Why do the Hospitals need to invest more in Advertising?

Hospitals in India hardly advertise. Most of them look at advertising as an unnecessary expense and keep it minimal. This really need not be so. Looked from another angle, advertising for a hospital can be a critical investment, which allows it to differentiate its services, educate customers about its core beliefs, introduce new products and services and help gain new customers. Unfortunately, in India hospitals believe that customers do not appreciate hospital advertising and may even be put off by it. Many hospitals, who are doing well do not see the need for advertising. With occupancy rates high, the hospitals feel they are wasting money by advertising. Little do they realise that advertising quite often is not only about getting more patients.

To make matters worse, whatever little advertising one sees is mostly inane and dull. The communication usually bears the imprint of too many cooks adding different flavours to the advertising, making it a weird medley of pictures, long copy and a strange layouts. The marketing teams in the hospital are forced to accommodate various view opinions (that of the hospital COO/CEO, the heads of medical departments, other leading physicians, the sales head, and sometimes the owner of the hospital ) to arrive at a piece of communication, which is usually a disaster from a marketing communications point of view. While, this piece assuaged inflated egos, ensures gory pictures (usually reflecting some landmark surgery) in the ads, highlights achievements of some or the other doctors, it fails in its primary purpose of connecting with the end-user.

Here are a few reasons, why hospitals should look at their advertising a lot more seriously and spend money wisely in connecting with their customers.

Core Beliefs and Positioning

A hospital must advertise its core beliefs through a well thought of brand campaign. It is imperative for customers to know what their hospital stands for, what its core values are and how does it strive to stay true to those beliefs. Thus, if a hospital professes to provide ‘Total Patient Care’as a consumer I would love to know, what it means and what all can I expect from the hospital. Similarly if a hospital is positioned as a ”cutting edge technology” centre I would like to know what that means to me as a customer. A hospital must stand for something in the consumer’s mind. I am not sure, our big hospital brands Apollo, Fortis, Max and Wockhardt (now part of Fortis) have been able to establish any kind of distinct identity in the consumer’s mind.

Products and Services

A hospital offers a multitude of services. Customers need to know about them and hence advertising is a good way of keeping customers informed. New services keep getting added from time to time and the hospitals need to keep their customers updated. Recently Max Healthcare started its cancer services. All that they did was release a solitary advertisement, welcoming the new Chairman of Cancer services!!! The ad was also supposed to serve the purpose of informing the customers about the commencement of cancer care services at the hospital. Wouldn’t it make greater sense to announce the commencement of a service with a nice campaign and if needed also feature the medical leader/team in the ads?

Hospital Launch

A new hospital commencing operations needs high decibel advertising. Artemis did this well, when we launched the hospital. We had large bill boards in Gurgaon, a fairly heavy presence in the local print media and local community engagement through ‘fam visits’ to the hospital. I recall Max Healthcare during their launch also did a fairly well orchestrated multi-media campaign. However, many hospitals too try to save money by launching quietly and hoping the customers will come through the word of mouth or through doctors pulling in their existing customers. I believe, these are sub-optimal ways of launching the hospital’s services and an old-fashioned media blitzkrieg works the best.

Renewing Existing Services

Sometimes it is necessary that a hospital ‘renew’ its existing services. These days, I am seeing some bill boards near my residence advertising Apollo’s new Knee Clinic. The communication is targeted at the elderly, informs about the new Knee Clinic, which offers Knee Replacement services at the hospital. Now, Apollo hospital has been doing knees for a long time, however the communication is trying to repackage the service and relaunch it. Unfortunately, There are just two bill boards and, while the intent is laudable, the hospital is being very stingy. Similarly, while in Bangalore recently I came across a ‘Short Stay Surgery’ campaign by Wockhardt Hospitals. Again the effort seems to be to reposition their Laparoscopic Surgery services in a customer friendly matrix, but the money behind the campaign appeared too little to make any significant impact. Other hospitals too need to often ‘renew’ and repackage their services smartly.

