PERSPECTIVES
MARKETING WORK PRACTICES tion, and at what benefit. Although this formula seems incredibly simple and very much a common sense approach to "telling what you do," many therapists consider even this basic marketing anathema to their profession. The obvious problem with this negative view of the therapist as a marketer is that when one finally implements some type of information delivery plan (marketing), one perpetuates the negative view by using less-than-professional techniques. Therapists' view of what marketing is comes to life and confirms, for them and for others, that marketing is akin to selling the Brooklyn Bridge.
Curtis Pickelle Chairman CurAnt Communications, Inc. Marina del Rey, California
As distasteful as it may sound to those schooled in the somewhat altruistic disciplines of health care, among those skills required for success in work programs throughout the 1990s is the knowledge of how to market yourself and/or your program. Before you protest, thinking that you'll now be trading in your functional assessment programs for a pair of white patent leather shoes and several bottles of snake oil, let's review the state of the marketing industry today . It may come as quite a surprise to many therapists to learn that marketing is a profession not unlike rehabilitation. Requirements for success as a marketer include such talents as a fundamental understanding of human behavior, technical skills utilizing several learned techniques, and (for most) a commitment to the ethical and professional use of these talents. In its most basic form, marketing for those involved in work programs should encompass nothing more than the delivery of information about what you can do, for whom, for what compensa-
TO INFORM AND PERSUADE If you can accept the fact that there are highly professional, ethical, and creative ways to deliver your message to whomever you wish, then you can construct a plan that will allow you to add a bit of persuasion to the basic flow of information from you to your audience.
How does it work? Let's look at an example within the context of this simplified marketing plan. Here's the scenario: Joan Smith, human resource manager for ACME Storage and Transfer in Yourtown, U.S.A., leaves a meeting at which she was given the assignment of finding out about something called "work hardening." Workers' compensation claims have gone through the roof, the firm's labor pool is diminishing, and it seems as though employees themselves are in complete control of back rehabilitation programs. The company has no comparative data. It doesn't know who is telling the truth and who isn't. Joan returns to her office and tries to figure out whom to call. She remembers receiving a letter from some type of "back specialist." Where did she file it? u~h, yes," she recalls, "it also had a business card designed to fit into the Rolodex. " Looking under "back," she finds the following card: WORK 1993; 3(2):2-5 Copyright © 1993 by Andover Medical
3
Bob Jones, OTR/L Specialist in Work Hardening, Return to Work Programs, Back Rehabilitation On-site Analysis and Rehab
Bob had employed some fundamental marketing techniques. He identified his audience, gave some thought to how his skills might benefit that audience, put together a brief message delivering the information, found his potential clients, sent them something about himself and his skills, and, with an extra twist of persuasion, added some insurance that his message would be kept. He used creativity. No snake oil. No white shoes. Consequently, Joan had at her fingertips someone licensed and qualified to conduct the program the company needed. Where else could she have turned? Most likely to the plethora of chiropractic ads in her yellow pages. By introducing this alternative, we have underscored perhaps the most basic rationale for developing some type of marketing program: If you don't, thry will! Who are thry? Here's the ugliest word of all in the business side of your practicethry are your competitors! The facts are indisputable. Work programs of all types are among the most visible and demanded programs in the United States today. With the aging population, staggering rise in costs of doing business, insurance claims going through the roof, and a tort system run amok (with six- and sevenfigure claims awarded as standard practice), the environment is ripe for therapists to get involved in a variety of work programs at corporations, municipalities, institutions, etc. This fact also is indisputable: Some enterprising practitioner will be proactive, will discover a way to find the Joan Smiths, and will persuade them to join the practitioner's list of clients. Less enterprising therapists, who may have superior skills but fail to see the need to be proactive in the development of a market-based practice, will be left on the sidelines with their integrity neatly in order, but without a practice or clients. If you're still not convinced, you should nevertheless read on. You might find some nugget of information for further use.
