And the first place is almost always with the source – the patient or the referring physician, whoever you consider your customer.  There are formal methods for obtaining good information about your customer’s wants and needs, i.e. surveys, physician relation liaisons, but let’s take a quick look at some informal methods that are easy to initiate right now.

Social media tools allow for listening in an informal method.  This kind of surveillance can help you be more nimble and lead you to a greater awareness of new trends or provide market insight that can help you navigate your outreach.

Listening can involve paying attention to your brand (or your competitors’) as it is mentioned in on-line conversations.  You most likely have set up a Google Alert for specific words and names to help you keep track of mentions. If you haven’t yet done that, go to Google Alert and get started. You can also set up a Twitter alert in the same manner with TweetBeep or use Twitter search for another great listening device. Both are free just like Google Alert.  With these search tools, you can capture what is being said about you or your brand on Twitter and in many online conversations.

You may have alerts set for your organization’s name but also consider more generic key words that you are interested in hearing about, i.e. “physician relations,”  “oncology,” “wound center” or “healthcare marketing.”   You can set up as many alerts as you choose and they can be formal names (your brand name, your competitor’s brand name, a specific physician’s name etc.) or key words or phrases.

There are a variety of services, free and premium that you can access to help you listen more closely.  Social Mention scan blogs, forums and such for your key words or brand name while BackType provides other social media listening devices.

Monitoring the alerts is only half of the process of listening.  Once you get beyond brand reporting, you need to consider the more complete context of the conversations. What drives the conversation?  Is there a need or a frustration? To get a more complete picture of your patients’ needs or how best to improve or promote your healthcare services, you will want to be more in touch with the overall conversation that is happening about the particular medical service you provide.  Scanning is worthwhile but make sure you a deeper sense of what the conversation is about.

If you are a provider, frustrated by your diminishing income and think your only choice is to add fees, consider a few things first – consider this from your patient’s perspective which is what I believe is the healthcare marketing perspective.

Physicians who charge additional or a la carte fees are still in the minority.  While some of your colleagues may be joining in the fray, think about your market and your patients and how best to communicate with them, before you take the fee plunge.

As with any new service or endeavor, you want to examine your market and have a solid understanding of what your patients will tolerate.  If you have a practice filled with patients struggling to make ends meet, the addition of a fee can easily push them in the direction of another provider.  You might be overwhelmed with the size and activity of your patient panel as it is and having some choose to go elsewhere may not harm your practice.  Either way, you need to take a good hard look at your situation.  Don’t leave out your competition either.  Are there others in your market who charge fees?  The more familiar your patients are with this concept, the more likely they are to accept it.

An appropriate communication effort is necessary.  While you may know that primary care physicians are becoming more and more scarce, your patient may not.  They may not understand that outside of your practice, things can be very different and they won’t know this until they leave.  If you decide to charge fees, help them understand your motivation.

Some physicians begin the fee charging process on a voluntary basis and while this eases your patients into the concept, it still may anger some so you need to be prepared.  Help your patients understand that many of the activities outside the office visit are simply not covered and therefore you do not receive a fee for them.  As 30 million  more Americans gain access to medical care with the nation’s new health reform law, primary care providers are likely to be pressed and wait times will increase significantly.  Even if you don’t intend to charge fees now, helping your patients understand the pressure on primary care providers will serve you and them well.

Helping your patients understand that the only way available to you to increase your income to cover higher costs of care and personnel is to increase your volume or to try a la carte pricing.  Patients might need to graphically understand that if you increase your volume, you have less time with each patient and in all likelihood, the care you provide will suffer.  Charging a fee is a better option.

Here are some suggested action steps to consider before charging a fee:

• Review your market.  Talk to your patients to get a feeling of their thoughts.
• Know what your competition is doing.
• Create a communication plan.
• Be prepared for the fall-out from your position.

Good luck!

Websites, some beautifully crafted, others demonstrating valuable services and information, cannot stand on their own. Plain and simple, websites need traffic to be effective.  The concept of “if you build it, they will come” just doesn’t work in our crowded and noisy marketplace.

When reviewing your marketing strategy (i.e. how to gain name recognition in a saturated market and get new patients in the door), you are smart to use your website as your central element but you need to utilize search engine optimization (SEO) to help bring traffic to your site.

SEO is not a simple concept and it continues to evolve.  You certainly can pay a firm to assist you in getting a high ranking on the terms you consider “key words” in your promotion or you can work on concepts yourself.  Either way, having an on-going awareness of SEO tactics will serve you well.

