Customer Advocacy is the new buzz word in the healthcare marketing space these days. Actually it is in many ways a bit of some old wine in a shiny new bottle. For many years now, healthcare marketers have known the power of customer advocacy, which in the olden days was known in somewhat more prosaic terms as ‘Word of Mouth’.

Customer Advocacy is all about patients talking about their experiences at hospitals and at various touch-points as they engage with healthcare service providers. In the healthcare space, patients talking well of a hospital, doctor or nursing care has always resonated a lot more than say, someone discussing a wonderful evening out in a restaurant or a five star hotel. In a hospital, a good experience usually means someone overcoming all odds, someone coming through a debilitating illness or someone recovering uneventfully from an emergent and unexpected surgery.

That patients will speak well of a hospital and its services is premised on one single fact – that the hospital will deliver a great experience to patients all the time. This is unfortunately easier said than done. A patient in the hospital today has many touch points and as the patient navigates her journey around the hospital, her experiences keep mounting. In the past, patients expected very little from the hospitals, the basic expectation was to just get out of the hospital alive!!!. Today, the hospital has to ensure its floors and rooms are spick and span, the doctors communicate well with the patients and the attendants, the nurses are ever vigilant and responsive, the quality of food served is comparable to a gourmet restaurants (no more jokes about the hospital food of yore!!!), the discharge process is quick and the billing is transparent. And an expected medical outcome is almost a given!!!!

There is nothing wrong with these expectations. A good modern day hospital should offer these and more. However, from the point of view of driving customer advocacy, it is a must that the hospital offers these experiences in a manner that meet patient expectations. To make matters more interesting a hospital, which hopes to use customer advocacy as a key marketing tool, must ensure that some of these experiences are delivered way beyond patient expectations and thus can become ‘talking points’. Thus, some of these experiences have to be tailored differently, delivered with great sincerity and truly from the heart to sway a customer to talk well about the hospitals.

Now if a hospital is geared to deliver superlative customer experiences, the marketer’s task becomes a little easier. He has to now ensure that the customer has easy ways of communicating his experiences to the wide world. In today’s 24×7 connected worlds, social media platforms like Twitter and Facebook come in very handy. Large hospital chains in the country have huge fanbases and followers and they encourage patients to record their experiences and then share them on these platforms. Hospital chains like Fortis and Max Healthcare extensively use slickly shot video testimonials, which are put up on different social media platforms and shared to generate the buzz.

A few hospitals also use in-hospital communication in the form of the traditional ‘wall of fame’ where they talk about positive patient experiences and simultaneously recognise employees showing exemplary behaviour based on patient feedback.

Many hospitals also encourage patients, who have had great experience at the hospitals to come and engage with others, currently undergoing therapy. This is usually a cathartic experience for many as they are able to closely identify with the speaker and feel motivated in their fight against a disease. In my many years of working in hospitals, I have organised many such events and the goodwill and joy that these events generate is best experienced by attending a session in person.

Many a times, I have seen patients volunteering to even participate with their doctors in media events organised by hospitals as spokespersons for the hospital. Recently, I was in Kenya for a media interaction that we were holding for the local media in Nairobi. The interaction featured two patients, who had received outstanding care at hospitals in India and they spoke beautifully about their successful fight against implacable foes like cancer and traumatic injuries. John began by saying that ‘Let me tell you that cancer can be cured…I know it better than anyone else…’ and Omar narrated how his 12 year old son recovered from an accidental injury that everyone has given up on. They spoke eloquently, answered questions, hugged their family and thanked the doctors for their support and care during difficult days. –Real patient stories at their best.

No amount of advertising can have the kind of impact that a patient telling his stories from the heart has. It is immensely powerful and the most potent way of building a brand and winning hearts.

An edited version of this piece has also appeared in Healthcare Radius/Feb 2015

Marketing The Healthcare Marketer

The Healthcare Marketer is always struggling to make his presence felt. In many hospitals and some very large ones at that he still continues to be a shadowy presence, someone who gets the job done, which may mean getting an ad developed, a brochure designed or an event organised and little else. The Healthcare Marketer’s role in most Indian Healthcare organisations remains a passive one, more of a messenger than anything else. This honestly need not be so and the blame for this sorry state of affairs also rests squarely with the marketers.

Healthcare Marketers need to emerge out of their self restricting cocoons. They need to take fresh initiatives, bring new ideas to the table and be seen and heard more often. It is time that the Healthcare Marketers turned their skills inwards and got busy with marketing themselves. They need to establish their own equity with the medical folks and make them understand the value that they bring to the table.

