Is the Healthcare Consumer Ignorant?

It's the kind of question that pauses one for a minute or two. How this question came about was in response to a post of mine a few weeks ago, regarding pricing at Urgent Care Centers and the $500 Band- Aid. In comments on a couple of LinkedIn groups, a few healthcare executives called consumers ignorant.

Really.

From a marketing perspective, that is a most interesting characterization of a healthcare consumer. And a dangerous belief to hold about one segment of your audience.

Ignorant.

I don't think so. Informed. Connected. Questioning. Seeking. Paying. Shopping. These words describe the healthcare consumer of today. A consumer who is awakening and demanding a voice in diagnosis and treatment options. After all, isn't that one of the major premises for healthcare reform, and CMSs' one opening statement in the proposed ACO regulations?

In ignorance there is opportunity.

So if you really believe that the healthcare consumer is ignorant, then what are you doing to change that to create an informed consumer? How are you interacting and building you organizational brand to change the healthcare consumers from ignorant to informed? Or, are you just happy to keep them that way, so those "pesky " informed consumers don't question your pricing, decision- making and quality?

Healthcare is changing from a provider-directed and dominated model to a consumer-driven model. And that means people will be informed. They will be involved. They will make quality and pricing decisions. They will play a very strong part in utilization decisions. The healthcare consumer is far from ignorant.

With a little work, they could actually put together their own price-affordable healthcare delivery network and never set foot in a hospital, or hospital-owned setting for care. Obviously, there will be those situations requiring major surgery or trauma care, for which a hospital is the most appropriate setting. But for the rest of it, doubtful.

So, don't be surprised in the future if a healthcare consumer-driven web site shows up that points the healthcare consumers to lower-cost providers for care. Your opportunity is to become that low cost provider, taking advantage of consumer shopping behavior though innovative, cost-effective programs and services.

For health plans and insurance companies, your opportunity is to educate your plan members about providers who have lower prices for services you are paying for, and giving consumers the option to seek lower-cost providers. You could also create loyalty and incentive programs for consumers to avail themselves of lower cost setting for care.

Just because its low cost, doesn't always mean low quality.

After all, almost all diagnosis and treatment can be done in lower-cost settings than a hospital or hospital-owned facility. Get ready for a different future than what you think it will be.

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is an entrepreneurial healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 38 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-1471. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; medical device and specialty pharmacy marketing; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.

How Do Your Marketing Efforts Counter Negative Quality Data From 3rd Parties?

On March 31, a new data release for consumers took place with CMS posting individual hospital performance on eight Hospital Acquired Conditions (HAC). Reaction has been highly critical to say the least by physician and hospital groups. There are legitimate question as to the methodology used in some of the data and that does need to be revised. So the question came to me after reading the various groups denial of the data, pointing out its flaws and generally trying to deep six any potential informational credibility for the public-  it's out there, so what is the brand opportunity if any?

How Does Your Marketing/PR Department Counter Negative Data Releases From 3rd Parties?

Hospitals and others are quick to bend over backwards and break their arms running ads and creating press releases when the data is in their favor or an award has been bestowed. This is not a criticism it is fact. Sometimes the information presented is misleading as well. When negative quality data is published, its everyone under the table time. If we howl with indignation at the outcome or just ignore it, then maybe it will go away. Well it's not. It is out there, so how are you going to respond?

Why not take a proactive approach with the same fervor that your Marketing and PR departments do when you have an award?

There is always opportunity to be leveraged in a potentially negative situation and that takes leadership, wisdom to see the opportunity and conviction to not follow the heard.

Can you be courageous?

Have your Marketing and PR departments follow these steps and you will find that you can strengthen build your brand, counter negative effects and be a force for change in the industry.

1. Acknowledge that this is another step in the transformation of healthcare from a provider-dominated to a consumer-driven transparent healthcare market.

2. Look at the CMS data for your organization and understand what is good and what is bad.

3. Create the documents and tools for internal and external audiences to learn how to use and understand the data. Be an educator. Frame the public's discussion.

4. Indicate the challenges with the data, how it was incorrectly calculated and how it can be simply fixed. Recalculate the data based on your hospitals performance against the true number of patients that received the service.

5. If you are a poor performer, then you have the opportunity to acknowledge that you can do better and inform your audiences what you are doing to improve.

6. Use the same techniques, and resources that you would use to tell the world what a great place you are because of a quality award.

7. Be proactive in a positive manner and not reactive with negativity. Be a solution the problem, not the problem. Hit the lecture circuit in your community.