Here is a link to a great blog that has lots of good information on SEO.

Way too many of us cut the corner of simply making assumptions and neglect to ask our customers what is really on their minds about our healthcare service. We are missing out on good opportunities to continually improve and grow our services.  I often hear the lament of how frustrated primary care physicians are about the lack of feedback they receive from consulting physicians or patients who tell their friends their frustration about the service they didn’t receive at their doctor’s office but don’t tell the people who can fix the problems.

Get in the habit of seeking feedback.  Whether positive and negative, feedback, can help tune work processes and services to better suit your current and future patients/customers. Obtaining feedback can move your healthcare organization from ordinary to extraordinary.

Varying Methods of Collection

There are many different ways to obtain the feedback.  There are several different on-line services that you can use such as SurveyMonkey or PollDaddy. Using such a site will help you create a survey of any size with the option of conducting analysis once the data is collected.  Or consider creating a quick survey on your website asking key questions or instill a face to face feedback moment at the end of a visit – give them a form or ask them to meet with one of your staff members to go over some service oriented questions.

Questions to Ask

Once you are in the habit of seeking feedback from your customers, you will seek out input on a variety of things.  Typically you will want to know about how your service is valued, what are road-blocks in the delivery of that service?  What can be done better and what is already done well.  Your questions will reflect what your interests are but here are some example questions:

• How old are you? (knowing this information can help you tailor the delivery of your service based on generational differences.)
• Why did you choose us as your service provider?
• How long did you have to wait before you were provided with an appointment?
• How would you rate your overall satisfaction with our service?
• How would you rate the overall customer service you received?
• Did you consider any alternatives to our service? If so, how did you make your decision?
• Are you familiar with our website? (This can lead to several other website questions)
• What do you wish was different about our practice/service?
• Would you recommend us to your friends and family?  Why/why not?

The Last Thing to Consider

What do you do with the data once you have collected it?  Be sure to systematically analyze the information you are receiving.  Set up studies so you can chart improvement and catch problems early on. Thoroughly review data to determine if you should change services, personnel, customer service efforts. Your patients are a great source of insight for your continued and future success as a healthcare provider.

1)               What makes (or will make) your healthcare organization unique for your patients? Perhaps it is your service delivery or maybe it is your brand, but make sure that you come to your prospective patients mind in an un-aided fashion – essentially you want to be on their short-list for the service you offer. You want to know that your patients or prospective patients want and need your service.

2)               Do you have good knowledge of the healthcare market? Not only do you want to know what works best for your patients but you also want to know what your competitors are doing and offering.  You want to know everything that is happening in your specific market.  And you want to be able to know why your patients prefer you or why they don’t.

3)               In tandem with knowledge of your market, you want to know as much as possible about your existing patients. What do they appreciate about your service and are there areas in which you can improve?  Having a deep sense of your service prowess will aid in stable patient retention.

4)               How will you communicate with your customers and keep them in the fold? You want your patients to think about you beyond when they obtain their bill for your services.  How often will you communicate?  What will be the purpose of these communications?  How personalize can you make them?

5)               What type of customer relationship management (CRM) system will you use to keep track of your healthcare customers? You can keep track of your patients as well as the physicians who refer patients to your service.  Learn about them and collect information to help enhance your relationship development.

6)               What benchmarks are you going to set to help you recognize progress? As you plan, you want to make sure you have metrics in place that can help you assess your success.  Your metrics may change as you grow.  You may start with website hits or patient volume but as your processes mature, you may refine the metrics to help you assess your practices in more detail.

7)               What is your organization’s culture? Developing a top-down and bottom-up culture that promotes the patient experience can help develop your reputation and reinforce your branding.

Step One:  Define your competition

Make sure you don’t leave anyone out when thinking about your competition.  You may have competitors that surprise you – it is possible that the local drug store is opening a “minute clinic” or a new practice is opening a concierge service.  Don’t rely on what you think you know, ask questions and do the research so you are not surprised.  This overview will also provide you with the dynamics of the overall market.

Tip —  One method for locating your competitors is to look around – physically (drive around your neighborhood) and virtually (use Google Maps, check out industry association directories and/or use a keyword search and see what other businesses are listed.