Healthcare Marketers must be active participants in the life of their hospitals. They need to be at the hospital floors more often, observing and gleaning insights from customer interactions. I have come across many marketers, who seem to operate more in the realm of woolly ideas, mostly suggested by their advertising agencies, who themselves have very little understanding of life in a hospital. This is the surest recipe for disaster because these are precisely the ideas that are likely to be shot down as the people running hospital operations will instinctively know how impractical these are. Thus the healthcare marketer along with his Teflon coated agency, would emerge looking completely out of touch with reality, reinforcing the existing belief that these guys know nothing and work out of their ivory towers, located at some 30000 ft.

Healthcare Marketers also need to forge win-win partnerships with the medical folks. I have come across marketers, who believe that the medical folks should stay confined to their OT’s and consult rooms and they  have scant understanding of marketing. This is as far from the truth as it gets. I have learnt over many hard years that medical folks and hospital operations people, who interact with customers know a lot more about customers and their real issues than any marketer can really hope to. It is always wise to spend time with the doctors talking with them about customer insights, about what might work in the market place and about their daily challenges. I have always made a great deal of effort to befriend doctors, particularly who have a keen sense of patient handling, good understanding of marketing communication and who themselves are exceptionally articulate people, well read and with wide-ranging interests. They are the ones, who will support new ideas, set up new medical programs, drive experiments with customer experiences and help bail out a marketer, when some day he will inevitably find himself in a corner.

Here is a word of caution as well. While, it is good to get suggestions and ideas from many sources, a healthcare marketer should have the wisdom and discretion to sift through those ideas and incorporate those, which add to the campaign and discretely drop those, which must not be accommodated. Many a times healthcare marketers make the serious error of letting the medical folks literally dictate the ad copy and the content as well, which causes a lot of heart burn and shoddy communication. This helps no one as when the communication fails to achieve the desired results, the marketing guy cops all the blame and comes under unnecessary pressure.

A Healthcare Marketer must be totally honest and transparent in his work.The campaigns that go out in the media, must first debut internally. Put them out on the hospital intranet, mail it to key stake-holders, put up the posters in the hospital cafeteria and come up with innovative ways of internal selling. It is important that the Healthcare Marketer is seen in action by those who matter with in the hospital. An invisible marketer, however brilliant he may be, will always be something of an oddity in the hospital.

And finally, sometimes it is good to do a bit of chest thumping and the good old-fashioned boasting. Thus celebrate a campaign that delivered a great return on investment, talk about the 10000th guy enrolled in that CRM program, which now in an year’s time contributes 20% of the top-line and bring the house down with that innovation that won the big award.

Let folks sit up and take notice, and come to you for that next break-through idea that only you can conjure!!!

PS: Well, a little chest thumping from me as well. This is the 150th post on this blog. Cliched as it may sound, when I started writing this, I of course had no idea that one day we will reach this landmark. Over a period of time, I guess the blog acquired a life of its own.My most sincere thanks to all those who read my stuff and provide me feedback, support and encouragement.

And special thanks to my friend Syamant Sandhir, for starting me off. 

The New Role of Marketing in Healthcare Organisations

Healthcare organisations, hospitals and the like have long believed that the role of the Marketing function in their organisation is limited to organising health camps, CME’s and marketing communication, mostly of the ‘below the line’ variety. Thus the patient information literature that you see in your hospital is largely the doing of the marketing folks, who usually download the basic material from the net, rewrite some of it to make it suitable for their hospital, get the advertising agency to do a layout as per the hospital brand guidelines, get the doctors to approve the medical content and send it for printing. Marketing folks also organise a couple of advertisements usually when the hospital wishes to announce a new celebrity doctor or a new ‘state of the art equipment’, ‘which the hospital acquires. Now lest you misunderstand, this piece is not meant to disparage the role of the marketing folks in a hospital, on the contrary, I believe they have a much greater role to play than customarily assigned to them.

The Marketing function in a hospital has surely to be much more than this. I believe the Marketing team in the hospital must play a critical role in customer engagement. Now you may wonder, if the marketers were to do this, than what would medical folks do? Aren’t they the ones tasked with the responsibility of patient care? Thus, here we must make the distinction between patient care and customer care, which is critical for a hospital. Patient care is the medical care provided to patients in a hospital, which of course is the domain of the doctors, nurses and other medical staff in the hospital. Customer care on the other hand is the sum total of care that hospitals need to deliver to the patient and his attendants, at all the points, where the hospital engages with the customer. In a hospital, the elements of customer care include customer interactions over the phone, on the website, through an advertisement,  at the front office, at the billing counters, at the nursing counters, in patient rooms, in doctor’s consult rooms, in the waiting areas, in the cafeterias… really anywhere that the patient or their attendants interact with the hospital.