Develop good Marketing and PR habits now. As change and time accelerates and the public becomes more involved in the choice of healthcare providers and treatment options, you need to control the discussion before others.

Define the discussion before they do. If you protest too much, or dive for under the tables, then the perception is there must be some truth to what's published. Maybe, maybe not, but it's there

The consumer is the new paparazzi, social media wiz and healthcare information seeker. Frame the discussion or be framed by it.

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is an entrepreneurial healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 36 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-1471. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; medical device and specialty pharmacy marketing; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.

Welcome to Accountable Care Organizations- Marketing Does Matter

On March 31, 2011, the healthcare system in the U.S. began to change forever with these words:

"An ACO will put the beneficiary and family at the center of all its activities. It will honor individual preferences, values, backgrounds, resources, and skills, and it will thoroughly engage people in shared decision-making about diagnostic and therapeutic options."

With these words, CMS has taken the bold step of moving the healthcare system from a provider-directed healthcare enterprise to a consumer-directed healthcare system. And the implications are enormous. It is also apparent that this will require leadership skills and abilities at the integration of culture and care. No more spin of shifting here among reimbursement options, playing docs off of one another, or avoiding difficult decisions.

Welcome to consumer-directed healthcare.

Eagerly or not so eagerly awaited, these 429 pages of proposed regulations mark the beginning of a great national discussion that will fundamentally change the healthcare delivery system in the U. S. Much as been written already by such publications as Becker's Hospital Review and more to follow.

Most of the commentary is focusing on the organizational structure and what it will require to successfully develop an ACO. My focus though is in what are the marketing implications? And there are many for what in the regulations is really a very small and insignificant portion, but can get newly developing ACOs in some serious difficulty should they fail to strategically plan and execute marketing properly. So, from the proposed regulations we find as an example:

11. ACO Marketing Guidelines:

"We believe there is a potential for beneficiaries to be misled about Medicare services available from an ACO or about the providers and suppliers from whom they can receive those services. We realize that care coordination is an important component of the Shared Savings Program; however, the potential for shared savings may be an incentive for ACOs, ACO participants, or ACO providers/suppliers to engage in behavior that may confuse or mislead beneficiaries about the Shared Savings Program or their Medicare rights.

As a result, issuing beneficiary communications or engaging in marketing activities that may be confusing or misleading would not be patient-centered because these activities restrict the ability of beneficiaries and/or their caregivers to be informed about their health care choices and thus limit the opportunity for beneficiaries to be properly involved in the management of their own care. We are proposing that all ACO marketing materials, communications, and activities related the ACO and its participation in the Shared Savings Program, such as mailings, telephone calls or community events, that are used to educate, solicit, notify, or contact Medicare beneficiaries or providers/suppliers regarding the ACO and its participation in the Shared Savings Program, be approved by us before use to protect beneficiaries and to ensure that they are not confusing or misleading. This requirement
would also apply to any materials or activities used by ACO participants or ACO providers/suppliers on behalf of the ACO to communicate about the ACO's participation in the Shared Savings Program in any manner to Medicare beneficiaries. In addition, we would want to ensure that materials distributed to beneficiaries do not misrepresent Shared Savings Program policies or suggest that we endorse the ACO, its ACO participants, or its ACO providers/suppliers.

We are further proposing that before any changes can be made to any approved materials, the revised materials must be approved by us before use. Finally, because the failure to comply with these requirements would demonstrate that the ACO does not meet the patient-centeredness criteria and therefore may no longer be eligible to participate in the program, we propose that an ACO that fails to adhere to these requirements may be placed under a corrective action plan or terminated, at our discretion.

For purposes of the Shared Savings Program, we are proposing to define ACO marketing materials, communications, and activities as including, but not limited to general audience materials such as brochures, advertisements, outreach events, letters to beneficiaries, web pages, mailings, or other activities, conducted by or on behalf of the ACO, or by ACO participants, or ACO providers/suppliers participating in the ACO, or by other individuals on behalf of the ACO or its participating providers and suppliers. If these materials or activities are used to educate, solicit, notify, or contact Medicare beneficiaries or providers and suppliers regarding the ACO and its participation in the Shared Savings Program, they must be approved by us.”

Marketing Does Matter

For those who have worked in pharmaceutical, medical device and health plans, you all know full well what happens when marketing materials are misleading and have not been approved by the responsible regulatory agencies. This just isn't throwing some brochures or flyers together, this requires high-quality, professionally-produced materials.