Step Two:  Learn as much as possible about your competition

Start with their website to learn what they offer, how they position their services and how they deliver healthcare.  There are several resources/methods, depending on the size of your competition, that may provide good market intelligence:

• Harris InfoSource, a division of Dun & Brandstrett —  www.harrisinfo.com
• Hoovers (www.hoovers.com)
• Standard and Poors (www.standardandpoors.com)
• Hospital association(s)
• Hospital physician directories
• Generic search for articles
• FaceBook page information/posts
• Twitter feed
• Actually sample their service in some fashion

Step Three:  Assess strengths and weaknesses

It isn’t enough to collect the market intelligence about your competitors, work to understand what makes them strong and where they are vulnerable.  Analyzing your competitor’s market position allows you to position your organization more carefully in the market.  Consider any un-served or under-served facets in the market.  Healthcare marketing is often more about service and access than about quality because healthcare consumers struggle with identifying quality markers leaving much of the comparison resting squarely on service features.

Step Four:  Determine your competitive advantage

Once you have gained valuable insight from your market awareness, you can use this analysis to help frame or update your marketing position.  You want to emphasize your strengths as a healthcare organization.  What makes your service the most attractive to potential patients?  Do you have the most convenient schedule?  Is your staff the friendliest?  Does your physician offer a distinctive service – concierge, geriatrics, multi-specialty approach?  Focus on what makes your service appealing to your target audience.  How are you truly different from those competitors?

These four steps sound remarkably easy and they are but you would be surprise at how many organizations do not know the specifics about their competitors and rely on their gut versus true market data.  Base your actions and even reactions on your knowledge about your competitors not on rumors!

Forgive my blog-cation.  It was not completely intentional.  There was a death in my extended family and that set solid planning on edge. I am returning to weekly publication.  Onward!

Often, I tell clients to be careful with advertising expenditures.  Of course, they know they need to be careful because typically, for healthcare providers, budgets are small, small, small and demand for return on investment (ROI) is great.  But still, with this knowledge many healthcare marketers still want to plunk down valuable dollars on traditional media outlets without doing a solid analysis of what they will get in return and worse, they place advertising because of a knee-jerk reaction instead of considering the longer term requirements.

At a minimum, I ask that you have an overall promotion plan and create a budget.  I could push you just a bit more and suggest that you develop metrics for measuring the effectiveness of your outreach but that is a different post.  Right now, the focus is on the basics of developing a healthcare marketing budget.

As a percentage of sales, advertising expenditures vary considerably from one organization to another.  Pharmaceutical companies spend approximately 20% of their sales on advertising. It is unlikely that a hospital or medical practice will spend such a high percentage on their healthcare promotion efforts.  But what should you spend?

Different Methods of Determining  a Heatlhcare Marketing Budget

Method #1 – Historical

Built upon whatever was used previously, often with a percentage increase.  This method is not typically tied to overall objective.

Method #2 – Fixed percentage of sales

Often used in markets with stable revenue volume and where it is easier to see the direct relationship between sales and advertising.  Organizations have recently found this method to be problematic with the economic downturn for advertising budgets have been slashed just when they needed to be increased.

Method #3 –  Based on marketing objectives or tasks

This approach centers on creating objectives that the actual advertising needs to complete – i.e. number of physician referrals requested based on advertising about physician referral service.

Method #4 – Accepting industry average or based on competition

This approach is not dissimilar to method #1 but is based on the concept of an industry average that is accepted by market leaders.  This method does not work in favor of an organization wanting to increase market share by detailing competitive advantages or spending beyond the acceptable average.

Method #5 – What’s left

I don’t even like to include this method because it is counter-intuitive.  Essentially, an organization budgets for all other costs and then determines that the remainder of funds can be expensed to advertizing.  This method is reactionary and does not recognize the value of outreach and promotion.

Recommended Method

In lieu of the above methods, I suggest that you decide on your objective(s) first which is like method #2.  What are you trying to do with your promotion dollars?  Are you trying to increase visibility for your new wellness center or do you want to promote the new primary care physician?  First, delineate what you want to accomplish.

You will also need to consider who is your target audience and how you might best reach them. There are blog posts about marketing segmentation that can help you think about your targets.  Once you know your objective and target, it will be easier to consider the methods to employ to reach that market.  If you are targeting new moms, you may want to reach out to parenting bloggers.  If you want to focus on new members to your community, then piggy-back onto new neighbor outreach programs or consider library postings or even direct mail to new homeowners.

In some cases, you might want to have a large bill board, especially if you intended objective it to build overall brand awareness.  The point is to match you tactics to your objective.

Then prioritize based on resource availability.  Gather estimates for each medium and pick and choose your promotion endeavors carefully.  If you are building a longer term budget, you can experiment with alternatives and make quarterly or annual assessments based on effectiveness.

