Managing Hospital Marketing Costs in Difficult Times

The last financial year has been a difficult one for most private healthcare services providers in India. The regulatory headwinds related to the capping of prices of stents and knee implants, the extremely negative media campaigns and unruly patient activism have pegged back revenues and dented profits. The Prime Minister has been running a most undignified campaign of his own caricaturing Indian doctors as blood-thirsty parasites out to mistreat patients and highlighting the fact that he has been able to stop the rot through legislative action. In Delhi, the Chief Minister is busy rolling out his pet half-baked schemes and many states have come up with draconian provisions under the so-called Clinical Establishment Acts.

However, all this has left private healthcare providers in a hard place. They are left with no option but to ruthlessly cut costs and scale back some long-term investments. Many are re-working their growth and investment strategy. Marketing budgets are being slashed, head-counts being ” rationalized” and various kinds of harsh cost control measures are being implemented.

Marketing costs and costs related to patient amenities in the hospital are perhaps the easiest to cut. They do not involve the pain let us say of reducing head-counts by handing out pink-slips. They also do not significantly impact patient outcomes.  A few lesser ads in the newspaper and maybe a water-bottle less in the patient room is unlikely to cause too much of pain.

This is also the commonest mistake hospitals make.

Marketing activities and great patient experiences help spread the word around. Brand communication works quietly in pushing a particular hospital in the consideration set of new patients. It helps build perceptions about the quality of care provided by the hospital. It also helps position the hospital as a possible choice whenever the need arises. The messaging has to be continuously reinforced in an unobtrusive manner, gently working on the consumer’s mind, building the desired imagery of the hospital.

In times of turmoil, when an unforgiving media is hellbent on creating issues where none may exist and when politicians are vying with each other in demonizing a reasonably well-working system the marketing communications put out by the hospital assumes greater significance. Patient stories in the form of nicely crafted testimonial ads can go a long way in reassuring new patients. Announcement ads related to the induction of new technology and equipment can inform patients about new choices available to them. A digital marketing campaign can help patients access the hospital services with greater convenience. A well-executed community outreach program can allow the hospital to enroll patients in long-term relationship programs, binding them together with the hospital.

Great patient experiences also work in a similar manner. Satisfied and happy patients are the finest brand ambassadors. Their credibility based on their own experiences counts for a lot more than any advertising would ever do. It is also foolish to assume that patients will not notice small things, which quietly disappear when stiff cost programs are executed. That nice friendly GDA who takes the wheel-chair, the missing dessert in the meals, the fraying blanket or the worn upholstery on the attendant’s sofa in the patient’s room will always be noticed. Discerning patients will be able to see through these ”small” compromises and will definitely talk about them. This kind of talk is extremely detrimental to the brand equity of the hospital and is almost always impossible to fix later on.

Many years ago I had learned that there is usually a cost associated with cutting cost. Sadly, sometimes this cost is not visible at least in the short run. One has to be very careful while taking drastic cost decisions particularly when they look easy or simple. They often are not. The costs thus cut, have a way of coming back and hitting hard in the future. Marketing and patient experience costs usually return with a much greater vengeance and that too in the not so distant future.

So, what should hospitals do in difficult times such as these?

While they knuckle down to protect their meager profits, they should avoid knee-jerk cost action at least in these two areas. If anything, they should further reinforce their communication and patient experiences to ride out the storms.

The views expressed are personal

 

 

 

The Sales Vs. Marketing Conundrum in Healthcare

The Sales and Marketing functions in many hospitals in India still work independently of each other. There are invisible boundaries that separate the two and often it is considered heretical to get the twain to meet. The Marketing folks are the smart and savvy guys, who sit in their cloistered offices working on the holy grail that is called ‘strategy’, while the sales guys are the lowly folks, who need to sweat it out in the ‘field’. They are the ones who chase ”numbers” and perpetually suffer from their tyranny, while the Marketing folks grapple with the subtle nuances and the neat turns of phrase of advertising communication and the like. The sales folks are street smart, the Marketing guys worldly wise, the sales folks are rough at the edges, the Marketing guys are all suave and well rounded, the sales folks are the ones with their sleeves rolled-up and with their hair in the eyes, while the Marketing guys are impeccably turned out with neatly gelled hair, all in the right place…you get the drift.