Driving Traffic

Hospitals can drive traffic to their OPD’s through innovative offers. In fact the bulk of hospital advertising today focuses here. A free Cardiac Camp around the World Heart Day is routine. Similar camps and offers in other specialities help drive traffic to the hospital OPD’s. The problem here is that hospitals do these sporadically, without adequate planning and often as band-aid solutions to transient OPD traffic related issues. Tactical campaigns need to be more consistent and better planned to yield optimal results.

Educating Customers

Wouldn’t it be wonderful if a hospital did an educational campaign about let us say heart disease or diabetes or any other lifestyle diseases. The campaign should aim to educate customers about the disease, its symptoms, treatment options, success rates, technology available and the medical expertise available to treat the disease. The objective should be to inform the customers, help them ask the right questions and thus make the right choices. Unfortunately, none of our hospitals including the big chains are willing to invest in patient education simply because the returns are relatively long-term.

Pic is indicative.

Indian Hospitals Need New Online Initiatives

Websites of Indian hospitals are hardly something to write home about. They are mostly poorly done, difficult to navigate and usually the information lies buried so deep that it tests ones patience to get the relevant information . The other day, it took me close to 20 minutes and numerous clicks to locate the address of a hospital from its website. I needed the address to send a Diwali card to a friend who works at the hospital and try as I might, I just did not seem to find the address of the hospital.

Almost all of the hospital websites that I am familiar with are largely static. Thus, they do not interact with patients or caregivers looking for specific information. They do not allow one to book appointments, download reports, interact with doctors taking care of ones loved ones, send good wishes or chat with the patients. They do not support e-commerce. Thus if I was an NRI living abroad and wanted to buy my parents an annual health check or if I wanted to pay their hospital bills on line, I just can not.

In the era of burgeoning medical travel and with Indian hospitals attracting a sizable chunk of patients from all over the world, this does seem strange. For some unfathomable reason, Indian hospitals have not invested too much on their websites or for that matter on online marketing per se. I believe it is high team someone woke up and used the net better.

It is indisputable that a certain kind of Indian consumer has fully embraced the e-revolution and their tribe is growing by leaps and bounds. With the broadband penetrating deeper, more and more Indian consumers will look at the internet for information, entertainment and commerce. They would seek information about doctors, medical facilities and would like to compare medical outcomes across hospitals. They would like to chat with doctors and customer experience executives in the hospital before making a choice. A hospital aspiring to attract these kind of patients must consider significant investments in their websites and in enhancing their online visibility.

The entire gamut of social media on the net can also be used by hospitals in interacting with their patients. At Artemis, we tried creating an online community of patients and caregivers, where members could post their hospital experiences, their recovery post discharge from the hospital, photographs showing their progress and interesting pieces of information on their disease and latest advancements in medicine. We also encouraged hospital doctors to interact with members of this community. Unfortunately the hospital discontinued this initiative once I left. The hospital was cutting costs and building an online community was considered too ‘long term’ for investments to continue.

The next level of online presence would require hospitals integrating their Hospital Information Systems (HIS) with their websites allowing patients and their relatives on line interactivity. This will facilitate hospitals inviting second opinions from experts anywhere in the world, keeping the patients family and relatives (who might be half way around the world) in the loop on the patient’s progress, interaction with their doctors and online payments. The big issue here is the online security of patient information. The hospitals will have to invest in a foolproof system, which guarantees authorised access to medical data. It would be a disaster if a hospital integrates its website with HIS and leaks confidential data.

With the current level of IT advancement, this and more is certainly possible. Indian hospitals have to look at these opportunities seriously and start investing. The returns would quickly follow

National Emergency Services-The Need of the Hour

The other day I was at the Delhi airport early in the morning waiting for the security check to get over, when I realised there was some commotion ahead in the queue. As I moved on, I saw a man flat on his back, and a lady, apparently an air hostess trying to revive him by administering the CPR. There were a bunch of people including some security men looking on. The lady was doing her best, but it was quite apparent that she would not succeed. She appeared to be going through the motions rather than making a desperate attempt to save a life.There was no one else to help her, while many watched idly. I did not see any medical personnel or the emergency medical paraphernalia, that one would expect on such an occasion. The man had been without a pulse for almost 20 minutes, before CPR had commenced.