Okay, I know I am cheating because I told you that I wouldn’t cover metrics in this post, but let’s just take one moment to consider results tracking. Set up a tracking report for every promotion action, a spreadsheet will be just fine and include, at a minimum, the following categories:

• Outreach description
• Contact information
• Placement date
• Repeat runs
• Cost (labor, design and placement)
• Intended target
• Impact (measured how)
• Comments

Advertising, to be effective, needs to be planned, tested and analyzed. And always be able to answer the question – Is our advertising most-effective in this medium?

What Is a Market Segment? Okay, a market segment, just like that CT scan slice is a part of the whole. But the part has some similarities or shared features that allow it to be a part of the whole – a segment – that you can direct specific actions toward. And the particular segment is usually unique from other segments in the market.

What’s the Value of a Segment? Segmenting your market into more manageable groupings allows you to reach out to them in a fashion they are more likely to respond. By limiting who you are approaching and focusing on some core commonalities, you can get closer to satisfying your customers’ needs. You have tailored your approach to their specific concerns. You have zeroed in on the target and don’t have to speak in gross general terms: Do you need a urologist? vs. Are you getting up several times a time to urinate without much success?

Depending on the segment, it will respond to various channels differently. For example, one of your market segments might be female baby boomers. What might be the best way to reach them? You can try print ads in your local paper – somewhat expensive or, if you have been collecting emails for your existing patients, you might reach them via email marketing. If you segment is Gen Y females, you know they spend less time on email and respond more favorably to social media outlets so you might rely more on FaceBook or even text messaging. In either case, a market segment is measurable. You want to make sure you know the result of your action upon this segment so that you can correct or augment your approach.

How Do You Segment? Okay, so you understand that dividing your segment into common features will allow you to focus specifically. But how do you make the cut? Some traditional ways to segment a market include:

• Geographically
• Demographically (i.e. age, income, gender)
• Psycho-graphically (i.e. values, lifestyle)
• Or through behavior (i.e. utilization rates)

Remember that the value in segmenting your market means that you can tailor the message to have more success. This approach demands a greater awareness of service processes but also lends itself to providing insight into which segments are more successfully served based on your resources. Not only are you able to address the market segment more precisely but you will utilize your marketing dollar more wisely.

Basic questions to ask when determining a market segment include:

1. Is this segment the right size? Large enough?
2. Does this segment have an identifiable need?
3. How viable is the segment? Will it grow? How might it change? Is it fixed? Who is already serving this segment and how does that impact my service?
4. How difficult will this segment be to reach? Impact? Approach?
5. Can my organization serve this segment well? Do we have the correct resources?
6. By targeting this segment, is my organization remaining true to its mission? What is the best way to segment?

Taking the first step is often the hardest. You may be re-tooling your outreach or starting fresh. Either way the process is the same. Take your current patient base and think about them in aggregate. Then look for some trends or common features. Do you see some patients more often? Are there more profitable services that certain types of patients need? Or, if you are working with physicians, do you want to focus on primary care providers? You want to find the commonality that suits treating the segment as a group – that will help you direct outreach to them in a more precise fashion. Segmenting by specialty allows you to develop a strategy that is more targeted and meaningful to that physician. Or in the case with your patients,  for example, if you are an OB-Gyn and want to grow your gynecology care, you might segment by age. Your outreach efforts will be more successful the more precisely you target your audience because you are creating messages that focus specifically on that targeted segment. If this process is new, you may want to start by just targeting one segment and seeing how it goes. And, like any outreach effort, make sure you track your results and tailor your efforts according to those results.

Okay, that’s it for healthcare marketing basics: segmentation. Next week we will look at your outreach budget.  And by the way, in case you didn’t know, SEO means search engine optimization. 

Periodically, I will gather thinkers or information and report on different perspectives to provide fodder for the rest of us to consider, mull and hopefully discuss.  I just heard an interview with the CEO at Cleveland Clinic, Toby Cosgrove, M.D. Check out the link but I have also included some key bullet points below – in most cases, the bullet points below are direct quotes from the interview posted on Fortune, February 17, 2010, on CNN/Money:

• We do not have a system of health-care delivery in the U.S. It’s a series of mom-and-pop shops all over the country, and it has not been systematized.

• So regardless of what happens [with reform], we can really only try to contain the rate of inflation. The cost is going to go up over time.

Cost drivers?  Areas to seek improvement?