Well, while one can go on in this vein, citing their differences, the fact remains that unless the Sales and Marketing folks work together, neither can really achieve great success. Yet, in many hospitals they hardly interact, leave alone work together.

The blame for this sorry state of affairs lies at both the ends of the spectrum. The sales people are programmed to chase, they are given no respite from the continuous and if I may add mind numbing quest for revenues. They do not have the time and even the inclination to sit back and think. A sales person, sitting idle, would soon enough invite the wrath of his supervisor. He would be labeled as a lazy day-dreamer who lacks ‘drive’ and ‘initiative’. On the other hand a Marketing person will have all the time in the world to think through each and every piece of communication that passes through his hands. He will weigh the pros and cons of the ‘copy’ and the way it is laid out in the ad. He will hold forth on the relevance of the ‘image’ that adorns the ad and of course the smallest detail like a misplaced comma or the uneven size of the font will not escape his attention. After all, he has been taught that God lies in the details.

In all this he will forget that the purpose of the advertising is perhaps to help the sales person drive in a few more customers through the hospital doors!

On the other hand this is what happens when sales guys try their hands at Marketing. Some time back I had the occasion to attend a sales review meeting at a hospital. The sales guy was holding forth on launching a few specialized clinics and the idea was to create communication informing the local community about the introduction and the benefits of these clinics. I recall one of the clinics to be launched was the ‘Heart Failure Clinic’, which offered specialized advise and support to patients in Heart Failure. The sales head briefed the Marketing team about the clinic and requested an ad. The Marketing team, sent out an ad, which talked about Heart Failure and exhorted patients suffering from heart failure to come to the clinic. The communication failed to inform the readers how to identify their condition as ‘Heart Failure’ and when exactly to approach the clinic. Strangely, it was also not very clear as to how a ‘Heart Failure Clinic’ was different from a routine consult with a cardiologist! ”If I am having a Heart Failure, wouldn’t I call the Emergency and rush to the hospital rather than wait for an appointment at the Heart Failure Clinic” asked a baffled HR person sitting in the review.

It was a mindless piece of communication done at the behest of the sales person, who was in a hurry to launch the clinic and a lazy Marketing guy, who wasn’t too bothered with the outcome of such inane advertising.

Now if only the Sales and Marketing teams had sat down together and looked at the issue at hand, which was how to drive cardiac patient volumes in the hospitals and come up with a plan, things could have been very different. Maybe a ”Heart Failure Clinic” might still have come up and the Marketing guy would have pointed out that it was best to market a Heart Failure Clinic to referring doctors rather than consumers in general. After all, isn’t Heart Failure a condition that will be identified by a local community doctor and would subsequently be referred to a ”Heart Failure Clinic” in a larger hospital.

If only the Sales and Marketing teams in hospitals forgot their differences and worked together, they could achieve so much more…together.

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.

Marketing A Laparoscopic Surgery Program

Marketing a surgery program is fraught with risks. Barring surgeons, I am yet to meet someone who looks forward to a surgery. Most people try to avoid surgery as much as they can. They will come up with all kinds of excuses including astrological considerations, the weather not being right (it is either too hot or cold or raining) or waiting for a son or a daughter who lives abroad to arrive before they can go under the knife.

The fear of surgery is universal and whatever the surgeon might say (I have done it a thousand times, I do it every day etc.), the fear of surgery just does not dissipate. Whatever the surgeon may say, the fact remains that patients undergo surgery only when they do not have any other medical recourse. Given a choice between a surgery and any other non-invasive medical procedure a patient will always choose the latter.

Now, marketing a surgical program, which no one wants (or at best agrees to only as a last resort) is to say the least, challenging. With the advancement of technology a whole lot of surgeries can be done using a laparoscopic techniques. This is indeed a great boon for patients, who as I mentioned earlier are extremely reluctant to go under the knife and by corollary once subjected to surgery are very keen to return home to normal life. Laparoscopic surgery, which is also at times called Minimally Invasive Surgery allows surgeons to operate with just a few holes through, which they insert a camera and other equipment necessary for the surgery. Minimally Invasive Surgery is far superior to conventional open surgery as it is a lot safer, allows faster recovery, has less chances of infection and usually involves minimal loss of blood.