How can a busy airport (brand new to boot) be without adequate medical emergency back-up? Almost a year ago when I was working for Artemis, we had proposed to the authorities to allow us to set up an emergency service at the airport. Artemis is reasonably close to the airport, has an Advanced Cardiac Life Support (ACLS) equipped ambulance service and the hospital is fully geared to manage medical emergencies round the clock. Nothing came of our proposal and the last we heard was that Indraprastha Apollo Hospitals has been awarded the contract to manage the medical room at the airport. Apollo Hospital is all of 40 kms or more from the airport and with the traffic that one usually encounters on the way, there is no way that an ambulance can reach the hospital in less than an hour. That fateful day, there was no one for at least 30 minutes from Apollo or anywhere else, to help the unfortunate man.

India attracts scores of patients from across the world, most of them benefit from the world class healthcare services now available in the country yet we do not have an emergency service that can be remotely called world class. This is a serious concern.

The government must take the lead in establishing a centralised medical emergency service through a statutory body, let us say, Medical Emergency Services Authority of India. It can work out the details of how this service will operate, the nodal hospitals, the communication infrastructure and the logistics of transporting patients to these network hospitals. It should set clear guidelines on managing emergencies (who, what, where, how), establish internationally benchmarked service levels and establish a monitoring authority to measure efficiency and service levels

The Medical Emergency Services Authority should be allowed to set up emergency handling outlets in high traffic areas like airports, on national highways and busy malls etc. The Authority would be required to invest in the communications and transport infrastructure including paramedical personnel, while the participating/network hospitals will be responsible for patient's care once the patient reaches the hospital.

While all this and more is possible, the key question is whether we should have private participation in something like this. I believe we should not. This is a service that should be rendered by the government to its citizens in distress. It should be paid for by the taxpayers. The government can charge a small sum from the taxpayers annually to keep the service afloat. The real challenge for the government would be to maintain high standards in the face of crippling bureaucratic controls that underlie all government initiatives. Corruption, sloth and inefficiency so characteristic of all government organisations must not be allowed to eat at the vitals of this service.

Easier said than done. Maybe the government can find another Nandan Nilekani or an E Sridharan and give him a free hand to set this up. I would like to believe if there is a will and a burning desire to accomplish something as important as setting up the National Emergency Services a way can certainly be found. It is afterall the need of the hour.

Pic courtesy www.flickr.com

Akkriti Bhatia and healthcare services in our schools

Here is the tragic case of Akkriti Bhatia, a 17 year old school girl, who died yesterday after collapsing in her school. The Hindustan Times reports that Akkriti complained of breathlessness to her classmates, who then called her mother to send a car to fetch her. Apparently when the car arrived, Akkriti requested her teacher’s permission to go home. The teacher realising that she was seriously ill sent her off to the nearby Holy Angels Hospital, where she was declared ‘brought dead’. Akkriti, it seems died on her way to the hospital.

This is a tragedy that could have been easily averted. Akkriti was an asthamatic child. This was known to the school authorities. Yet it seems there was no one in the school, who had the sense to realise that the girl was in acute respiratory distress and someone needed to call an ambulance. Apparently the school by way of medical support had a medical room and a nurse, and the young girl was administered oxygen in the medical room. Curiously enough when her mother’s car came to pick her up, she was taken off the oxygen cylinder and was sent to the hospital gasping for breath accompanied by the school nurse and another student!

How is it that no one realised how ill Akkriti really was? Why did no one summon an ambulance and trained paramedics? Why was she sent in a car, without oxygen to the hospital? Who should be held accountable for these lapses? Are our children safe in schools?