• Let’s take obesity [as a health concern and cost driver.] It accounts for 10% of the cost of health care in the U.S. — we will never be able to control the cost of health care until we begin to control the epidemic of obesity. Two-thirds of the U.S. is overweight, and one-third is obese. We are the fattest nation in the world.

• [When considering preventive measures for employees,] it’s always been a question of “What’s the ROI on this?” Until very recently, people didn’t realize the ROI is probably 3 to 1: For every dollar invested, you get three back in terms of employees being better.

• Three things — smoking, diet, and lack of exercise — cause 40% of premature deaths in the U.S. They contribute to 70% of the chronic diseases, things like emphysema and heart disease. And that’s 75% of the cost of health care. It’s huge!

How Cleveland Clinic is different:

• Very few hospitals are organized the way we are. First, all of us have salaries. It doesn’t make any difference, if I’m a cardiac surgeon, whether I do two heart operations a day or four. I take home the same amount of money at the end of the week. So there’s no incentive to do extra tests or any of that.

• Second, we all have one-year contracts, and we have annual professional reviews. So the quality of the doctors is controlled, there’s no tenure, and if you don’t make it, you don’t get a pay raise or you may not stay. That is one of the most important things we do. It’s quite different from most places, where doctors can practice for as long as they want to practice.

• We are physician-led, which is quite different from most medical organizations…

How will hospitals change?

• There are a lot of very successful for-profit hospitals. I think what we’re going to see is a roll-up of hospitals. I don’t think it’s reasonable anymore to think that each hospital can be independent — have its own financial support, its own purchasing, its own back office. You need efficiency.

• We have an electronic thing called MyChart, where you can go on the Internet and read your record. Few other hospitals around the country have done it. But we think it’s the patients’ information. It’s about them. We’re working for them. Why shouldn’t they have the data?

Here is the link to CEO of Cleveland Clinic interview once more…it is worth reading Dr. Cosgrove’s thoughts and the interview is well done.  Keep the conversation going!

The American Society for Hospital and Human Resources Administrators recently released a study of the workforce trends for the year 2015.  Entitled, “Strategy Trumps Shortage”, they came to the following conclusions:

• Work processes will need to be redesigned
• Retention of existing staff is critical, even those able to retire
• Companies must do the right things to attract the new generation of worker

While on the surface, these conclusions don’t seem to be much different from what we have heard in the past, when you put them into the context of the current generational shift going on in the work force, they are actually quite relevant.

Let’s start with work processes…By 2015, the majority of our workforce will be made up of Generation Y and Millennials.  These generations thrive on independence, rapid feedback and a desire for balance between their work and personal lives.  They are much more likely to judge their organizational experience on individual relationships…not on the overall organization.  Therefore, they will chose to work for places where they can exercise their creativity within a flexible work environment.  Are you designed to meet their needs as an employer, or does a top down, hierarchical environment best describe you?

Thinking about retention of staff, one of the greatest expenses a company incurs is in losing a staff member.  The hard costs of a turnover include the money spent to fill the gap until a person is hired (overtime, temporary staff), training time for the new person, loss of productivity during the training period and others.  While some turnover is good, it’s key to understand who you are losing.  If it’s your good people, something in your environment needs to change.  Your good people can always find a job, and they are the ones providing the great experiences for your customers.  You cannot afford to lose them.  Find out what motivates your top performers to stay.

What about attracting the new generation of worker?  As noted above, the newest generations look for a workplace that will allow them the freedom to not only do their jobs, but to also design how they would like to do those jobs.  While there are certain requirements and rigor to each job, it’s important to look at where you can be flexible.  While tradition is important, doing things the same old way just won’t endure.

To meet these challenges, the study noted that there are certain leadership approaches that will be necessary to create environments so that employees will be energized and focused on providing your customers with great experience.  Some of those traits include:  an appetite for change, the desire to engage the workforce, the thirst for innovation and an approach that welcomes new generations to the workplace.  Do your leaders possess these traits?

To best serve your customers, you must best serve your employees first.  Make it a focus for 2010 and you will see great results!

OUR GUEST BLOGGER:  Catherine Baumgardner has extensive experience in leading operations of clinical services for a regional health system, and in consulting with clients to develop and implement strategies that will deliver desired results. Her outstanding skills in customer service culture development and implementation have made her a favorite choice with her clients.  If you are looking for someone with a strategic awareness to customer experience and operational excellence, Catherine is a good person to contact.  She recently started her own consulting firm, Catherine Baumgardner and Associates and we are pleased to have Catherine as our first guest blogger!