BACKGROUND: THE MARKETING PERSPECTIVE IN HEALTH CARE Marketing in the increasingly competitive health care marketplace is a relatively new phenomenon. Although individual communication dates back to the dawn of civilization, when early man inscribed crude symbols on his or her tools as messages to his or her often hostile audience, the now sophisticated economic discipline has been considered declasse in health care circles . Unfairly, P. T. Barnum and cure-all pitch men have been synonymous with the art (science?) of persuasion. Most health care practitioners are still uncertain about the productivity of marketing because productivity is typically defined as units of output divided by units of input. Goods and services are output and marketing factors of production are input. Marketing input can be measured as money invested, but output (business generated) is difficult to quantify or attribute to the marketing effort. Reliable and objective data are available to help serious health care marketers sift through the rubble of failed campaigns and wasted expenditures to determine the proper cost-benefit ratio percentages of revenue formulas and case histories. As in the health care profession itself, even the most die-hard statistician can find data enough to warm his or her heart. The creative side of marketing, which is among the more visible of its various parts, is subject to criticism by countless armchair advisors. Even this, however, can be relatively objective discipline when viewed through the eyes of a professional communicator. Consumers at every level of society are bombarded daily with messages-often compellingdesigned to motivate them to do what marketers want them to do. On any given day, each human being is exposed, through various media, to hundreds of presentations. Those that succeed in evoking strong feelings among their receivers and moving them to action penetrate what is known in communication circles as the noise level, and they have some fairly basic principles of communication in common. Industry sources indicate that those similarities include the following ten points:
4
WORK / SPRING 1993
1. There is a clear product or service differential (not just the same old place, not just the same old thing). 2. There is what Procter & Gamble labeled best as the USP (unique selling proposition), e.g., "specialist in work hardening" 3. The message's goals dovetail with the goals of the product or service (a "we care" ad for a hospital must be followed by a caring attitude at the hospital). 4. The advertising generated is based on a thoroughly analyzed plan that includes the following essential points: • objectives • a media strategy (target audience/reachlfrequency/media mix/timing/environment) • a creative strategy (benefits/positioning/ copy points) • firm budgets 5. The message's source must be perceived as credible by the consumer. Exhaustive research has been done relating credibility values to the advertising spokesperson. Hiring a recognized spokesperson who has actually had first-hand experience as a consumer may be helpful. 6. Successful messages stress benefits over features. Simply announcing that a hospital has added work hardening to its services will do little to influence consumers who are unconvinced of its benefit to them. What is the benefit in obtaining rehabilitation center designation? The fact that the hospital has stateof-the-art equipment and board-certified orthopedic physicians? No. The benefits are workers returned to work and reduced workers' compensation claims. That's the message that penetrates. 7. Successful messages are transmitted in two steps, first, to opinion leaders, who in turn transmit and influence the ultimate receivers. Health care marketers, of course, have a built-in level of opinion leadership in the ranks of the referral base. Here the theory is particularly true, since this group's perception of the provider institution will often mean
the difference between the institution's success and failure. 8. Although the watchdog Federal Trade Commission has an on-again, off-again attitude toward comparative advertising (they mostly encourage it as a true measure of competitiveness), most consumers have negative feelings about the "Coke versus Pepsi" approach. They much prefer the positive presentation of benefits, letting the ultimate decision on which is best be determined by their own experience. "Theirs is bad, ours is good" rarely, if ever, has been a believable message. 9. Successful messages place consumers in a situation that is familiar and comfortable and with which they can identify. For example, presenting real-life testimonials about saved work days from those who were rehabilitated is a formula that is hard to beat. 10. Successful messages "position" the product or service without confusion or nebulous attributes. Don't pretend to be something you are not. Successful positioning strategies answer these questions: • • • • •
Who is the customer (segmentation)? What does he or she need? What can I offer? What does my competition offer? What does the customer think I offer (perceptions)?