I believe that the school was just not equipped to take care of an emergency. There was no one including the nurse, who understood the gravity of the problem. I also suspect seeing the child’s condition deteriorating, the school authorities paniced and failed to act rationally. There was neither a person nor any system to deal with a situation like this and in the ensuing confusion, a patently wrong decision of not calling an ambulance and attempting to transfer Akkriti in her mother’s car without oxygen was taken, pretty much sealing her fate.

This is scary.

Particularly, when I know hospitals routinely approach schools requesting them to manage their medical rooms professionally with well trained staff (doctors and nurses), equipment and supplies and emergency hotlines being available all the time. While working for both Max Healthcare as well as Artemis Health Institute in Gurgaon I have myself in the past proposed such arrangements to various schools. I am afraid not a single school responded favourably. The school authorities usually fobbed us off by saying that they had a nurse and at times a doctor, who visited the school two hours a day and they believed that this was more than adequate for their needs. The hospital was always looked upon with suspicion of making money off the school. Many a times, I would request our paediatricians to accompany me to help convince the school head mistresses but all to no avail. They just could not look beyond their noses and my old fear of school authorities would make me beat a hasty retreat.

The blame for this tragedy must lie squarely with the school authorities. A child, while in school is their responsibility. In an emergency they must have set protocols and trained personnel to handle the situation in an orderly and efficient manner. That a well known school like the Modern School, reacted in a manner that cost one of their student’s her life is not only tragic but downright shameful.

Pricing Healthcare Services

The pricing of services in a hospital is perhaps one of the most complex and difficult exercise undertaken by the hospital managers. Pricing is  usually a Marketing function in most industries and the final call would usually rest with the Marketing chief. However, in hospitals this seldom happens. Pricing issues are generally discussed and debated in the executive committees and the leadership teams, views are sought from senior medical leaders and usually a consensus is arrived at. l,

Many hospitals follow a ‘market based’ pricing model, which simply means they comb through the pricing policies of their competitors, get pricing data from various labs and other diagnostic centres through their referral sales teams and establish their pricing either basis a premium or a discount from their chosen competitors.

Very few hospitals have a ‘cost plus’ pricing system. Developing an accurate costing of all medical procedures is next to impossible. This is simply because the medical consumables used vary from doctor to doctor and also depend on the complexity, age and general condition of the patient. The cost is also invariably a function of the training and competence of the concerned doctors and medical staff attending on the patient. Thus the cost of a bypass surgery may vary dramatically depending on the condition of the patient, the competence of the surgeon and his team and co-morbidities like diabetes.

The calculation of a price is usually based on a ’surgeon’s fee’. On top of this is added the cost of anaesthetic gases, the anesthetist’s fee, an OT fee and OT consumables. The surgeon’s fee is usually checked with the hospital’s surgeons and if it is Rs. X, the fee for surgery inclusive of gases, anaesthetist’s fee and the OT charges usually adds up to Rs. 2X. 

The patient on top of this is charged room rent depending on his choice of the hospital room, the cost of medicines and room/ward consumables and all diagnostics. The hospital also charges exorbitant consultant’s visiting fee every time he/she visits a patient in the hospital. (Some hospitals like Artemis cap this to a maximum of two chargeable visits). Strangely all hospitals charge a premium on all services if a patient chooses a single or higher category rooms. This simply means that if one opts for a single room one pays higher for everything, the surgeons fee, the cost of surgery and diagnostic tests. Most people do not know this and believe that the hospitals charge a premium only on room rent. Many would consider this a pernicious practice simply because a surgeon’s skill and time, which are the determinants of his fee has nothing to do with the room category a patient is in.  

Some hospitals like Max Hospitals create price bands for surgeries based on their complexity and average duration. Thus all surgeries in a particular band has the same basic surgeon’s fee. On top of it is added everything else.