So as you being to assess you organizational capability, several marketing considerations become apparent:

Marketing needs to be at the table in the ACO development and decision making process as a senior management contributing member.
Marketing resources and systems need to be planned for.
Seek out an agency that has pharmaceutical, medical device and or heath plan experience. They already know what it's like to deal with and how to deal with regulatory agencies. This isn't something you do in-house.
Develop a highly integrated strategic marketing plan. Clarify brand architecture, messaging, and outcomes. Tactical execution comes last, not first.
Honestly assess the marketing organization, talent and level of expertise existing within the organization and change it if necessary. Seek out individuals with pharma, medical device or health plan expertise.
Understand this is not about making things look pretty.
It's not about you but about the consumer.

And this is important, it is not just communication strategies.

The regulations will change over the next year as comments are taken and considered. Even with change, these are marketing steps your organization needs to be taking anyway. You will be a lot better off in the long run.

By the way, did I mention the 65 quality of care indicators for ACOs that you will need to report on as well?

2012 is almost here.

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is an entrepreneurial healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 36 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at 815-293-1471 mailto:ormichael@themichaeljgroup.com . Areas of expertise include: brand management; strategic marketing; sales and marketing integration; medical device and specialty pharmacy marketing; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.




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So Tell Me, How Do You Market a $500 Band-Aid in a Hospital Urgent Care Center?

A story on hospital urgent care centers the other day in the Sun Sentinel, Orlando, Florida caught my eye. In a nut-shell, some hospital and system owned urgent care centers charge emergency room prices. When I started looking around the country, the same story can be repeated in community after community. This is just not an isolated one-time event.

What don't they get?

In a consumer-driven healthcare market, pricing matters. And charging $500 for a 15-minute visit that required a Band-Aid is the perfect example of why there is such an uproar by government, employers, consumers and health plans regarding healthcare cost. It also points out why Walgreens, CVS, Wal-Mart and entrepreneurs are driving the expansion of retail healthcare and outperforming the more traditional healthcare providers.

I get it. Hospitals and health systems need to expand and see the urgent care market as a means of revenue generation for combating falling volumes and declining reimbursement. Urgent care centers will be a part of any ACO strategy as well. But there are alternatives existing that makes the use of hospital-based or owned services at the prices charged, and in some cases, the quality choice of last resort.

This may indicate a lack of understanding of the basic market forces now sweeping the country as healthcare transforms from a provider-dominated " build it and they will come mentality" to a healthcare consumer-dominated market. Could it be in these cases, the age old resistance to change that hospitals and other healthcare providers exhibit from time-to-time?

Entrepreneurial individuals and Venture Capitalists are looking at this type of example nationwide and are chomping at the bit to put their own centers up and compete head-to-head against the hospitals and health systems.


The marketing keys to a successful urgent care center is location, service and price. Urgent care centers are just that urgent care, not emergency life or death care. The consumer usually walks in for minor treatment. If you want a successful urgent care center than provide the services at the price that healthcare consumers will buy. Not the ER charges that you think you can obtain by gouging consumers.

Fast, convenient, affordable. That's the marketing. That's the message. Or should be at least. Keep it simple and convenient.

I feel for that marketing department, I mean, how do you market an urgent care center that charges ER price? Besides having to handle the PR fall-out and loss of credibility to the healthcare consumer, you don't.

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich


Michael Krivich is a senior healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 36 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-1471. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.

Crafting a Social Media Strategy to Engage the Healthcare Consumer

To tweet or not to tweet, that is the question?

Faced with a dizzying array of possibilities from twitter to facebook to YouTube, LinkedIn, flicker and others, healthcare providers are struggling with developing a comprehensive social media strategy to engage their customers.

Understandable really. Some of the concern comes from not understanding the power and uses of social media and how consumers are the new paparazzi. Some comes from trying to figure out how a social media strategy fits into the overall marketing plan. Some is purely from executive ignorance in not understanding the place and uses of social media in the life of the healthcare consumer.

In many cases its all of the above and others, including and by far the most pervasive, the never ending paralysis by analysis planning loop and engaging in that quest for the perfect best practice before proceeding.

In these situations it is about internal marketing leadership.


As the marketing expert in your organization, you need to step forward and educate what social media is, how to use it and its advantages to the organization.

It's not just a facebook page, LinkedIn, blog, web site or twitter.

This is an opportunity to experiment, to deliver new content, new key messages with non-traditional methods to reach out too and engage in a meaningful way the healthcare consumer. An opportunity to engage in dialogue, a dialogue which the healthcare consumer desires to have more than you can imagine.