If the institution's strength is quick, efficient, offhour ambulatory care, don't advertise its research facilities or network of diagnostic services.
COMPETITIVE LIFE AFTER DRGs One of the most noticeable, if not dramatic, effects of the post-DRG era has been increased reliance on marketing strategies by hospitals fighting for survival in a battle for which they have had little preparation. It is not surprising, then, that their use of advertising, one of marketing's most powerful tools, reflects this lack of preparedness. The result is that health care marketers often extend their negative perception of marketing into
5
their own plans, thus creating a self-perpetuating series of bad messages. Most health care marketers seem to think that the messages have to be bad to be real marketing. The old maxim from the film The Man in the Gray Flannel Suit suggested that to be a success, advertising, for example, must "irritate, irritate, irritate." More recent analyses, however, have shattered this myth by noting that dislike of ads correlates with negative attitudes toward the industry that is advertised.
appear on a typical flow chart outlining the situation analysis and marketing plan. A therapist involved in setting up a work progrilm at a rehabilitation facility might review a plan that looks something like this: Benefits Delivered
Total Market
CALL TO ACTION There is ample evidence to support the need for today's occupational and physical therapists to use marketing in the development of a private practice. The same requirements, techniques, and principles can be used by those within an institutional setting challenged with the task of setting up a program, department, or market-based awareness campaign.
Work Programs Assuming some level of perceived need to market, those involved in work programs should consider developing a situation analysis similar to the chart adapted from the American Management Association. The figure depicts how these points might
Segments
Positioning
Preplacement or postoffer screening Reduced workers' compensation costs Empirical data on low-back strength Insurance companies Local corporations Case managers Rehabilitation counselors Risk managers Human resource managers Most qualified licensed practitioner with experience in work-related issues
CONCLUSION Develop a creative message that reaches those interested in receiving it. Present it professionally and watch your program or practice grow. Notice, also, that you have brought good-quality health care to those who need it. You are still living the life you set out to live, and have not compromised your principles.
MARKETING WORK PRACTICES tion, and at what benefit. Although this formula seems incredibly simple and very much a common sense approach to "telling what you do," many therapists consider even this basic marketing anathema to their profession. The obvious problem with this negative view of the therapist as a marketer is that when one finally implements some type of information delivery plan (marketing), one perpetuates the negative view by using less-than-professional techniques. Therapists' view of what marketing is comes to life and confirms, for them and for others, that marketing is akin to selling the Brooklyn Bridge.
Curtis Pickelle Chairman CurAnt Communications, Inc. Marina del Rey, California
As distasteful as it may sound to those schooled in the somewhat altruistic disciplines of health care, among those skills required for success in work programs throughout the 1990s is the knowledge of how to market yourself and/or your program. Before you protest, thinking that you'll now be trading in your functional assessment programs for a pair of white patent leather shoes and several bottles of snake oil, let's review the state of the marketing industry today . It may come as quite a surprise to many therapists to learn that marketing is a profession not unlike rehabilitation. Requirements for success as a marketer include such talents as a fundamental understanding of human behavior, technical skills utilizing several learned techniques, and (for most) a commitment to the ethical and professional use of these talents. In its most basic form, marketing for those involved in work programs should encompass nothing more than the delivery of information about what you can do, for whom, for what compensa-
TO INFORM AND PERSUADE If you can accept the fact that there are highly professional, ethical, and creative ways to deliver your message to whomever you wish, then you can construct a plan that will allow you to add a bit of persuasion to the basic flow of information from you to your audience.
