This is a blog dedicated to the Marketing of Healthcare Services. I welcome comments and feedback.

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Sunday, December 27, 2009

Doctors and Healthcare Advertising in India


Many years ago when I worked at a hospital chain, our advertising agency had come up with a campaign featuring happy patients. The hospital wanted to showcase their doctors. The objective of the advertising was to showcase the hospital’s expertise and superior services and position it on the ‘care’ platform.

The advertising agency and the hospital had been at loggerheads on this. The agency was dead certain that showing hospital doctors in ad visuals was a bad idea. They had come up with the images of happy people, who had had wonderful experiences at the hospital. The copy proceeded to narrate the experience in glowing terms, capturing the essence of the hospital and making a point about its medical and other services. I had liked the ads, though I found them a little run of the mill. Nothing very extraordinary but steady communication, which made its point. It however never saw the light of the day.

In those days (and I suspect in many hospitals even today) the brand manager had to run the ads past the medical folks. The prevalent thinking was that the medical people will be able to spot bloomers and also come up with great suggestions and those could be incorporated in the communication. However, I quickly learnt that the reality was usually very different. Most medical folks had very little understanding of consumer facing communication, and most wanted themselves featuring in the ads. Many also wanted images of them operating on patients and were keen to showcase all the gory details of their glorious profession. Some even had suggestions on how ad copy headlines and even hospital logo was to be arranged. The advertising agencies hated this mutilation of their advertising and the brand manager had the task of balancing the demands of the doctor, the agency and the brand itself.

As I gained in experience, I realized that a lot of hospital advertising had very little to do with end consumers. Now, this may sound absurd, but let me explain. Often hospitals would hire high profile doctors committing huge marketing spends on promoting them and their specialities. This would be the understanding between the hospital bigwigs and the doctor concerned. Thus, a significant purpose of the advertising will be to keep the doctor in good humour and honour a commitment made to him. Thus the doctor would legitimately expect to feature in the communication and try and showcase his skills.

Unfortunately, even now one rarely comes across real ‘brand’ advertising in healthcare in India. Most hospitals still prefer to bet on individual doctors and shy away from investing in the hospital brand. New hospitals do a little ‘launch’ related advertising, however there too quite often one encounters a well known doctor prominently featured in the communication.

Recently I came across advertising for Alchemist Hospital in Gurgaon, featuring the well known cardiac surgeon Dr. P Venugopal. He was till recently the director of the All India Institute of Medical Sciences and has now joined Alchemist Hospital in Gurgaon. Max Healthcare announced the commencement of their cancer services leading in with the doctors they have hired. They also ran ads featuring Dr. Pradeep Choubey, a well known laparoscopic surgeon who has joined them from Sir Gangaram Hospital.As a consumer, why do I need to know how Dr. Choubey looks to understand that he has now moved from Sir Gangaram Hospital to Max Hopsital. Yes, as a consumer I would like to know how Dr. Choubey’s expertise and services makes Max Healthcare a better hospital.

Seeing these ads recently reminded me of my struggles as a young brand manager. Even after so many years, it seems in healthcare communication nothing much has changed.

Here is wishing everyone a Merry Christmas!!!

Pic courtesy www.istockphoto.com

Friday, December 11, 2009

The Importance of Small Things in Hospitals


Here are a bunch of ’small’ things I noticed during the 3 days I attended on my father, who underwent prostate surgery in a South Delhi hospital a couple of weeks ago. On their own, they really do not count for much and I am sure they did not impact the care my father received during his convalescence. However, do they add up to a less than satisfactory customer experience, I leave you to draw your own conclusions.

1. Right behind my father’s pillow, on the wall there were stains, which looked like congealed blood. In two places in the room, the plaster had pealed off.

2. The walls had marks, most probably made by the patient beds rubbing against them particularly when the patients are transferred from the room. The walls look like they need a fresh coat of paint.

3. The patient beds had mechanical controls requiring a lever to raise or lower them. The lever jutted out from under the bed and when not in place, one could safely conclude that it had been borrowed by the patient in the next room.

4. There were for some reason no curtains around the patient’s bed.

5. The sofa cum bed meant for the attendants had a ragged worn out handrest.

6. There appeared to be hoards of people in the in patient areas. The hospital corridors were always humming with either hospital staff or patient attendants. Many whiled away their time at the bustling nursing station, which also appeared to be the hospital staff’s favourite spot for socialising. Attendants merrily browsed through patient files, their own as well as anyone else’s.

7. All the trolleys used for transporting food, medicines, linen etc. squeaked to high heavens. Someone just forgot to have their wheels greased in a long time.

8. There is nothing called ‘Do not Disturb’ sign in the hospital room. On a particular day we had 16 different set of people requesting permission for something or the other. When does a patient get to rest?