Follow these steps and you're on your way to developing and implementing a strategically-focused, comprehensive and fully integrated social media strategy:

1. Strategy first, tactics second. Any old road will get you to where you want to go without a clear identifiable strategy. This is no different than a traditional marketing approach. Integrate the tools and techniques of social media into your overall marketing efforts.

2. Be clear about your messages and what value using these tools will bring to your healthcare consumers. The purpose is to engage in a dialogue not shout at them. You have to understand what type of information and content your consumers want. Without that knowledge you can say whatever you want, but chances are no one will be reading, responding or listening.

3. Take an integrated approach. What goes on your web site is also on facebook and used in twitter to drive traffic to you. Twitter is a great way to send out links for health related articles or news and information. Have a video? Post it on YouTube. Writing a healthcare blog? You should be if you're not. Make sure twitter, facebook, YouTube, flicker etc., follow you buttons are on your site. Running Back-to- School, Sports or Camp physicals? Put it on twitter, facebook and even those coupon sites like Groupon. Holding a health and wellness event, ditto.

4. Use QR codes with your web site or specific page links or phone number embedded in them to drive them to your site, call center or service line. Through the use of QR codes you can make your print and traditional activities social in nature.

5. Remember at all times your are building brand, perception and experience. This just isn't nice to have, people will remember what you say and do. Be right the first time.

6. Devote resources, budget, time and personnel for the task. This is not a part-time job. It requires a full time position to manage the channels, content and distribution. Your challenge is to keep in front of your healthcare consumers with relevant information, all the time. Attention spans are short. If someone sees no changes on a pretty regular basis in your content or information, they will fall away.

7. Measure everything. Evaluate. Adjust based on your findings.

8. Be creative, don't limit yourself to the tried and true or what a competitor is doing. Be an innovator.

9. Use social media with your physicians and employees to communicate, build organizational support and loyalty.

10. Build excitement around what you are doing, then start all over and begin again.

Jump right in the waters fine!

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is a senior healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 36 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-1471. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.

Creating a Sustainable Healthcare Marketing Operation in a Consumer-Driven Market

Sustainability...Presence...Perception...Experience...

These are the four constants that direct-care healthcare providers need to understand and incorporate for success in their marketing operations and campaign efforts in a consumer-driven market. No longer nice to have, these four basic concepts are now business requirements.

Sustainability- The resources to effectively and continuously communicate brand and differentiate your offering across multiple channels.

Presence - By maintaining a continuous presence across multiple channels as in so many other consumer-directed industries, you build brand preference.

Perception- With a sustainable, continuous presence in the marketplace, sooner rather than latter, your key messages become the opinion of you by consumers and they become fact in their minds.

Experience- The actual customer experience matches the brand image, perceptions and opinions of customers that you created in the marketplace that had been communicated in an integrated multi-channel sustained effort.

Change and Survive

A consumer-directed market is much different than a provider-directed market which requires skills and abilities that may or may not exist in an organization. Key success factors for creating a high performance marketing operation that delivers revenue and market share in the new healthcare environment include:

A Vice President of Marketing senior management position that reports to the CEO and is involved in all decision making.

Marketing resources human, operational and capital budgets to support a multi-channel effort externally and internally.

Comprehensive strategic and measurably focused marketing plan that is integrated with the financial and operational plan of the organization.

Tactical execution plan and timetable that integrates all the campaigning to be done over the fiscal year.

Internal communication and training to educate the organization around marketing efforts, expectations and their role in the execution of the plan.

Creation of a comprehensive marketing dashboard which communicates activities and results on a monthly basis to all levels of the organization.

The above organizational marketing success factors are at a minimum what is needed to move direct- care healthcare providers from a cottage-industry approach to marketing to a comprehensive multimillion or billion dollar corporation approach to marketing, that in realty, most of you are.

As the healthcare providers continue to consolidate across all segments, marketing will assume an increasingly important role in the survival and revenue generating activities for the organization in a consumer dominated and directed healthcare marketplace.

And that requires a far different innovative sustainable presence that changes perceptions than the old way of doing things.

You can continue the conversation with me on:

LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is a senior healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 20 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-1471. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni. healthcare marketing, brnd, hospitals, health systems

Customer Experience Management Applied to Healthcare- Part 7

Or, the dangers of only viewing the customer-patient experience management as only the patient encounter.

An Intuit survey, "Healthcare consumers want online control"- HealthcareFinanceNews.com, March 3, 2011, indicates overwhelming support by the general public for more control over their healthcare via online activities. They want healthcare providers including physicians, to be accessible online. They want to pay their bills online, communicate with the provider, request appointments and get lab results. A clearly demonstrated experience need and expectation of consumers, that except for a few isolated healthcare organizations, is generally lacking among healthcare providers.