How does it work? Let's look at an example within the context of this simplified marketing plan. Here's the scenario: Joan Smith, human resource manager for ACME Storage and Transfer in Yourtown, U.S.A., leaves a meeting at which she was given the assignment of finding out about something called "work hardening." Workers' compensation claims have gone through the roof, the firm's labor pool is diminishing, and it seems as though employees themselves are in complete control of back rehabilitation programs. The company has no comparative data. It doesn't know who is telling the truth and who isn't. Joan returns to her office and tries to figure out whom to call. She remembers receiving a letter from some type of "back specialist." Where did she file it? u~h, yes," she recalls, "it also had a business card designed to fit into the Rolodex. " Looking under "back," she finds the following card: WORK 1993; 3(2):2-5 Copyright © 1993 by Andover Medical
3
Bob Jones, OTR/L Specialist in Work Hardening, Return to Work Programs, Back Rehabilitation On-site Analysis and Rehab
Bob had employed some fundamental marketing techniques. He identified his audience, gave some thought to how his skills might benefit that audience, put together a brief message delivering the information, found his potential clients, sent them something about himself and his skills, and, with an extra twist of persuasion, added some insurance that his message would be kept. He used creativity. No snake oil. No white shoes. Consequently, Joan had at her fingertips someone licensed and qualified to conduct the program the company needed. Where else could she have turned? Most likely to the plethora of chiropractic ads in her yellow pages. By introducing this alternative, we have underscored perhaps the most basic rationale for developing some type of marketing program: If you don't, thry will! Who are thry? Here's the ugliest word of all in the business side of your practicethry are your competitors! The facts are indisputable. Work programs of all types are among the most visible and demanded programs in the United States today. With the aging population, staggering rise in costs of doing business, insurance claims going through the roof, and a tort system run amok (with six- and sevenfigure claims awarded as standard practice), the environment is ripe for therapists to get involved in a variety of work programs at corporations, municipalities, institutions, etc. This fact also is indisputable: Some enterprising practitioner will be proactive, will discover a way to find the Joan Smiths, and will persuade them to join the practitioner's list of clients. Less enterprising therapists, who may have superior skills but fail to see the need to be proactive in the development of a market-based practice, will be left on the sidelines with their integrity neatly in order, but without a practice or clients. If you're still not convinced, you should nevertheless read on. You might find some nugget of information for further use.
BACKGROUND: THE MARKETING PERSPECTIVE IN HEALTH CARE Marketing in the increasingly competitive health care marketplace is a relatively new phenomenon. Although individual communication dates back to the dawn of civilization, when early man inscribed crude symbols on his or her tools as messages to his or her often hostile audience, the now sophisticated economic discipline has been considered declasse in health care circles . Unfairly, P. T. Barnum and cure-all pitch men have been synonymous with the art (science?) of persuasion. Most health care practitioners are still uncertain about the productivity of marketing because productivity is typically defined as units of output divided by units of input. Goods and services are output and marketing factors of production are input. Marketing input can be measured as money invested, but output (business generated) is difficult to quantify or attribute to the marketing effort. Reliable and objective data are available to help serious health care marketers sift through the rubble of failed campaigns and wasted expenditures to determine the proper cost-benefit ratio percentages of revenue formulas and case histories. As in the health care profession itself, even the most die-hard statistician can find data enough to warm his or her heart. The creative side of marketing, which is among the more visible of its various parts, is subject to criticism by countless armchair advisors. Even this, however, can be relatively objective discipline when viewed through the eyes of a professional communicator. Consumers at every level of society are bombarded daily with messages-often compellingdesigned to motivate them to do what marketers want them to do. On any given day, each human being is exposed, through various media, to hundreds of presentations. Those that succeed in evoking strong feelings among their receivers and moving them to action penetrate what is known in communication circles as the noise level, and they have some fairly basic principles of communication in common. Industry sources indicate that those similarities include the following ten points:
4
WORK / SPRING 1993
