By Joanne Bladd June 2007
When it comes to running a practice, don't make the mistake of thinking that medicine is above money. Call it a career, call it a vocation, but call it a business, because your accountant does. The simple fact is; patients mean profits, and practices are like any other small company battling for market share. They need to attract consumers. So why do so many physicians recoil at the prospect of marketing their services?
Even if you're an excellent physician, patients won't be queuing up in your waiting room if they don't know you exist
It's an emotive issue, explains Stewart Gandolf, co-founder of Healthcare Success and a leading practice marketer. "There's a stigma attached. Doctors mistakenly believe there is a correlation between how good a doctor you are, and how busy you are," he says. "So doctors who need to market are bad doctors, and look needy and sleazy.
"It's a mistake, because there are good doctors who market and there are bad doctors who market. It helps both get business."
It's a concept that has divided the market neatly into doctors who are paralyzed by their principles, and those that understand the need for practice promotion. As Gandolf says: "It's a window of opportunity for the smart, but most physicians sit around and wonder what happened."
If the perception that marketing is a dirty word is holding you back, a short aphorism could help. Put simply, says Rachael Sizeland, founder of RAS Marketing, if you aren't out marketing your services, somebody else will be.
"Even if you're an excellent physician, patients won't be queuing up in your waiting room if they don't know you exist," she explains frankly.
But if the thought of promoting your services brings you out in a cold sweat, don't panic. Marketing is not all about slick, big-budget advertising campaigns. "It is not the same thing as selling," says Gandolf. "It's about building the product to match what the customer needs, not trying to get the consumer to fit the product."
What this translates to is effective, low-cost methods that can build your profile without snapping your purse strings. And, as with all successful businesses, it all comes down to pleasing the customer.
When it comes to promotion, your current patients are your best assets. As Aileen Culligan, account director at Dubai-based public relations firm Asdaa, outlines; "In healthcare, it is a market of habit. Doctors and patients build an emotional bond and doctors need to focus on patient loyalty. They can get patients by word of mouth."
Even better, says Gandolf, it costs nothing to cultivate them. "Patients already have a level of trust in you. Asking them for referrals, following up appropriately and giving them a good experience is your highest return on investment.
"Patients may have had great healthcare, but give them a little extra, and it will open the door to recommendations."
While acknowledging that many doctors feel uncomfortable about asking patients to refer on friends or family, Gandolf argues that physicians that don't ask, don't get. "A lot of practices are perceived as busy, so if you're not asking for referrals, patient won't think to do it."
So how can you encourage word-of-mouth recommendations? In this instance, a cutting-edge logo or a 10ft billboard isn't going to cut it. Instead, it's about learning to think of patients as more than a medical record. "The real issue is the product," Gandolf stresses. "It's the sum total of the experience the patient has. Do you find ways of making billing easy for them? Do you smile at them? Do you treat them as individuals?"
Dubbed 'internal marketing', your success in this approach can make or break your practice. According to a survey by Healthcare Branding Group, a poll of 3,000 senior level executives from the healthcare sector showed that more than 40% of respondents marked patient experience as the driving force behind consumer perceptions of medical facilities. "Whether you know it or not, you're marketing to your patients every time they contact your practice," Sizeland says.
Typically, patients look for clear and simple reasons to choose one healthcare provider over another, explains Matthew Pearman, an account director for PR firm Memac Ogilvy. So, while high quality care is certainly important when it comes to customer appeal, it can be difficult for patients to assess.
"I think, if you ask someone in the street to distinguish between, say Welcare Hospital and The American Hospital; in my opinion, I don't think they could identify the difference," Pearman says.
Instead, explains Gandolf, patients use proxy measures to determine value. For example, in a restaurant, if the tables are dirty, customers subconsciously believe that the kitchen is dirty. In the minds of diners, grubby tablecloths equate to sloppy food hygiene. If your waiting room or your bedside manner is shoddy, patients have less faith in your skills. "Patients judge what they can't see by what they can see," he says. "So a way of differentiating yourself is simply by getting to them on time, and treating them well when you see them.