Had you been conducting market research on your customers-patients in the experience management process outside of the patient interaction, you would have understood that expectation and need. But unfortunately, most customer-patient experience management programs in healthcare providers are focused on the 1/3rd of the encounter with you as a patient.

Where do you go from here?

Healthcare providers do "dumb things" all the time. And they never seem to learn from that experience. So what happens when test results aren't available, the bill is wrong and a person cannot get the information they want or is on hold for too long? Well, all the compensatory goodwill built up in the patient encounter is lost because of these little "dumb mistakes" that healthcare providers make day-in and day-out. Those mistakes continue to build until they become non-compensatory event. Meaning that all the good encountered in the patient experience is washed away like a flood.

That's why its important to view Customer-Patient Experience Management(CEM or PEM) in its totality and not as an one service or clinical line experience. It may be for you, but to the healthcare customer-patient who views your organization across numerous touch-points and aggregates all of it into one overall experience, it's not.

Use the Internet and social media to frame the experience and meet customer-patient expectations.

Online bill payment, searching for information, communications via email, chats, facebook, twitter, YouTube and other mediums is an everyday occurrence for healthcare consumer. You, as a healthcare provider, need to understand that expectation and experience and integrate it into your efforts.

Part of the process of experience management is actively managing customers-patients experiences to meet expectations and change their experiences to drive revenue and market share improvements. It's not all about the patient satisfaction numbers. CEM or PEM has a definable and measurable financial outcomes. But you cannot achieve those revenue outcomes if you are not looking at experience management in its totality.

You may not want patient portals, but your customers do. You may not want online bill payment but your customers do. You may not want to have people schedule appointments online, but your customers do. You may not want them to have access to their medical information online, but your customers do.

By not fully understanding your customer-patient in their totality, you are not successfully managing their experience or expectations.

The wave is here to use an oft quoted metaphor. Its consumer-directed not provider-directed healthcare. And the sooner you get on the surfboard of true CEM or PEM, and start looking at the customer experience in its totality, the better the chances of your survival in the coming years.

The public, health plans, employers and government are running out of patience with healthcare providers and the "dumb mistakes" that continue to be made due to the lack of understanding of their needs, expectations and experiences.

Change or be swept away.

You can continue the conversation with me on:
LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich

Michael Krivich is a senior healthcare marketing executive and internationally followed healthcare marketing blogger read daily in over 20 countries around the world. A Fellow, American College of Healthcare Executives as well as a Professional Certified Marketer, American Marketing Association, he can be reached at michael@themichaeljgroup.com or 815-293-147. Areas of expertise include: brand management; strategic marketing; sales and marketing integration; physician marketing; product launch; start-up launch and revenue growth; tactical market planning; customer experience management; rebuilding and revitalizing marketing operations; media relations; and service line revitalizations. Mike is Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni.

Selling the Physician to Increase Volume and Revenue

Any number of healthcare organizations are looking to increase admissions to drive revenue and volume by associated physicians. Some providers are returning to the days of employing physicians and that seems to be making a big comeback due to the Patient Protection and Affordable Care Act (PPAAC). Here's hoping lessons learned from the last go around of physician employment will result in fewer mistakes this time.

Sales staffs are popping up all over like weeds-in-a-field, complete with goals and objectives, territories and sales quotas for specific docs along identified and profitable disease-states. In most cases they are managed by people who have never sold anything in their life. Little understanding of the relationship sales cycle, what is important to the physicians, their needs and ultimately their patients. The first time the sale person comes back to the organization with "This needs to change" request, it all breaks down because nobody internally wants to really change anything. We just want volume and revenue. Besides, with all the Stark considerations we really can't do too much anyway.

What's wrong with this picture?

Too sell to physicians successfully, you need more than office lunches and how are the kids kind of conversations. Its about their experience in admitting, treating and referring patients to your emergency room, hospital, pharmacy, surgical center or a home care agency to name a few of the providers docs deal with on a daily basis. Everyone is out there with the send to me, me, me, message. And that can't go on any longer.

Its more than your own perceived features and benefits.

This is a relationship sell and your sales team needs to be on track with a common sales methodology that they all use. Leaving it up to the nice person in the medical staff office to do this because she makes the docs laugh, or assigning a sales managerial function to someone who has never sold a day in their life, especially in healthcare, is a receipt for disaster.

