Great Experiences and Brand Promises – Lessons from Indigo Airlines

Indigo”It is time you packed-up and left for the airport. You are on Indigo and they always leave on time”, said my colleagues at work. I was in Bangalore and had a busy day at work. I was trying to cram in as much as I possibly could in the day and I guess, I was getting late for my flight to Delhi. In any case, with the way the Bangalore traffic these days is, reaching the airport is akin to a lottery.

The Gods were kind that day, Mr David managed to get me to the airport well in time and, sure enough, Indigo boarded right on the dot. However, much to our chagrin we learnt that there would be some delay before we took off. Soon after being air-borne we had the captain on the PA system, proudly telling us that though we had departed Bangalore 10 minutes behind schedule (and it was all because of the congestion at the airport), he was quite hopeful of getting us into Delhi on time. He explained the benefits of a friendly tail-wind assisting us in the journey and also how he would try his best to get us on ground in Delhi on schedule.

It was soon evident that we had a chatty captain, who would tell us that we could see the lights of Hyderabad towards our right and that we were over Jaipur and were cruising over 33000 ft. The captain kept us engaged. He was never intrusive, but I did observe that in almost all announcements that he made, he did refer to the fact that we were likely to reach our destination on time. The crew also kept reminding us that an ón-time’ performance was their paramount goal. They urged us not to leave any waste around, so that they can turn around the aircraft faster for the next flight. It seemed that the crew was really focused and keen to get us to Delhi on time.

As soon as we touched down in Delhi, the crew announced that we have indeed arrived a little before schedule. They seemed to be genuinely pleased with their performance and wore big smiles. As I headed out of the aircraft, I noticed the captain standing just outside the door of the flight deck, wishing passengers the time of the day and amicably chatting with his crew. The captain and the crew looked like a wonderful team to me, who had enjoyed flying us to Delhi that evening and were genuinely happy that they managed to get us to our destination well in time.

This episode left me wondering how difficult it really is to conjure up this kind of experience every time Indigo takes flight, day in and day out. This would mean hundreds of flights everyday, flying thousands of passengers and ensuring a steady and consistent experience delivered through thousands of employees. No wonder, Indigo is one of the most successful airline in the country and their brand promise is synonymous with timely flights.

And since, I work for in healthcare, where a great experience is perhaps so much more important, it left me wondering, why most hospitals in India fail to deliver a consistent experience that can become their calling card. Unfortunately, we still do not have hospitals, which can deliver some if not all experiences in a pre-defined and consistent manner. Is there any hospital in India, which can claim that the OPD’s in its hospitals always begin on time, or where patients with prior appointments don’t have to wait or where physicians see off patients at their doors? Or, where patients are uniformly greeted by the staff at the front office, always treated with courtesy and where compassion counts for more than anything else?

I am aware that this is no easy task. Unlike passengers in an aircraft, patients are sick people, some are in life threatening situations, many are in the hospital for the first time in their lives and are truly unsure of what to expect. I also understand that unlike the airline, patients in a hospital will be staying for several days, they will be interacting with a multitude of people (doctors, nurses, paramedics,housekeeping, F&B services, general maintenance, billing etc.) and it is so much more difficult to synchronize all of these interactions into one great experience, which can be crystallized into a succinct and powerful brand promise.

However, hospitals, which hope to build a brand for themselves must start looking at ways and means of doing this. They must meld their varied customer interactions into one great experience that a customer can expect even before she enters the hospital. The true power of a hospital brand will only be unleashed, when it will learn to deliver that one experience again and again, every time that a patient walks through its door.

A Business Case for Branded Primary Healthcare Services In India

This winter Delhi has been smothered with fog or rather smog. While, I am one of those who enjoy the cold and love my walks in the neighbourhood park, pretty much like almost everyone else in the city I am not immune to the cough, cold and the respiratory track infections that that the damp and the cold brings.

I have been struggling with a bad cough for the last few days and have been wondering that it is perhaps about time I saw a family physician. Unfortunately, we do not have a regular family physician and I am not sure where to go. I also know if the problem worsens and a fever materialises I would go and see a specialist at Max Hospital and with a course of antibiotics I would be fine.

However, this is not the way it is meant to be. For something like this shouldn’t I be going to a neighbourhood clinic and getting the problem fixed before it became bad enough for me to see a specialist at a big hospital? And this brings me to the point that we need good quality and reliable primary healthcare in our neighboourhoods. There is a significant business opportunity here waiting to be tapped.