"Stand out from the crowd in terms of your service, and you'll do better than the guy down the street."
If you're ready to reassess your internal marketing, some small points can help lay the right groundwork. A basic model many marketers use is the 'Four Ps approach', which can help determine your marketing mix.
Product - The first 'P' refers to your practice and the services you offer. This is your product. "Think about the needs you're serving in the marketplace," Gandolf says. Pinning down your product is key to establishing the brand values of your practice and defining what makes you stand out.
Sizeland recommends coming up with five or ten adjectives that describe what your business; for example, 'friendly', or 'thorough'. "These words are going to inform everything you do," she explains. "Your words become your brand, and the whole package should follow that philosophy."
Once you've found your unique identity, your practice and your staff have to live up to it. "From having your first logo and brochures designed, to the way your staff talk to patients, your brand values should come across," Sizeland stresses. "Staff need to know what's expected of them. If your practice claims to be friendly, they need to be friendly."
If you can come up with a message, adds Gandolf, and hammer it over and over again; "That's effective. That's marketing."
Place - The adage 'location, location, location' holds true for marketing. An integral part of your plan is your physical facility. Are you pushing the right services for the local demographic? Can your patients get to you? "Identify who exactly you want to be communicating with," advises Pearman. "Who do you want to focus on and how are you going to do that?"
The appearance of your practice is another deciding factor, adds Sizeland. "Does the appearance of the practice reflect your brand? What does your waiting room say about your doctors?"
To help look at your practice through new eyes, try checking in as if you were a patient.
How many forms do you need to fill in? Could you simplify the process? Is your practice easy to navigate round? Performing a 'door-to-door tour' can help pinpoint areas for improvement.
Price - Simple but key; how much are you charging, and does your practice live up to its price tag? "Your charges should be appropriate to your market," says Sizeland. "Make sure you are not pricing yourself out or under the range of your target patients."
Promotion - "Whether internal or external, marketing should be consistent and professional," Sizeland stresses. "Get your name out there by working traditional, affordable measures."
In short, adds Gandolf; "Doing anything is better than doing nothing."
Once you have a brand statement, how can you translate these platitudes into practice?
For your internal marketing plan, take a look at the following:
Information leaflets - "Leaflets or brochures explaining your practice statement and exactly what services you offer are a vital part of the marketing wrap," Sizeland says. If your patients don't know that you can treat skin lesions, you'll lose them to a dermatologist who can.
Information packs on specific conditions or procedures can also help educate patients, helping to push the message that your interest goes beyond that day's appointment. "From the moment patients contact you, they should be impressed that you're offering them extra, more than they expected," Sizeland explains.
Dr Soliman Fakeeh Hospital, Saudi Arabia, has taken this point on board with the launch of its free patient teaching center. Open to all hospital patients, the center is staffed by doctors, health educators and nurses, and aims to help patients achieve a better understanding of their illnesses. What it also provides is a more customer-focused experience and a reason for patients to come back.
Appointment reminders - These have a double bonus; along with cutting the number of no-shows your practice notches up, appointment reminders help project an impression of efficiency. Patients are left with the image of an organised practice.
Timely follow-up - Consider sending new patients a 'welcome to the practice' note. Again, alongside giving the impression of a caring, compassionate doctor, it's another opportunity to use your brand and highlight your services. "New referrals only work if you can keep them," says Gandolf. "All the marketing in the world won't help you if you have a terrible product. You need both; good promotion and a good product."
If these measures seem too simplistic to make a real difference to your bottom line, remember that while good customer care is not rocket science, it will help your business grow. "Patients see things differently to you," Gandolf stresses. "It's a key principle, so put it on your screen and highlight it; 'You are not the patient.'
"When you find yourself starting to say 'Well, I wouldn't respond to that,' stop. You're about to make a mistake."
Outside of your practice, one of the most effective, low-cost ways of boosting your profile is involvement in community events. Gandolf recommends patient appreciation days as a good source of new referrals. "Invite your patients and ask them to bring friends or family, and offer a free check-up," he suggests. "It's slightly quirky and you can get a bunch of new patients."