Healthcare Pricing in India is still very unscientific and subjective. This is a far cry from the pricing models prevalent in the US, where ICD and other scientifically designed parameters help assess the cost of a procedure and patient billing. Health Insurance companies have been able to push through accurate and scientific billing procedures.

The need for a better system for patient billing in hospitals is acute. The government must establish a regulatory body to help fix the basic billing rules for all hospitals. The hospitals should than be allowed to price themselves as they wish keeping in mind their expenses etc. I would reckon once insurance companies gain prominence as payors, they would start dictating their terms to the hospitals.

And that would be a different story altogether.

Homeopathy in a Modern Hospital

A few days ago I received an sms from Artemis Hospital exhorting me to check out their Homeopathy services! This seemed strange as Artemis Hospital is one of the most advanced centres of medical care in North India and boasts of the highest level of medical advancement. It has invested tonnes of money on advanced imaging equipment such as a 3T MR, a 64 slice CT scanner, a PET CT and a 4D Doppler amongst other fancy stuff.

Artemis has highly experienced doctors and surgeons who literally operate on the cutting edge of technology. Amongst all this Homeopathy seems to be a little out of place.

Ask any doctor worth his salt about homeopathy and other alternate systems of medicine common in India and he will be downright derisive or at best will say that he is not sure of their efficacy. Doctors are trained in the science of medicine and surgery and rely on scientific evidence proven in laboratories and tested on animals and humans in scientifically designed and executed clinical trials. For them to accept homeopathy, ayurveda or the yunani system of medicine as effective treatment is difficult. Yet we have a modern hospital offering the services of a homeopath. I am intrigued.

Now, I have nothing against any system of medicine. I am sure the practitioners of any of these alternate systems of medicine have their own methods of diagnosing and treating people and I would also concede that there are enough people who believe in them. However I do know that God forbid, if I ever need serious medical attention I would head straight to a doctor qualified and experienced in the western system of medicine.  To me that is a straightforward choice.

I am also against mixing the modern western medicine with the likes of homoepathy and ayurveda. They just do not mix well. I would think twice about referring a friend to a modern hospital, which also offers homeopathy and ayurveda. Somehow, it appears that the hospital and the medical folks do not have enough faith in their own system of medicine. It seems like a tacit admission of the fact that these ancient alternative systems of medicines have something to offer even when modern medicine has failed. This I personally find hard to believe.

Arguments about offering a choice of medical systems to patients are also common place. This to my mind is bunkum. The patient wants a cure for whatever ails him. He wants it fast,with minimal pain and with a certain degree of reliability. He cares two hoots about the choice of medical system. If he walks into a hospital, he has already professed his faith in the western system of medicine. Offering anything else to him is downright foolhardy.

Why would Artemis hire the services of a homeopath and than go about promoting it? I can only say that if they are serious about homeopathy, they can always consider launching a homeopathy institute and call it something appropriate. After all Artemis Homeopathy Institute does sound weird. 

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.  

Neighbourhood Engagement

A hospital wanting to have a buzzing OPD, must try and engage with those living in the neighbourhood. A busy OPD usually means that the hospital enjoys the patronage of its neighbours in a big way. Thus weekend neighbourhood health camps,  regular clinics in the societies around the hospital and fam visits to the hospital by local opinion leaders goes a long way in establishing a good connect between the hospital and the local communities. Neighbourhood relationship programs offering benefits to local residents and the senior citizens always works.

Connecting with the Doctors

It is imperative that the doctors doing the OPD's connect with the local populace. Artemis Hospital started doing a monthly lecture involving its senior doctors. Every month on a Sunday morning the hospital would invite residents to listen to its expert doctors talk about Heart Disease, Arthritis, Back Pain and even more serious issues like dealing with Cancer. The program worked well with the auditorium filling up and people have a wonderful time interacting with the experts. They got to know and interact with the doctors outside their OPD chambers and it worked wonders in establishing relationships. 