A Little bit of History

Apollo Hospitals tried setting up Apollo Clinics a few years ago. I was part of the founding team, which went into planning the clinics and the business around them. Apollo however was clear that it was not going to own or fund these clinics. They were supposed to be franchised with Apollo providing medical knowhow, its brand name, some of its doctors and IT support connecting the clinics with the hospitals. Ratan Jalan the than CEO had a vision of opening 200 clinics in 3 years. The clinics were supposed to provide outpatient services, namely consulting with doctors, diagnostic imaging services which included an X-Ray and an Ultrasound basic cardiology diagnostics like an ECG and a Treadmill test and a pathology sample collection centre. We sold some of these franchises and the Apollo Clinics started functioning with the first one commencing operations in Janakpuri in New Delhi. The owners were businessmen running a computer hardware store in Nehru Place and had no prior experience of healthcare. Similarly a few other clinics were also franchised and were set up in Delhi, Kolkata, Bangalore and elsewhere . However, it became apparent early on that Apollo was hardly serious about this business. They were keen on netting more patients for their large hospitals through this network and saw these as no more than referring centres and the support that was promised to the franchise owners  never materialised. The smarter ones quickly realised that in this new business they were pretty much on their own, learnt the ropes of this new business fast and managed to survive. Many did, many shut shop. Apollo was hardly bothered with any of this.

Max Healthcare too experimented with Dr. Max Clinics in New Delhi. Two clinics were set up in South Delhi. Unlike Apollo, Max invested in the clinics and had no desire to franchise. This experiment unfortunately failed mainly because Max in those days was focussed on rolling out its large hospitals and these clinics did not get any management attention. They were just not worth the trouble in the larger scheme of things and were closed down after a few years of experimentation.

The Learnings

While Apollo and Max both tried to set up Primary Healthcare Clinics, they were hardly serious attempts at the business. Apollo did not want to invest and was keen on skimming profits at the cost of the hapless franchisees and Max was just not ready at that point in time for something like this.

Apollo Clinics had a large upfront investment of approx. Rs. 20MN in the venture and since they themselves were not investing, they allowed the costs to go up and with the franchisee not knowing any better, they got away with this. When we crunched the numbers at Max we realised that a fairly decent clinic can be set up for as much as INR 5-7 MN.

The biggest challenge really here was about getting quality doctors (Family Physicians, Paediatricians, Internal Medicine, Obs and Gynae and Cardiologists) to join the clinic. Since the clinic is a very local enterprise one would want to pull in local doctors. However, we discovered at Max that many of them were just not interested as they saw the clinic as serious competition. They were afraid that if they moved to a Dr. Max Clinic and asked their patients to come there, the patients in future might prefer the superior and more professional services of the clinic. We tried hard to convince the local doctors that we sought a win win partnership but it really did not go anywhere.

The solution thus lies in forging a relationship with the local prominent doctors, which safeguards their economic interests. This can be achieved by asking them to invest in the venture. Thus 50% of the ownership of the clinic can reside with the lead consultants in the clinic. Thus let us say a sum of INR 2.5-3.5MN can be invested by the doctors and the balance by the entrepreneur, who sets up the business. A city like Delhi can easily absorb at least 100 such clinics and the model can be scaled up and rolled out across the country.

The clinics can than be established as a chain and can be marketed under a single brand name, 50% owned by an entrepreneur and 50% by local doctors. The clinics can all be connected under an IT backbone and data can be shared seamlessly. This can also open up enormous revenue possibilities from scientific research and allied work. Costs can be driven down by centralised purchasing and efficient supply chain management. Superior and unique customer experiences can be delivered through processes integrations and people training. I personally believe time has come for these clinics to emerge and claim their rightful place under the sun.

Finally, will this mean the McDonaldisation of primary healthcare in India? Well, may be yes, but than don’t we all love the neighbourhood McDonalds.

Pic Courtesy http://theapolloclinic.com/CorMainArticle.asp?Id=3

The Silly Question of RoI in Healthcare Marketing

The other day I was with Dr. Jadhav who heads the Marketing function at the well known Narayan Hrudayalaya in Bangalore. Dr. Jadhav was keen to use radio for his hospital’s communication needs and I was hoping to persuade him to advertise with Fever 104, the radio station owned by The Hindustan Times, my current employers. Narayan Hrudayalaya, which is a well-known cardiac hospital thanks to the famous Dr. Devi Shetty and his pioneering initiatives, has recently started a Cancer Centre as well as a Multi Speciality hospital and wanted to promote these. The aim of the communication was to tell the citizens of Bangalore about these services available at Narayan Hrudayalaya and to drive ‘footfalls’.