Welcare Hospital, Dubai, is a follower of this method. In support of World Hypertension Day, the Hospital offered free blood pressure screening to all walk-in patients. By aligning itself with a major, nationwide campaign, the Hospital received newspaper and radio coverage, and is likely to have gained new patients.
"This is a way of getting coverage from the local media, and it's a feel-good thing," Gandolf confirms.
"These sort of activities can aid in building a profile," Pearman agrees. "The Dubai Bone & Joint Clinic are particularly good at positioning themselves within the community. Take the Emirates Arthritis Foundation as an example. Under this umbrella they launched the region's first arthritis support groups.
"That sort of exposure is good exposure."
Marketing, whether internally or externally, doesn't mean bankruptcy and shouldn't cause you an ethical dilemma. But as the market becomes more competitive, explains Sizeland, all physicians will need to sit up and take notice.
"I can't think of any practice that doesn't need to market itself," she says frankly.
To stay ahead of the game, Gandolf warns smart physicians to begin planning their strategy now. "Whatever flurry there is in the marketplace, as practices wake up to marketing, it will be a speck of what's to come," he says. "If you can hear the rumble of the river coming down the mountain, it might be along way away, but it is coming.
"If you want to stand out, do your homework now."
Casebook: Moorfields Eye Hospital, Dubai (MEHD)
Despite being Moorfields Eye Hospital's first foray into private care, the facility's Dubai-based branch has quickly grasped the importance of the customer in a competitive market.
From the moment patients step out of the lift, their first view is of the Moorfields crest etched into the sliding glass doors that lead into the reception area. It's a deliberate branding ploy, explains medical director Dr Chris Canning. "We use the crest everywhere we can, so patients learn to associate the established Moorfields brand with the clinic," he explains. "It's very striking, so patients remember it."
The facility itself is designed in a circular format, so patients follow a logical path during their appointment. The layout, Canning explains, was selected to give a natural sense of progressing through the stages of the clinic.
The first stop is the reception area, which leads on to check-in desks where patients are booked in. The facility is smart-card compliant, so paper-free beyond this point. Patients are then led in to a waiting area, surrounded by individual appointment rooms. Each pod has a light above the door, which is activated once the attending nurse or physician inserts the customer's smart card into the computer. "Staff can see at a glance which rooms are occupied," Canning explains. "It means patients aren't disturbed during their consultations."
The goal of a calm patient experience, Canning notes, has been prioritised during the design of the clinic. The appointment rooms, while facing the patient waiting area, also back on to a second, hidden corridor. This path, Canning says, allows staff to flit between rooms without crossing the central waiting area. "The idea is to keep the room as tranquil as possible, to minimise stress for waiting patients, " he explains. Digital whiteboards displayed in the corridor allow staff to see immediately which patients are in which room, and how long each has been waiting.
MEHD is equally adept at the smaller touches. Patients with upcoming appointments can expect an SMS message the day before, reminding them of their visit. "We're in the final stages of organising this service with Du," Canning says. On leaving the clinic, all patients also receive an individual folder holding their diagnosis, the results of any tests they have had, information sheets, a copy of their prescription, and details of any upcoming appointments. "Should they want a second opinion," Canning explains, "They have all the information to hand." Referring GPs can expect an equally comprehensive brief, he adds. "We're still working out the best way of communicating with primary care physicians here, but whether by fax, post or secure email, they'll receive the same information."
Be patient-focused. Build your practice around what your patients want, rather than what is convenient for you. Your current patients are your best source of future referrals.
Build your brand and use it in everything you do. Establish the image you want to portray and ensure that your corporate message, from your practice literature to your staff's telephone manner, is consistent and credible.
See your marketing plan as an investment, not a cost. "It's a question of how much you make, versus how much it cost," says Gandolf. "US $30,000 sounds like a huge amount of money, but not if you're making $300,000 as a result.