9. Newspapers were never delivered in patient rooms, while a huge bunch lay about at the Nursing station.

10. The F&B services really take the cake. On day 01, my father was served soup and sandwiches 5 times. The same soup and the same soggy sandwiches all the time. The next day, he did not get anything to eat till lunch because the dietitians thought that he was to undergo a surgery that day, never mind that that the surgery was scheduled the next day! The rice was served on the tray mats and one was to eat straight from there. In spite of requesting for a non-vegetarian diet, he received a vegetarian meal and the best of all, even after clearly indicating his allergy to egg (boldly mentioned on his medical file for all to see except the dietitians!), he did manage to get an omelet for breakfast.

11. The hand sanitizer was empty and was removed on my request. The new one never materialised.

12. My father was taken for an ultrasound. He was wheeled out on a wheel chair and taken to the radiology department and was kept waiting there for 40 minutes, with his bladder full. Apparently no one coordinates this. The OPD and the IPD patients are taken down Radiology and than they await their turn, without anyone knowing how the system works. (Strangely, when I screamed at a lady sitting in one of the offices adjacent to the Ultrasound room, my father had his ultrasound on the double).

13. Finally, I pointed out a small mice which ran around in the area occupied by the hospital’s TPA executive.

Looked in isolation these incidents perhaps do not amount to much. Some may even accuse me of nitpicking but the fact remains I did notice all this and it made me immensely sad. This is a hospital I was involved with during its early days and I am fully aware of its founder’s commitment and the high standards he had set towards patient care.

While my father had a uneventful surgery and a quick recovery for which I am immensely thankful, the customer experience was really not something to write home about. I wish someone, somewhere is listening.

Friday, December 4, 2009

Why some of our doctors have such poor bedside manners?


I have often thought about, why some of our doctors have such poor bedside manners and never more so since my father’s surgery.

My father underwent an urgent Prostate Surgery earlier this week. The surgery was conducted at one of the most well-known and if I may add, sought after hospitals in South Delhi. The hospital and the surgeon are familiar to me from many years and yet this is what happened one evening.

The surgery in the morning had been uneventful and the surgeon was happy with my father’s progress. In the evening as my wife and I sat in his room in the hospital, two gentlemen barged in and started examining my father. They lowered his pyjamas for the examination, chatted with each other, assured him that all was well and walked off. As they were leaving I asked them who they were and one of them introduced himself as an associate of my father’s surgeon and left.

Now here is my problem.

I have no idea who these people were. They wore no surgeon’s gowns, they had no telltale stethoscope around their necks. They marched into our room without a knock and proceeded to examine a patient, without his permission. They removed his pyjamas for an examination, with two people sitting in the room and the door wide open. I was shocked to witness this humiliation and I could feel my father’s acute discomfort.

To the doctors, strangely nothing appeared to be amiss! When I stepped out to have a word with these gentlemen and pointed out their completely unacceptable behaviour, they appeared surprised that a patient’s attendant has the gall to question them and arrogantly dismissed me saying that if I had any complaints I needed to address those to my surgeon! They did not deem it fit to utter a word of apology for their appalling conduct.

All this at as I said earlier at one of Delhi’s finest and most expensive hospital.

Why do some doctor’s treat their patients as if they do not exist or matter? I believe this is primarily because we patients allow them to. In India, a career in medicine enjoys tremendous social prestige and doctors are treated with enormous amount of respect. We bestow on our doctors God like powers of life and death and since in our eyes they are Gods, we refuse to see their shortcomings and failings. Gods afterall can treat us, the mere mortals, as they please.

To make matters worse, most of our doctors receive their training in government hospitals, where the poor and the uneducated see these doctors in their shiny white coats and stethoscopes as people from another world. In these hospitals overflowing with people from ‘darkness’ (to borrow a word from Arvind Adiga’s ‘The White Tiger’) they are treated as the lords and the masters of all whom they survey. These doctors from an early stage in their training imbibe these behavioural patterns and one assumes that in later life, in different hospitals and while treating educated folks, the old habits refuse to die.

Lastly I also believe, that parental and peer pressure force many a youngster to choose medicine as a career, while they just do not have the calling. The admission procedures are also flawed as they test knowledge but not aptitude. Thus we have doctors, who have no business being doctors. They are trapped in a glorified profession from which there truly is no escape. Can we really blame them for (mis)treating patients the way they do?

How do we cope with such arrogant and errant doctors? Well, I see no reason why we cannot simply ask them to treat us better. Their ego may stand in the way of apologising or showing contrition, but I am sure they will think twice about being discourteous the next time around.

And that should be a good enough start.

PS:Lest this sounds like a diatribe against doctors I hasten to add that I also know many very competent doctors who treat patients with great courtesy and professionalism. They are warm individuals, love their profession, have great compassion for the sick and look upon their profession as nothing less than a calling. They not only treat but heal and that is where the real difference lies.

PicCourtesy: http://thyroid.about.com/b/2008/08/19/six-rules-doctors-need-to-know-and-six-ways-to-be-a-better-patient.htm