Be ready to make changes in how you do things. When your sales person comes back, and says he or she is finding a trend in obstacles physicians are encountering in admitting or practicing medicine in your organization, be ready to make meaningful changes. If not, your just wasting your time and money sending out people to increase volume and revenue from a physician or multispecialty group. Nothing worse than over-promising and under-delivering.

10 Steps for Success

1. Hire a sales manager that has healthcare sales experience. Make it a VP level position at the senior management table. They drive strategy to make sure it is in sync with the organizational business plan and financial objects, as well as act as an agent for internal change.

One of the great weaknesses in healthcare senior management is that people who are very well educated, read an article, go to a seminar and then think they know everything they need to know too implement a strategy. Healthcare leadership has got to change in this new consumer driven environment and learn they don't know everything. The sooner you make that realization the more successful you will be.

2. Hire trained healthcare physician sales individuals. Lots of people from pharma and medical device companies make great hospital and other healthcare provider sales representatives.

3. Make sure that everyone is using the same sales methodology, techniques and materials. All sales and marketing materials should be designed for use in for the specific point in the sales cycle.. One size does not fit all.

4. Use a sales database system like SalesForce.com for example for accountability, tracking, etc., and make sure your marketing department has full access to the information. Mine the data for strategy and new opportunities.

5. Integrate your marketing and sales efforts from day one. You have to avoid the internal conflicts which arise and those "Marketing is clueless about what we need" or "The feet on the street don't sell it like we want them too", kind of conversations. Integrate and create a joint sales marketing committee to solve a lot of that. Make sure your marketing team is trained in the sales methodology the sales force is using. Marketing should also be attending sales calls.

6. Establish joint goals, objectives and revenue targets for sales and marketing. Share in the pain, share in the gain.

7. Make meaningful changes to your products and services based on the needs and expectations of your customers. That does not mean one-offs, but changes across the enterprise that will benefit many.

8. Remember it's about the brand, your brand promise and how your brand delivers upon those expectations.

9. Make sure that the entire organization knows what you are doing. Nothing more embarrassing or damaging when someone at any level of the organization is clueless and can't be supportive of the sales and marketing efforts. Makes you look like you do not know what you are doing.

10, Evaluate, monitor performance, make changes as needed in the program or staff and start the cycle again.

To your success.

You can continue the conversation with me on:

LinkedIn: http://www.linkedin.com/in/krivich0707
Twitter: http://www.twitter.com/mkrivich
facebook: http://www.facebook.com/michaelkrivich

Michael Krivich is Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association and can be reached at michael@themichaeljgroup.com or 815-293-1471 for consulting services in strategic marketing, integration of sales and marketing, media relations and interim marketing executive leadership assignments. Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni, both highly respected and successful international sales training organizations, I can lead your organization though the challenge of integrating sales and marketing.

A Lesson in Public Relations Continues

What a case study for healthcare!

The Chicago Bears just can't get it right. This has been a continuing comedy of PR errors that only leaves you scratching your head.

Damage control.....

Day after the press conference, the President of the team goes on the media tour to clarify statements on what the organization meant. (See my previous post) Damage control pure and simple.

It gets even better......

Then it turns out the press release about the firings was wrong and that really two of the assistants weren't fired, but were more like employee-at-will kind of relationships with no contracts. The offensive coordinator and his position coaches had contracts and will be paid. Probably some legal issues now because of that.

PR lesson continued.....

Look. For your own PR efforts, you control the message and the day when you decide to go public. Winning or losing a PR battle is not controlled by the media, it is your responsibility. You, through your actions or inaction's will determine whether you are successful or not. There was no reason in the world for the Chicago Bears to lose the media and message battle. All they did by this comedy of errors is further reinforce to the fan base, local media and national audiences that management is clueless about what to do. The Bears have lost any benefit of the doubt that remained. If this goes south when the 2010 season starts, the fire storm will be unrelenting. Sports fans have long memories.

What you can do to avoid this......

First, admit (and your ego will get bruised) that you may not have a clue about what to do.

Next, listen to your PR staff if you have any, and I am assuming at this point they know what they are doing.

Develop the right messages and practice, practice, practice with whomever you are sending out there to represent the organization. Limit the CEO or president's exposure.

Make sure the press release is right the first time.

If you have never been in a crisis communication situation before, bring in outside expertise. You can not handle it by yourself. This is no time to learn by doing, too much is at stake.

Physicians, patients and the media in your community will remember what you did or did not do for a very long time.

If you don't do it right on a day that you can control the outcome through right planning, thought and action, then you have no one to blame but yourself.

