At the start of 2008, Vox Medica was structured in a traditional manner, with advertising, public relations and medical education housed in separate silos. While the set-up wasn’t not working, it wasn’t working as well as the agency’s higher-ups would’ve liked. As a result, Vox Medica chose in mid-2008 to restructure, eliminating those silos in what president and chief branding officer George Glatcz calls “a complete re-engineering” of the company’s business model.

The move was spurred less by internal/administrative issues than by tectonic shifts within the healthcare and pharmaceutical worlds. “It was in response to those changes. We did it so that we could mirror how those companies operate,” explains Glatcz. “They’re under extreme pressure to reduce fixed costs, so their decision-making isn’t as linear as it used to be. Decisions are made in a community context.”

As a result, Vox toppled the PR/ad silos and replaced them with core competencies and practice areas. The new structure allowed the firm to eliminate duplicative administrative functions and, Glatcz says, cut costs by 20%. Internal response to the new business model was largely positive. Vox polled employees both before and after the structural changes, and found that satisfaction had surged: 90% gave the new set-up a thumbs-up. So, while Glatcz identifies managing change as the firm’s biggest challenge during the last year, he’s thrilled that Vox chose to go through with it. “There was a big boost in morale. What we had before wasn’t as universally appreciated as what we have now,” he says.

Changes that came along with the restructuring include an intensified pro-bono initiative—Glatcz says the firm has given back more than $100,000 in time and contributions—and the creation of a community activation practice, which he describes as “sort of a sister to how Obama got elected. What we do is identify community leaders and we get them involved.” That practice has already completed assignments for several of Vox’s biggest clients, including Pfizer, Cephalon and AstraZeneca.

Vox also took pains to make sure its employees were on board with the changes. “We took everyone off-site for one day and let them know how things would work with the restructuring. We called it ‘Untraining Day,’” Glatcz quips. It went over well enough that Vox held a second such day in April.

Still, as happy as Vox itself might be with the new agency structure, it wouldn’t mean a lot if clients weren’t similarly pleased. They are—though Glatcz admits it took a little work. “Some clients bought us as either a PR firm or an ad firm, so that’s what they saw us as. The challenge for us was to change their opinion of who we are. We did some re-education and proved our worth,” he says.

To that end, since the restructuring took hold, the firm has snared 12 new brands. Vox snared a chunk of business from Ansell Healthcare, as well as from HealthCore (corporate work), Pfizer (promotional med ed for Lyrica), KOWA (brand strategy and PR for Livalo) and Alkermes (for Vivitrol). The firm was tapped by Cephalon as PR AOR for Nuvigil and for activities for the company’s immunology franchise.

The structural changes didn’t impact Vox’s ability to attract talent. Among the top-level execs it imported were Grey’s Ross Thomson (as EVP, chief ideation officer) and Dudnyk president Lorna Weir (as chief marketing strategist, a role in which “she’s sort of our quarterback,” Glatcz notes). Headcount sits at 100, up from around 80 a year ago, and Glatcz expects revenue growth in the 20% range for 2009.