Local Advertising

Local advertising helps the hospital brand remain top of the mind. Advertisements talking about the hospital's philosophy and commitment, its super specialities, its highly evolved expertise in certain areas and the emergency services help demystify the hospital and keep it fresh in the consumer's mind.

Specialised OPD Clinics

With in the OPD there is always the opportunity of establishing super specialised clinics involving several consultants and services and offering these as a bundled convenient offer. Thus a diabetes clinic would involve a diabetologist,  an ophthalmologist, a podiatrist, a dietician and even a psychologist. They can come together to offer a package, which would involve round the year care through active follow ups and regular testing. 

These are just a bunch of thoughts and I am afraid nothing very revolutionary. However, I have seen in my experience that very often hospitals fail to do these 'small' things consistently well. The programs are initiated and then abandoned, management attention gets diverted to more flamboyant projects and these 'day to day' programs are given short shrift. I believe that OPD's can only be built gradually, one step a time and constant engagement through well thought out programs and communication goes a long way in establishing the trust, which drives the OPD.

Hospital Marketing 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.

Members of the local community are not going to queue outside a hospital just because it has opened its doors in their community. They have existing relationships, habits and healthcare consumption patterns that they have been comfortable with for years. A new hospital needs to make a serious effort to engage with them and persuade them to give the new hospital a try.
Some of the things that I have learnt, while being involved in the launch of 5 hospitals in the last few years in and around Delhi involve strategies for creating awareness, engagement and a uniquely differentiated experience to those in the neighbourhood.

Local communities will start taking an interest in the hospital if the hospital takes the initiative to engage with them. At the Artemis Health Institute in Gurgaon we started a program, which involved conducting a healthcamp in the condominiums in the neighbourhood of the hospital. The camps were held with clockwork regularity for more than a year. In the initial stages I would often go myself and hang out with the residents, while they met the doctors and underwent basic tests. I and other members of my sales team would talk about the hospital's facilities, services and the like without making it apparent that we were actually delivering a sales pitch. I would also meet the office bearers of the the local condo associations and discuss over a cup of tea as to how the hospital can be a part of the life of the local community. Since most of them were elderly folks who would need healthcare, this was generally a topic of great and often personal interest.

We soon hit upon an idea that in communities where the numbers of the elderly were large, we may set up small clinics with in the community. The clinic was run from a small room provided by the community and we would send a doctor for a few hours per day. The community also allowed us to advertise the clinic, which created greater awareness about the clinic and by association of the hospital. Soon we started getting referrals from these clinics and the emergency calls too increased. Buoyed by the success of the experiment we set up a few more clinics and with in a year we were getting calls from various communities asking us to open these clinics in their communities. The good word spread quickly.

At Artemis we also started awareness programs called 'Public Forums', which were lectures delivered by our doctors. We would advertise the lecture let us say on 'back ache' through print ads in local newspaper supplements and handbills. We would hold the lectures on Sunday mornings in the hospital auditorium and would typically have over 200 people from local communities attend. The sessions will include a lecture followed by a lively question and answer session with the experts and end with a light lunch. We discovered that many people would stay back to consult with the doctors. We believed that an aware customer will find it easy to choose us for his surgical needs. The success of Public Forums branded 'Let's Talk' were an example of how the Medical teams in the hospital worked with the sales and marketing teams to engage with the local residents.

Soon we also introduced an interactive website, uploaded the content of these lectures for people to download and also allowed them the freedom to write to the doctors, create their own pages and share relevant content with each other. The effort was to create a community of people, who suffered from a particular condition and to allow them to interact with each other as well as with the hospital.

While at Max Healthcare, we initiated a branded Neighbourhood Program for the adjacent South Delhi localities, which offered special benefits to folks living around the medical centre. The benefits included discounts on the hospital's regular charges, priority services and a dedicated family physcian to take care of day to day needs of the residents. The local residents were required to enrol for the program and were issued nicely designed cards, which served to identify them at the hospital counters.