I can be reached at 815-293-1471 or by email to themichaeljgroup@aol.com

Back to basics and de-marketing services

With major cuts in funding coming for hospitals, the only way to survive is to get back to the core. Meaning, what are those core services and programs that regardless of what happens in the world of healthcare, will pay the bills and create market strength and position for you.

Its hard to exit programs and services. I have been saying for years that hospitals can not be all things to all people anymore. That means hard choices. It also means a de-marketing program for all those classes of trade that you exit from.

It will require organizational strategic planning, a willingness to tackle the scared cows, close collaboration with your physicians, intense internal communications and a solid de-marketing and communication plan to sell it to the community.

You will be required to collaborate with your competition. Hard to admit you can't do all things well. If you want to survive, you have too.

Find the expertise to assist you along. De-marketing is an area where hospitals have little experience.

The Patient Satisfaction Imperative

As the old song goes, I can't get no....satisfaction.......

Ever wonder why in the healthcare industry that satisfaction is sometimes so hard to come by?

That is not to say that every hospital or health system has a satisfaction or service problem. There are many exemplary examples of service focused healthcare organizations that day-in and day-out deliver high levels of patient and physician satisfaction. Yet, in an industry where we "serve" individuals, we hear from consumer research that it's the other guy. My doctor and my hospital is fine as consumers report general happiness with their healthcare providers. Hospitals regularly report satisfaction in the 90th percentile. Get people outside of the hospital and you hear some pretty common complaints: the food is cold; I did not know about my test; you woke me up in the middle of the night; it was noisy; the room to cold; the room is hot; and on and on. As organizations tout the JD Powers Satisfaction Award, show great improvements in Press Ganey or NRC-Picker or other survey instruments, there is still the uneasy feeling that all was not okay. These and other survey tools are all very valid, all worthwhile, show trends and document accomplishments. With the government HCAPHS Hospital survey in play by reporting provider satisfaction as a common basis for measurement and consumer comparison, all the more imperative the focus on patient satisfaction.

Healthcare is not an easy business by any stretch of the imagination. We work with people who are patients and their families that are at various states of emotional distress, caring employees (for the most part), good physicians etc. So satisfaction for so many different groups becomes interrelated.

Why is it important?

For several valid and researched reasons.

Satisfied patients are more compliant with treatment regimens.

A satisfied patient even if the medical outcome is not good, believes that he or she had a quality medical experience.

Satisfied patients recommend you to others.

Satisfied patients return to you for care.

Satisfied patients tend to ligate less.

It's the right thing to do.

Where does satisfaction start?

No surprise here - right in the executive suite. Yep, the CEO and senior leadership sets the tone, tenor and actions by what they do or don't do. How they treat others. How they measure and hold themselves accountable in the performance evaluation process. It's either part of the culture or not. People clearly understand the organizational rationale, polices and procedures for satisfaction and are part of the program, or they see it as the flavor of the day because so and so said so.

Satisfaction is not a program or a slogan, or simply a set of behaviors codified in polices or procedures, a bar chart on the wall. It is not the notice in the hallway or patient room that if you can't rate us as very good or excellent, call this person to immediately address your needs. Satisfaction is all that and more. The defining culture of the organization. A recognition that satisfaction is every ones responsibility. It is anticipating the needs of the person or family. Taking care of the little details day-in and day-out is what creates a satisfied patient. The successful healthcare organization recognizes and understands that patient, employee and physician satisfaction are interrelated, is a process and is controllable!

The Changing Dynamic

Did you know that here appears to be a major shift in how patients and their families judge the quality of medical care? Used to be it was all based on the the hotel services, food service, housekeeping etc. Arrogantly, clinicians and hospital leaders confidently stated that patients did not have the ability to judge the technical quality of what we do.... its magic to them!

With the information available from the Internet, health and wellness programs, news stories etc, patients are very well informed and are making technical judgements of the quality of the care that they receive. Most of the time research is indicating patients technical judgement of care is on par with those of the attending physician. Now that is a dramatic change and one which is little recognized. However, it goes one step further. The dirty floor, the torn wallpaper, the piece of paper on the floor are now adding into the mix. The patient is now judging, "If they can't take care of the little things, then how can I expect them to take care of the big things...... like my treatment......... "

OK now what?

With the advent of HCHAPS, pay-for-performance, awards as well as the bragging and marketing rights in the community, patient satisfaction moves to the forefront of operational excellence. Here's the rub.... now comes the program to increase satisfaction and how to show statistically why we are better...

Here comes the program, the flavor of the day, the decree from on high....

Lies.... damn lies....and statistics........