While I discussed the plans with Dr. Jadhav, I could not help but notice his concern about the RoI on his marketing spends. Dr. Jadhav was very clear that if he spent Rs. 100, he needed 3 times the  sum in revenue, which could be directly attributed to this activity. I could easily relate to this because this is exactly the kind of  expectations the management teams had of me, when I headed the Marketing function at Max Healthcare and Artemis Health Institute.

I wish calculating RoI on healthcare spends was this easy. While there are many websites, which help one calculate RoI on marketing spends using complex formulae and spreadsheets involving the lifetime value of a customer, the cost of capital and what have you, I believe quite often the best way forward is a subjective gut feel and patience.

Measuring the success of a healthcare marketing campaign by merely counting the number of queries/walk ins generated in the hospital OPD is a great folly. The hospital business is unlike any other business and one must remember that exciting marketing communication alone will not lead to people walking in to check out the services of the hospital. This can happen for a new restaurant or a movie theatre,  but for someone to visit a hospital he must have a pressing need.

Tactical communication involving discounts, freebies and the like should be handled with care. I am not sure I would prefer to go to hospital for cardiac surgery because there is a discount being offered on the surgery, or I would like to go under the knife at a particular time just because the hospital is offering a deal. Come to think of it, I would be downright suspicious of the hospital if it tries to hustle me into a medical procedure by making a commercial offer.

Marketing spends in a hospital must be looked upon as an investment in the hospital brand and the values it stands for. The customers should be informed about the services of the hospital, the experience and training of its doctors, the robustness of its systems and processes and above all the promise of the experience the hospital hopes to deliver to its customers. It can highlight its ease of access, competitive pricing vis-a-vis other hospitals and superior services.  The hospital must showcase medical excellence, send out stories of success against great odds and constantly remind its customers what it truly stands for. It needs to communicate all or some of these over time before it should even attempt to measure the RoI.

A hospital’s brand equity is built over many years and much as hospital marketers would like to hurry this up, there are just no shortcuts. A hospital must set aside a small sum of money (7% of sales in the first years tapering to 2-3% in later years) year on year to spend on connecting with its patients and the local communities it hopes to serve. It should diligently spend this money informing, educating and reinforcing its brand values.

A few years later, the hospital will find itself buzzing with patients and no one would really be interested in the RoI on marketing spends.

The PR Story

newspaper-storiesAs I wearily settled into the cramped seat of a Spicejet flight to Mumbai this morning, I pulled out the Metro Nation a tabloid format newspaper and started flipping through the pages. Suddenly an image of my former colleague Dr. Deep Goel, the head of Laparoscopic and Bariatric Surgery at Artemis Health Institute, Gurgaon caught my attention. Dr. Goel was featured in the story along with a 200 kg Canadian patient, whom he had successfully operated upon (performing sleeve gastrectomy) and discharged from the hospital with in 24 hours. The story albeit poorly written (the journalist appears to be totally ignorant about medicine, medical procedures, surgeries et al), did manage to inform the readers about Dr. Goel’s superlative skills and about the Bariatric Surgery at Artemis.

Last week I had come across the story of a successful heart transplant in Chennai, when the donor was in Bangalore a team of surgeons from Chennai successfully harvested a heart in Bangaloreand transplanted it in a policeman in Chennai. Stories about Pakistani children being successfully treated for congenital heart diseases at Narayan Hridyalaya in Bangalore and undergoing liver transplants at Apollo Hospital in Delhi have routinely appeared in national media. Celebrities being treated at Leelawati and Breach Candy hospitals in Mumbai are also commonplace.   Continue reading

My Travels circa 2008

2008_0520kabul0209 The festivities of a New Year never fail to lift my spirits.  It is that time of the year, when one stops to look back  and than ahead, with a mixture of hope and renewed  vigour. As the old year slips into oblivion and we  celebrate the new one I thought I would look back and reminisce about some of the wonderful places I have been to in the year 2008.

The year saw me traveling both on work as well as on vacations with family. In January, I visited Oman on work. I barely made it as my passport needed renewal and had to be organised at the last minute. The Omani authorities in Delhi worked on a holiday to organise a last minute visa. We landed in Muscat on Jan 07 and lo and behold had a car waiting for us right besides the aircraft. We were quickly whisked into a most magnificentlounge and accorded the traditional welcome with halwaand dates. I had the honour and privilege of experiencing the legendary hospitality of our Omani hosts.  We had many meetings with the Omani officials, visited their hospitals and were entertained like visiting royalty. I would always remember the most wonderful banquet hosted by Shaikh Hilal in our honour at his palatial residence outside Muscat. And surprisingly all this, when the purpose of our visit was to solicit business for Artemis from the various arms of the government of Oman.   Continue reading