Question: What do you get if you send seven talented journalists on a six-week-long mission to research, interview and report on the biggest 100 healthcare marketing and advertising agencies in North America? Answer: the most extensive and objective guide ever produced.

Bragging alert:  It’s also our biggest-ever print issue since Medical Marketing & Media was first published in 1966 (by 8 pages). It’s a thrill to have overseen it and I’m extremely proud of what team MM&M has achieved. I’m also truly thankful for the generous support that has allowed us to execute this project in a way that is as meaningful as possible (read: objective) to our largely client-side audience—we believe it’s the only way to do it.

What awaits you on the following pages? The bulk of this tome is given to individual profiles of the Top 100 agencies—namely, those firms deemed by MM&M editors to be the largest in North America, based on 2012 revenues (estimated, where necessary) and head counts.

Collectively, these profiles draw on hundreds of hours of painstaking research and more than 120 extensive interviews with agency leaders. Instead of merely creating laundry lists of clients and capabilities, the writers were charged with injecting into these reports, wherever possible, the personality of each agency and the vision of its leadership. In such a fast-paced and dynamic sector, where numerous agencies now offer increasingly similar (and increasingly large) menus of services, solutions and expertise, we know that it is often these “less-tangibles” that can help marketing execs differentiate between the DNAs of similarly qualified, but culturally opposed, firms.

However, when you meld together these unique snapshots, you get a serendipitous feel for the overall psyche of the entire healthcare agency sector. And, unless I’m mistaken, it’s getting better. Sure it’s still tough, but moving in the right direction.

It’s no secret that the healthcare industry continues to undergo vast changes born out of the confluence of a number of forces, trends and events. These pressures have, in turn, manifested themselves into the agency set, often in different ways, but with equally daunting magnitude. Last year, we found that most firms were in the process of taking a step back, developing new skills and offerings, diversifying, collaborating, redefining goals and reinventing their brands.

The process of transition is ongoing, of course, and still very much apparent this year. But there’s an overriding feeling that the retrenchment period is largely over, that the objectives have been redefined, and now it’s a case of putting it all into practice.

Data from our annual agency survey suggest that a good number of agencies, at least one-third, are experiencing growth so far in 2013 (pages 9-11). Not only that, but the digital revenue buckets are getting larger. Another good sign is that when we asked agencies what was the biggest challenge they currently face, among the most popular answers were “talent acquisition,” “diversification” and “managing growth.” Strikingly absent from the top of this list were previously perennial problems, such as “digital” (we get it now), “pharma’s preferred agencies” (it is what it is), “social media” (who needs guidelines?) and “the patent cliff” (we’re so over it).

The healthcare agency sector might just be the best example of widespread evolution that’s fast enough to track with the naked eye. The storm is not over yet. But, having figured out survival, many retooled agencies now have their sights set on flourishing.