To remain top of the mind and ensure good relations with the local communities we supported by advertising in the local resident directories, sponsoring local events and signing up advertising space with in the communities.

The engagement with the local communities is an investment that a hospital should not think twice about. It brings returns much faster than big ticket advertising and fancy launch parties. It also costs a lot less.

All it takes is dogged persistance, patience and a bit of luck.

The images are sourced from www.flickr.com

On the Back of a Star

The star syndrome is a common phenomenon, which dazzles many a newly minted hospital.

I have been part of several start-up hospitals and have attended numerous meetings where all those who matter spout the now so familiar arguements about staying away from the 'stars' in the medical firmament. The arguements run something like this.

The star doctor (a well established doctor with a roaring practice) will be too set in his practices, will bring too much baggage and will never follow our pristine processes, which are far superior to his current practices. He will be a bad influence on everybody else. Another arguement goes that we do not believe in the 'star' system. Why should a 'star' enjoy priviliges, which are not available to our other doctors. A third arguement goes that we believe in growing our own stars. The hospital brand should be the real star and not individual doctors.

One can not really pick a flaw in any of these arguements. Star doctors are known to be egoistic, believe that making patients wait only adds to their stature, often indulge in practices, which are against the laid down hospital policy, break rules with impunity and in general do what they please. The management treats them with undue deference often causing resentment amongst peers. All this because they know they pull in a large number of patients and contribute significantly to the hospital revenue.

Once a new hospital commences operations without stars and the overheads mount relentlessly, while the revenue stream is at best a trickle, the need of a 'star' is felt acutely. The desire to ramp up fast and keep the promoters and other stakeholders off ones back takes precedence over all those arguements cited earlier.

The Star becomes the saviour. The CEO and all other 'chiefs' go 'star' chasing. The star is difficult to catch and quite often one can only sight it in the middle of the night. Meetings happen at his convenience usually anytime between midnight and 3 in the morning. Once on board he is treated like royalty. The star joins with a retinue comprising of his personal staff (numerous secretries, personal assiatants etc.), other doctors ranging from senior consultants to residents and the like. The star is presented to potential patients as as a great trophy. The hospital starts shining in the star's reflected glory. The patients start coming in and life becomes wonderful.

The bliss lasts for a few years. The star is able to fill up many beds. The trouble begins when one realises that under the star's dazzle nothing else grows. He eclipses the hospital brand, does not allow others to take roots, keeps the hospital management genuflecting to his whims and fancies and often bullies patients leading to bad word of mouth. The aura of the star starts diminishing.

Soon the hospital realises that probably they were better off without the star. The old arguements are resurrected. The star starts becoming a mere mortal. The hospital realises that getting rid of the star might not be a bad idea. However, it is easier said than done. Rememeber within the hospital's system the star has many a planets revolving around him.

Eventually the star is either eclipsed or simple allowed to wither away. The management team now believes that they can pull in patients on the strength of the hospital's brand name and soon the star finds itself being wooed by another new hospital, which has come up in these years and is desperately looking for a star to shore up its fortunes.

I wish this was a fable. Folks at all the leading hospitals in Delhi, which include Max Healthcare, Fortis, Apollo Hospitals and Artemis will bear this out. Some are at the stage where their 'stars' are falling, others are desperately looking for the stars to light up their lives.

The great game goes on...