Most hospitals realise that their biggest asset is a satisfied customer. However, many still believe that a good medical outcome is perhaps the surest way of ensuring a patient’s loyalty. Unfortunately, the modern day patients are far more demanding to be satisfied with just a good medical outcome. In fact, many believe that a positive medical outcome for most procedures and surgeries is a given. What they are really looking for is a great hospital experience, which includes an a lot more than an expected medical outcome. Since, a lot of people still choose a hospital or a doctor based on advise from friends and family, a great customer experience becomes an essential marketing tool.  

Let me illustrate the point with a few recent experiences that I have had at Max Healthcare in New Delhi. My father has been battling an oral cancer, and was undergoing radiation therapy at the hospital. Much of the last month I took him to the hospital in the morning everyday. I had requested the hospital to give me a slot early in the morning so that I could go to work later in the day. The hospital obliged without a fuss. Now the General Duty Assistants (GDA’s), who usually wheel patients to the radiation areas report to work at around 8 in the morning and thus I would happily wheel my father over. Imagine, my utter surprise, when the security personnel at the hospital’s gate refused to allow me to do this chore and insisted that he would gladly do it. This was not a one-off, this happened everyday that we went there. A small incident in a hospital’s busy day, but it made all the difference to us, we felt welcomed and cared for. Similarly, many a times in the morning as I waited for my father to finish radiation, I was offered a cup of tea by the staff on duty in the radiation area. Again a small matter, but done instinctively and always with a smile. The fact that I remember these small incidents and write about them here, is excellent marketing for the hospital.

A busy hospital delivers thousands of these experiences every day. Each of them is delivered by individuals, who come from different backgrounds, socio-economic strata, having very differing educational backgrounds, yet they are united at work in aiming to deliver a great customer experience at the hospital. Each of these experiences must exceed customer expectations for them to talk about the hospital and its services.

Many a times a customer experience is delivered even when the customer has not walked into the hospital. These are just as important and include, the effectiveness and ease of handling of the hospital website when the log on to it, the efficiency and knowledge of the telephone operator when they call the hospital and the response of the hospital when in an emergency.

I believe in a new age hospital, the Marketing team must be the custodian of all customer experiences. It should work closely with the hospital operations team in defining the customer engagement paradigm and help them in delivering great customer experiences. The marketing team should have a single goal, to excel in delivering a great customer experience at all customer touch points, whether in the hospital, in the virtual world or outside of the hospital.

The Healthcare Marketer’s Life

Yesterday evening while I was returning from work a friend called. He has recently taken over as the Head of Marketing Communications at an upcoming hospital. I had met him a few weeks ago to congratulate him on his new assignment and he seemed quite kicked about his new role. He had grand plans of changing the way the hospital communicated with its patients and other stakeholders, he wanted to run customer facing programs, drive relationships with patients through effective engagement and deliver uniformly great experiences to those who touched the hospital.

Yesterday over the phone Ajay felt he had made a big mistake by joining the hospital. I was quite flummoxed by this turn-around. Further inquiries revealed a familiar story. The hospital has a brand new CEO, someone who has worked for many years in hospital operations but have no knowledge or appreciation of communication. However, like most folks he too believes that marketing communications is hardly something to be left to experts. In fact the CEO believes that he knows exactly how a piece of advertising or a brochure should look like. Download the text from the web, adapt it by rewriting some of it, slap a few images downloaded from the net and include the mandatory images of some if the hospital doctors, run it past a few senior hospital bigwigs and, voila the ad or the brochure is ready. As far as hospital signage are concerned, the CEO feels that they really are meant to provide legible directions to the patients and fussing over them, their aesthetics and design is a gross waste of time, energy and money. Well I might be exaggerating a little here but this is really the long and short of what Ajay felt his CEO was doing and no wonder he had started feeling frustrated in the set up.

Marketing folks in hospitals always grapple with the problem of every one who is anyone coming up and advising them on how to create a piece of communication. Some doctors love to see their pictures in the ads and some other feel great if gory images of them operating heroically could be included in the communication. The CEO’s love to mutilate the advertising copy, insist on correcting perfectly well written text, increasing or decreasing the font and of course having the logo bigger, bolder and always 2mm to the right! Many a times the marketing communication executive has to sweat many hours trying to accommodate the conflicting wishes  of the CEO, the star surgeon and his favourite flunky. All in a day’s work for the intrepid marketing guy, who can be forgiven for wondering if he is the only one who knows nothing about marketing communications.

Those who have worked in hospitals long enough know how to maintain a fine balance. They will wait till the last-minute, before asking a doctor to go through the text and approve the ad, they will sneak it past a doctor who they know is not too interested in the brochure’s finer details, they will get the mailer made and when a livid doctor would approach them on their failure to show it to him, they will deftly show an e-mail sent a few days ago knowing fully well that the doctor rarely checked the mail. Tricks of the trade, which one learns on the job.