1. There is a clear product or service differential (not just the same old place, not just the same old thing). 2. There is what Procter & Gamble labeled best as the USP (unique selling proposition), e.g., "specialist in work hardening" 3. The message's goals dovetail with the goals of the product or service (a "we care" ad for a hospital must be followed by a caring attitude at the hospital). 4. The advertising generated is based on a thoroughly analyzed plan that includes the following essential points: • objectives • a media strategy (target audience/reachlfrequency/media mix/timing/environment) • a creative strategy (benefits/positioning/ copy points) • firm budgets 5. The message's source must be perceived as credible by the consumer. Exhaustive research has been done relating credibility values to the advertising spokesperson. Hiring a recognized spokesperson who has actually had first-hand experience as a consumer may be helpful. 6. Successful messages stress benefits over features. Simply announcing that a hospital has added work hardening to its services will do little to influence consumers who are unconvinced of its benefit to them. What is the benefit in obtaining rehabilitation center designation? The fact that the hospital has stateof-the-art equipment and board-certified orthopedic physicians? No. The benefits are workers returned to work and reduced workers' compensation claims. That's the message that penetrates. 7. Successful messages are transmitted in two steps, first, to opinion leaders, who in turn transmit and influence the ultimate receivers. Health care marketers, of course, have a built-in level of opinion leadership in the ranks of the referral base. Here the theory is particularly true, since this group's perception of the provider institution will often mean
the difference between the institution's success and failure. 8. Although the watchdog Federal Trade Commission has an on-again, off-again attitude toward comparative advertising (they mostly encourage it as a true measure of competitiveness), most consumers have negative feelings about the "Coke versus Pepsi" approach. They much prefer the positive presentation of benefits, letting the ultimate decision on which is best be determined by their own experience. "Theirs is bad, ours is good" rarely, if ever, has been a believable message. 9. Successful messages place consumers in a situation that is familiar and comfortable and with which they can identify. For example, presenting real-life testimonials about saved work days from those who were rehabilitated is a formula that is hard to beat. 10. Successful messages "position" the product or service without confusion or nebulous attributes. Don't pretend to be something you are not. Successful positioning strategies answer these questions: • • • • •
Who is the customer (segmentation)? What does he or she need? What can I offer? What does my competition offer? What does the customer think I offer (perceptions)?
If the institution's strength is quick, efficient, offhour ambulatory care, don't advertise its research facilities or network of diagnostic services.
COMPETITIVE LIFE AFTER DRGs One of the most noticeable, if not dramatic, effects of the post-DRG era has been increased reliance on marketing strategies by hospitals fighting for survival in a battle for which they have had little preparation. It is not surprising, then, that their use of advertising, one of marketing's most powerful tools, reflects this lack of preparedness. The result is that health care marketers often extend their negative perception of marketing into
5
their own plans, thus creating a self-perpetuating series of bad messages. Most health care marketers seem to think that the messages have to be bad to be real marketing. The old maxim from the film The Man in the Gray Flannel Suit suggested that to be a success, advertising, for example, must "irritate, irritate, irritate." More recent analyses, however, have shattered this myth by noting that dislike of ads correlates with negative attitudes toward the industry that is advertised.
appear on a typical flow chart outlining the situation analysis and marketing plan. A therapist involved in setting up a work progrilm at a rehabilitation facility might review a plan that looks something like this: Benefits Delivered
Total Market
CALL TO ACTION There is ample evidence to support the need for today's occupational and physical therapists to use marketing in the development of a private practice. The same requirements, techniques, and principles can be used by those within an institutional setting challenged with the task of setting up a program, department, or market-based awareness campaign.
Work Programs Assuming some level of perceived need to market, those involved in work programs should consider developing a situation analysis similar to the chart adapted from the American Management Association. The figure depicts how these points might
Segments
Positioning
Preplacement or postoffer screening Reduced workers' compensation costs Empirical data on low-back strength Insurance companies Local corporations Case managers Rehabilitation counselors Risk managers Human resource managers Most qualified licensed practitioner with experience in work-related issues
CONCLUSION Develop a creative message that reaches those interested in receiving it. Present it professionally and watch your program or practice grow. Notice, also, that you have brought good-quality health care to those who need it. You are still living the life you set out to live, and have not compromised your principles.