To effectively market a laparoscopic surgical program it is essential that the patient understands its huge benefits. Since, patients after a surgery want to return home faster, I would suggest that we brand the laparoscopic surgery program as ‘Short Stay Surgery’ program. This is easily understood by all and has a certain appeal for patients-instead of focusing on surgery, they would rather look forward to a short hospital stay and a quick return to home. Fortunately, many surgical procedures done laparoscopically allows patients to return home with in 24 hours, which is just great.

Once the program is branded as ‘Short Stay Surgery’ program the other benefits of the program must be highlighted all flowing into the core benefit of  a short stay in the hospital. The surgeons in their spiel should highlight this aspect of surgery as much as they can. This is not to say that they should gloss over the risk factors of the surgical procedure, it is just that the prospect of a possible shorter stay in the hospital will make the patient feel a lot better.

The advertising communication should highlight facts such as faster recovery, minimal scarring, less pain, low blood loss  and less chances of infection as clear advantages of laparoscopic surgery. It should then connect this up with the core benefit of a shorter stay in the hospital. I believe such an approach can go a long way in popularising minimally invasive surgery and patients will actively seek a surgical intervention at the right time rather than wait till there is an emergency and waiting may no longer be possible.

The tonality of messaging is just as critical as the message itself. One has to be very careful in not sounding over enthusiastic and too keen in the advertising. One must remember that inspite of all the advantages of laparoscopic surgery, it still is surgery. From a patient’s perspective this involves a detour to the hospital and the attendant risks can not be just wished away. The communication must be couched in a language, which is solicitous, understanding and educative. It should connect with the patient and help him understand that the short stay surgery program lessens risks significantly and allows him to get over the medical crisis faster.

The use of media of course depends on the budget available with the hospital.  Print, Television, Outdoors, Radio, digital and BTL can all be effectively used to create an impactful campaign. The choice of media can amplify the messaging and help more people connect with the hospital.

And choose laparoscopic surgery in time rather than wait till they are left with no choice.

The Power of a Compelling Story in the Marketing of a Hospital

Many years ago, when I worked at Max Healthcare, I met an elderly man whose grand daughter had had a major cardiac surgery and was admitted in the hospital. The child was on her way to recovery and the old man was profoundly grateful to Dr. Anil Bhan, who had operated on the child. The old man narrated a very interesting tale.

The old man and his wife lived in Roorkee, a University town about 150 miles from Delhi. His son worked in a nationalised bank in Delhi and he had two grand children, twins as a matter of fact, a grand daughter and a grand son. The children now aged 11 years lived apart, the son in Delhi with his parents and the daughter with them in Roorkee.  The daughter from the time of her birth had been a sickly child and had required heart surgery, when she was 9 months old. Being a girl child and that too a sick one, her parents had entrusted her care to the old couple and they had brought her up. Clearly, the old man and his wife were extremely attached with this child and she was the apple of their eyes.

The child too enjoyed living with her grand parents and they clearly doted on her. They ensured that she received the best medical care and would regularly bring her over to AIIMS, the premier medical institute in Delhi for regular monitoring and check ups. About two years ago, when the child was 9, they had noticed that she would become breathless after a little exertion. Initially they did not worry too much, however things grew steadily worse and they became quite alarmed and brought her to Delhi.

The paediatric cardiologist at AIIMS, who has been taking care of the child in all these years told them that the child needed another surgery, an extremely rare and very risky procedure and she needed it fast. They were also told that without the surgery the prognosis was very poor. Dr. Anil Bhan, who was the paediatric surgeon who had operated on her as a eight month old infant had now moved to Max as their chief of cardiac surgery.

The old couple brought the child to Dr. Bhan, who examined her carefully and pronounced that while the surgery was extremely rare and very risky he was willing to do his best. The old couple let things in the hands of Dr. Bhan and prayed to the almighty to save their grand daughter. Dr. Bhan operated on the child and she was wheeled into the Paediatric ICU after the surgery. Soon post surgical complications set in and hopes of her survival dimmed. Dr. Bhan, however approached the old couple again and requested permission to try surgery once again. The old couple with nothing to lose, told him to go ahead.

The child was again wheeled into the OR and Dr. Bhan and his team once again made a heroic attempt to save her life. She survived the surgery and spent the next 9 days in the ICU under the watch of some very dedicated doctors. The child was than shifted to a ward and when I met the old man, he was preparing for her discharge from the hospital.

