize that part of the reason for the disconnect I see is that many people in our industry, including our clients, haven’t had the opportunity to get to know respondents personally in the way that I have. So, I decided to make an introduction. Please meet our one-star reviewer, Julia G.

Julia G. is a former respondent who, in her review filed with the Better Business Bureau, gave public voice to the frustration and, frankly, justifiable anger that we hear privately from credible healthcare professionals on a regular basis. Here is an excerpt:

"I do not know if MedSurvey can qualify for a scam or data fishing machine, but here is the fact: out of more than a couple of dozens of surveys I was invited to, I did not "qualify" for EVEN A SINGLE ONE...Being pretty well rounded and competent professional, I am "not qualified" to answer questions about things I apparently work with every day. And, BTW, each and every time I have to give out a piece or two of my professional and personal information…I get a strong impression that everything Medsurvey wants is some sort of personal information which professional people will be otherwise not willing to present. Therefore, from now on in my book Medsurvey IS A SCAM."

Of course, the truth is that MedSurvey and many other similar companies are not a scam, nor do they ever set out to “steal data.” Not only that, but challenging recruits are actually part of our niche, and we work hard to target healthcare professionals who are most likely to qualify for the surveys we invite them to complete. So why did we get such a terrible review and why on earth am I sharing it? The short answer is that Julia G’s sentiments are ultimately not about us or any individual company—her review is an indictment of our industry.

If we take a moment to put ourselves in her shoes, her frustration and anger make sense on a fundamental human level. As an expert in her field, she has undergone extensive training and feels that she has valuable insights to offer (and may even be eager to share her opinions), only to be told repeatedly that she is somehow “not good enough.” It is no wonder that she would feel that this is disrespectful of both her expertise and her time. I’ve spoken with so many healthcare professionals who have emailed and called, saying, “Why did I disqualify? I know I’m qualified to talk about this; I know everything there is to know about this disease. Why would you invite me to share my expertise if you don’t want my opinion?” They’re not shy about venting their anger, often in very colorful language, and who can blame them? It is already a challenge to persuade respondents that survey invites are legitimate; but when they are asked to complete long screeners that are often small surveys in themselves, only to be told that they don’t qualify and will not be compensated for their information and time, it makes sense that they might conclude that they are being scammed.

Whereas clients see respondents disqualifying from surveys in terms of numbers and incidence rates, our respondents see this as a personal and professional rejection.

Julia G. is the “cost” of a “low incidence rate.” And while it might be tempting to shrug and say, “Sure, this is a shame, but it’s just one bad review,” to do so would be naive. Behind every Julia G., there are countless other healthcare professionals who are leaving market research without taking the time to write a review. But even if they aren’t publishing their criticism online, they are almost certainly passing on the message to their colleagues: “Such-and-Such Sample Company is stealing data. Market research is a scam. Don’t waste your time.”

Of course, there will always be respondents who disqualify from surveys; this is the nature of market research. But while we can’t expect a 100% incidence rate, what we can do is work to limit the frequency with which respondents are disqualifying while also taking steps to improve the survey experience and treat respondents with respect and care. My hope is that by sharing Julia G’s review, I have helped illuminate the people behind the numbers. From a short-term, data-oriented perspective, Julia G’s withdrawal from MedSurvey (and likely from market research altogether) is just a blip on the screen, a fraction of a percentage point in one study’s incidence rate. In the bigger picture, she is not just a metric but one of many individuals whose aggregated decisions to leave market research constitute an existential threat to our industry.

So this is a call to action. We urgently need to make changes, from better survey designs to more proactive customer service and outreach. Because this is an industry-wide problem, it requires an industry-wide approach, and we will all need to hold one another accountable (even if that means sharing uncomfortably negative respondent reviews). We all see the iceberg. If we don’t change course now, we’re all going down with the ship.