Well, while all this may sound hilarious, the fact is that a hospital marketer’s life is not easy. If the hospital is doing well, his budgets are the first to be cut (why do we need to spend money on advertising, we have hardly a bed to spare!) and God forbid, if the hospital is not doing too well, the marketer knows that the hospital can hardly spare cash to blow its own trumpet. The doctors and particularly who head various departments are always after his life to see their ads in the newspapers, whether the marketer has the budget for such advertising is of course none of their concern. The CEO is always looking to pinch a few more pennies from a meager budget and he insists on stretching the money to impossible levels.

Such is than the life of a healthcare marketer.

Usually, in all this the silver lining is a boss, who understands the inner dynamics of the hospital, who knows how to work with medical folks without unnecessary confrontations, who lets the marketing guy go about his job without much hindrance and steps in to resolve conflict as it arises. He is the one who understands the aspirations of a good marketer as well as the concerns of the medical folks in the hospital and strives to achieve a balance.

At the end of the day, and in like most other things in life, a fine balance is the key.




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.

Catch them Young: Healthcare Marketing to School Kids

Schools have become new battle grounds for all kinds of marketers pushing soaps, candies, cosmetics, toothpastes, music and a new exhilarating lifestyle to the youngsters. The schools view most of this as frivolous and wholly unnecessary and often resist it. Sometimes the marketing effort is cloaked in interesting events, which are entertaining and educative.  Schools allow these and healthcare marketers are able to reach out to school kids through School Health Quizes,  talks on diet, exercise, hygiene and healthy lifestyle habits.

Some may be wary of allowing healthcare marketers to reach out to school kids. Children are generally healthy, it is a carefree time and weighty matters like healthcare should really be no concern to them. I am not sure I agree with this line of thinking. I would have a kid grow up in an environment, which helps him make ‘healthier’ choices. As a kid I was taught the benefits of ‘early to bed and early to rise’. I still swear by it.

Healthcare Marketers can reach out to schools, with specially designed programs, which educate and inform about how healthy choices made early, allow for a healthier lifestyle later on. This should really be looked upon as an investment by the hospital in a long relationship. To expect instant monetary rewards from a school program is expecting the moon. Persistence is the key here.

Some of the engagement programs that hospitals can run with schools are highlighted here.   Continue reading

Lessons in Healthcare Marketing Communication

Building healthcare brands is an arduous task. 

It takes enormous effort to get it all right. The mix of customer experiences at various hospital touchpoints, the look and the feel of the hospital, the people and of course the communication. No one goes to a hospital willingly or to enjoy a few days of well deserved rest. Neither is it a place, which attracts willing repeat customers. Customers in a hospital are necessarily driven by a misfortune, which involves something as precious as their or a loved ones health. A hospital visit is also usually fraught with risk. Fear and anxiety generally accompany a customer to the hospital.

Building brands by delivering great experiences to customers who are in this frame of mind is tough. Communicating with customers to influence their choice of a hospital in dire and difficult circumstances is often akin to walking a tight rope. The message runs the risk of being perceived as either too commercial (this hospital seems to be hoping that I fall sick and land at its doorsteps), too glib (it trivialise something as serious as my health and well being) or just too smart or plain dumb.

Here are some lessons that I learnt, while handling communications for large hospitals.   Continue reading

Marketing a Hospital to those Next Doors

Marketing a hospital to those in the neighbourhood is often looked upon as the ‘low hanging fruit’ by many a marketer. The thinking goes something like this. ‘We have just started a great hospital and those in the neighbourhood cannot help but notice the swanky chrome and glass exteriors and the blazing signages on the top of the 10 floor edifice. We have world beating technology and some of the most competent and respected doctors joining us. We are streets ahead of all those who have been in this neighbourhood for years and we really do not consider them as competition. All those who have been living in this community will now flock to us.’

Honestly, this is a recipe for disaster, yet so many of us marketers are so blinded by our spanking new hospital that we do not see anything beyond it.   Continue reading

The Role of ‘Referral Fee’ in Healthcare Marketing

Referral Fee has always been one of the most controversial issue in the Marketing of Healthcare Services in India.

Large tertiary care hospitals derive much of their revenue from patients who are admitted in the hospital. The revenue comes from the room rent (that the hospital charges from the patients), the surgical fee, the anaesthetist’s fee, the Operating room charges, the investigations that the patients need during their stay in the hospital and the medicines and other sundry consumables that are used by the patients.

Patients who need admission rarely walk into the hospital requesting admission. They generally come through the Emergency Room (the ER) or are referred by their family physicians or other specialists who practice outside the hospital. Many a times patients are also referred by smaller secondary care hospitals or nursing homes.    Continue reading