The gratitude this man had for Dr. Bhan and his team, the ICU staff and for the hospital was immense. He showed me a poem he had composed in Dr. Bhan’s honour. He could not help narrate the wonderful things that happened to him in the hospital, about the extraordinary skills of the doctors, their commitment and their indomitable spirit in not giving up on them even in the face of unbelievably daunting odds.

There can be no greater hospital marketing tool than a powerful and a compelling story narrated by the patient or a patient attendant about his experiences in the hospital.

 

PS: Dr. Bhan and his team has since moved to Batra Hospital in New Delhi

 

Pic courtesy http://www.flickr.com

 

Driving OPD’s

Outpatient Department or the OPD is critical in the marketing of a hospital. It is the OPD, which drives the admissions in the hospital and the diagnostics including the pathology and imaging. It keeps the doctors busy and the hospital buzzing. The success of various Marketing activities is usually measured by the number of incremental patients who walk through the hospital doors during the promotion.

Here are some ideas on driving the OPD volumes.

Marketing Promotions

I know, many people believe that for a hospital to be involved in Marketing promotions is a strict no no. Offers like free consults and 30% off on all diagnostics somehow seems too much like a ‘Sale’ at the neighbourhood supermarket. However, the truth is that promotions work. Many people like to avail of the promotional offers, walk into the hospital to see a doctor for a long ignored niggling problem and many like to avail themselves of a discount on a CT or MR. The trick here is not to overdo it and to ensure that the communication is not overtly commercial or over the top. I would reckon 4 big promotions a year, (one a quarter) would be fine.  

Doctors and Grassroots Marketing Initiatives

 During my many years as a healthcare services marketer, my biggest challenge has been to  involve doctors in the marketing of their service lines. I have tried to think through this.  How can I possibly have a greater and an in depth involvement of doctors in the marketing  of a program. It seems that many are just not interested and consider getting involved in  something as prosaic as grassroots level marketing beneath their dignity as doctors.

Frankly, as a marketer I would hate to start a marketing program, without a complete buy in from the doctors concerned. That unfortunately happens rarely. I recall my efforts at starting a relationship program for individuals with a high risk of cardiac diseases as well as those, who are currently under medication for the treatment of heart disease.    

Service Recovery and Word of Mouth Hospital Marketing

Goof ups in hospitals are always round the corner.

I dare suggest that quite often they are unavoidable. Do what you may, there will always be someone who will slip once in a while and you will have an irate customer. The headcount in a typical 300 bed tertiary care hospital in India can easily be 800 people or more. In spite of all the care in hiring the right set of people and putting them through rigorous training, they will still end up making mistakes.

Good hospitals, while trying to minimise errors also learn to accept them as inevitable and put in place systems, that help them handle difficult situations well. Great hospitals go one step further, they not only do excellent service recovery, they also ensure that the the patients leave the hospital with a positive frame of mind, in spite of the mishap.  

Marketing Those Who Came Back

Step into a hospital anywhere in the western world and you are in all likelihood to run into an Indian doctor sooner than later. The medical education system in India churns out doctors in large numbers and many of them choose to go abroad for advanced training and skills enhancement. Many of these settle down in the new country, which is more than happy to welcome highly educated and skilled doctors to its shores. It works well for the doctors too, they learn new things, train in some of the finest institutions in the world and than are able to make a decent living in their adopted country.

This is the way it was till recently.

Now with India making rapid strides in healthcare and even attracting patients from across the globe, many of these doctors are choosing to return to India. They are able to find employment in the new high tech hospitals, which have sprung up in the last 8-10 years. The reasons for this are not far to seek. Indian hospitals can now easily be compared with any that they might have worked in earlier, in the west, the standard of care is often superior, the financial rewards far better than what they were a few years ago, and life in upmarket urban India quite comfortable. Moreover, India is home for many with responsibilities for aging parents. Some are also not comfortable with their children growing up seeped in the ubiquitous and consumerist western culture.

All this is great, except for the fact that some find going in India quite tough. The hospitals that employ the returning prodigals, soon realise that these doctors will take time to settle down and find their feet in the changed Indian environment. Having been away for years they do not have a bank of patients, who can start patronising the hospital. Often their salaries are more than those hired from other Indian hospitals and with no patient base to speak off, these doctors are immediately under pressure to justify their high salaries. They usually need urgent Marketing support.