Patient Satisfaction is a process

Patient satisfaction is a process that is controllable and understandable. It is the voice of your customer. By listening to that voice, I mean really listening to that voice, you would be surprised at the improvements that you can make in your healthcare setting. Patients, physicians and others view the hospital experience not as a set of unrelated departments where things are done to me, but as a coordinated whole in a continuous process.

Is the process of satisfaction in or out or control?

Ask any hospital executive that question and for the most part, I think they would say yes it is. Ask them to show you the data that it is in control, nine times out of ten, the subject gets changed. The simple fact is they don't know. Healthcare leadership needs to know if their process of satisfaction is in or out of control to know if they even have a satisfaction issue. A simple percentage explanation won't do that. A bar chart won't do that. A new program that is the flavor of the day for increasing satisfaction won't do that. It takes a commitment to in-depth analysis, using all the tools of Quality Management. It takes a willingness to change the culture of the organization. That is not easy. Its hard and forces some very difficult personnel decisions.

For example, say hypothetical Hospital A is dismayed about its satisfaction scores and the CEO declares, we need a 10 percent improvement in the scores. Admirable, but misguided.

If I am housekeeping and my percentage score of patient satisfaction is 70 percent, a seven point increase over time is probably doable. If I am nursing and my percentage score is 90 percent, a nine point score improvement is impossible. Flat out can't do it, not going to happen, Nada, no way. That is what happens when you only use percentage scores or a bar chart as the basis for action.

Now, had the organization been analysing the satisfaction data with the tools of Quality Management, this could have been the action on the part of leadership in a conversation in hypothetical Hospital A.

" We really need to move the culture of the organization and improve our satisfaction scores. I asked our Quality Department to do an in-depth analysis. When you look at the bar charts we see steady improvement, but regression analysis shows really not much change over time. The telling difference was when we looked at patient satisfaction scores though the use of Statistical Process Control Charts and what a story that told.

It looks like our process of satisfaction is out of control, there seems is no rhyme or reason why the scores fluctuate so much. Yes, they are all in a narrow range, but this tells me we really don't understand the process of satisfaction and how to control it. When applying this analysis to individual departments and units, we find some striking differences. Some units and departments are outperforming the organization as a whole, others could really use some improvement. I really think we need to get to those units and departments outperforming the whole and benchmark what they are doing.

So instead of everyone trying to improve 10 percent overall lets use the upper control limit of the charts as the incremental target for improvement based on historical performance. That means housekeeping you can improve 10 percent, but nursing, its really only one percent at this time. Lets make this measurement an ongoing process so that we know the point of when we designed an intervention, implemented and see the result.

What gets measure gets done, so in your goals and objectives put in place a measurement for patient satisfaction for your departments that the scores will not vary by more than 2 points plus or minus of the top score.

This isn't going to be easy. We need to really change the organization. I know we have done this before and seen some improvement. But we always fall back after a couple of months. If we go at this the right way, the employees won't see it as the flavor of the day. And we all know what that means. It may mean over time that we will lose some people. That is never good nor is it easy. But consumers, the government, payers and employers are all demanding higher performance from us. This does have a financial impact to us. As we move forward, we need to set behaviors and hold people accountable, that includes us. We need to become world class in delivering high levels of patient satisfaction."

That unfortunately is a conversation that does not take place nearly enough.

Where do we go from here

It starts with learning. It starts with an honest assessment of here is where you are. It starts in the C-suite. Commitment, compassion, understanding, listening, process control and improvement. Every hospital and healthcare provider out in the wider world has the talent, experience and expertise to do this. But what is lacking is the will. What is lacking is the understanding of the importance of patient satisfaction. Its not sexy and really hard work. For those that are willing to start, learn and change - the benefits are enormous!

If we as an industry really understood satisfaction as we claim too, do you really think that year after year dozens of books would still be published on how to improve patient satisfaction in healthcare organizations?

My Book

Okay, here is the plug for the book..."How to Use Patient Satisfaction Data to Improve Healthcare Quality", Raph Bell, Ph.D., and Michael J. Krivich, FACHE, Quality Press, January 2000, 156 pages and available on Amazon.com or from Quality Press at the American Society for Quality. Its all detailed in an easy, readable book that will assist you in reaching your satisfaction goals. Patient satisfaction is a process, it is controllable and takes work and at the end of the day, you will be better for it, your patients will be happier for it and you can outperform your competition with it.

Unless the hospital industry begins to take a more detailed data analysis and organizational approach to patient satisfaction and make it a part of the culture of the organization, we are left with lies.... damn lies.... and statistics.....

And in the end, we may be very proud of ourselves, but our patients will still have that nagging doubt about what just happened.