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