The image is from http://www.flickr.com/

The Marketing of a Hospital

Before I get into the business of writing about the Marketing of a Hospital in India I must establish my credentials.
I have been working in the arena of Marketing of Heathcare Services for the last 8 years or so. I have been involved with Apollo Health and Lifestyle Ltd., which is the franchisor of Apollo Clinics part of the Apollo Hospitals Group, headed the Marketing and later the Corporate and International Sales for Max Healthcare a large healthcare services company based in Delhi and for the last two years have been heading the Sales and Marketing function at Artemis Health Institute, a tertiary care hospital based in Gurgaon and promoted by the Apollo Tyres group.
When I started working for Apollo Hospitals as the Marketing Manager for The Apollo Clinics and later at Max Healthcare I was often asked the question as to what really a Marketing person did in a hospital. Marketing of hospitals was understood to be a big no no. If you had a good hospital infrastructure and some well known doctors working for you the conventional wisdom dictated that the patients will follow.
Over the years this line of thinking has completely changed. Healthcare Services Marketing is gradually coming of age. We now even have advertising agencies dedicated to healthcare!
Some of the reasons for this sea change are not far to seek.
Patients to Customers
Patients are fast metamorphing into customers. They are just not satisfied with being a passive presence in their treatment. Increasingly they are demanding that they be included as active partners in their care. They are far more knowledgable and willing to question their care givers including the doctors. Hospitals are realising that for them to succeed in today’s environment they have to engage with patients/customers in a manner which they appreciate and understand. The communication, which engages with customers is generally the prerogative of the Marketing folks. This often translates into Patient Information booklets, detailed instructions before admission, during hospital stay and after the discharge. Extensive websites provide authentic information and hospitals like Artemis also provide interactive websites (http://www.artemisinteractive.in/), which allow patients to communicate freely with each other. Artemis also engages with customers by organising Public Forums, where eminent doctors interact with the public at large.
The Need to Standout
The healthcare revolution is truly underway in India now. The great urban middle class in large metros has multiple choices for their healthcare needs. Most of these hospitals have a lot going for them. However, most of them do not have much to differentiate them from each other. The failure rate of a bypass surgery in Apollo, Escorts, Max and Fortis Hospital is less than 2% and would compare favourably with any hospital across the world. Increasingly the medical expertise is becoming a given. The battle for differentiation is now gradually moving towards the overall customer experience that a hospital is able to deliver to its customers at all touchpoints. The Marketing teams in a hospital defines customer experience parameters and oversee the delivery of this experience at various touchpoints.
The Advertising Conundrum
Advertising in healthcare services have always been a contentious issue. Many people see hospitals splurging money on slick advertising as an effort to profit from some people’s misery. Afterall no one goes to a hospital to enjoy themselves. Hospitals are quite aware of this latent sentiment and try to be discreet about their marketing communication. However, with the patients gradually moving towards becoming customers the old taboos are disappearing fast. An increasing number of customers see private hospitals as commercial enterprise and understand that the stakeholders do need profits. (What they continue to object to and rightly so is to reckless profiteering) In the future healthcare advertising will gain more prominence and we will see more hospitals and probably doctors advertising their services in various media.
The Health Insurance
Presently Health Insurance has a miniscule penetration (4%) in India. With pureplay health insurance companies (Star Health, Apollo DKV and yet to start Max BUPA) commencing operations and with MNC’s offering health insurance coverage to their employees and their families, health insurance is poised for explosive growth. From the perspective of the customers cashless services at all corporate hospitals have taken the all important issue of price out of the customer equation. Thus in this unfolding scenario the differentiation will be through communication salience and top of the mind recall.
The Constant Customer Engagement Paradigm
In the days of yore a hospital interacted with patients only when they came to the hospital and stayed as inpatients. In today’s dynamic environment hospitals engage with customers throughout their lifestyle. Specialised programs are being devised, which enrol customers who are high risk for a disease (cardiac diseases-people with a family history, sedantary lifestyle, high stress levels, smokers and hypertensives). The hospital endeavours to be in constant touch with this group of people. The idea is to remain engaged so that God forbid if something happens the hospital is not too far off. The hospitals are now also devising Post Discharge Care Programs, which allows them to maintain a dialogue with patients even after they have been discharged from the hospital.
These in reality are another version of ‘loyalty programs’. (More on this in a separate post) adapted to the needs of the healthcare industry.
The Marketing function in hospitals is thus fast emerging as a critical function. The Marketing folks are tasked with engaging with customers (no more patients) both outside and inside the hospital. Happily for customers this can only mean a far better hospital experience and not just better care