C hapter 5

M a rk e tin g o f H ealth care Services

5.0 Introduction

Health care organizations are amongst the last ones to adopt m odern

marketing practices into their marketing systems. Prior to the late 1970,

marketing, as w e know, it had no significant presence in any health care

provider. People w ho had no formal training or prior experience in

marketing outside the health care industry conducted those marketing

functions that were perform ed at all under the auspicious department with

titles like "development” and "Public relations". The lack in the field o f

marketing was soon to be replaced with the hunger of marketing talent.

Marketing is certainly not the only functional department that has

undergone sea changes in its role in health care management, but certainly

it is one of the most controversial departments as its role is concerned.

5.1 Concept o f M arketin g

W h a t is Mariteting?

Marketing deals with identifying and meeting human and social needs. One

of the shortest definitions of marketing is meeting needs profitably.

133
American Marketing Association offers the following formal definition;

Marketing is an organizational function and a set o f processes for creating,

communicating and delivering value to the customers and for managing

customer relationships in ways that benefit the organization and its

stakeholders

Marketing Management is the art and Science of choosing target markets

and getting, keeping, and grow ing customers through creating, offering,

and freely exchanging products and services of value with others.)

5.1.1 W h a t can b e M arketed?

Products / Goods which are physical in nature. In healthcare, medicines /

tablets, with or without brand names (paracetamol, which is a medicine

Crocin is the brand nam e)are common examples.

Services are invariably intangible in nature. Consultancy by doctors, their

advice, etc., is an example of service. As will be explained later, there could

be pure services and some services are combined with products and goods.

In today's economic scenario, services are the biggest grow ing businesses.

A conference, a medical check-up camp, the Olympics, cricket tournaments

are events that are being marketed for effective response.

134
Places this is an entirely novel concept that is being done today. To take a

simple example, tourism spots like Goa and Kerala are being marketed to

attract tourists. In the field of healthcare, a city may market itself as a place

to come for the right treatment due to availability of the right type of

treatment.

Eminent surgeon who has gained expertise and reputation, winners like

Miss W orld / Miss Universe, a sporting megastar like Sachin Tendulkar,

Kiran Bedi who is known as the most powerful lady is now being marketed

who probably was never ever was thought will be marketed, Dhoni the

most successful Cricket Captain, Coaches o f various teams example Hockey

cricket coach Mr. Negi being asked to promote reality shows, Amitabh

Bachchan , Sharukh Khan are being marketed on various lines. Perfumes

men accessories being names after the celebrities are examples of persons

being marketed.

Organizations in order to build a good image for the customers,

organizations toil to market themselves. Examples like Apollo Hospitals in

healthcare, Pfizer in pharmaceuticals, and Sony in consumer electronics.

N ew Medical Centre in UAE, Pune Based Pharmaceutical Company like

Emcure Pharmaceuticals, a number of IT healthcare solution based

companies like Seed healthcare, Religare, Metropolis, a num ber of

135
insurance based organizations like mediassist. Paramount, TATA AIG, Raio

service Providers like the Radio Mirchi promoting on the reality shows,

Radio one associating with the Leading Symbiosis Institute to Promote

various radio related courses and many many more.

Information is one of the emerging industries in marketing. Information is

collected, packaged and sold to customers. This could be by way of market

research on various aspects to even as basic as a database. This may or may

not be ethical practice. Like for example the Operation Research Group

who collects the product sales data, new product launch data from across a

set of 2000 chemists and extrapolates to 21acs chemists and does the

ranking of ach of the pharmaceutical company products as well as all the

competitors information on similar lines and provides to the companies in

the form of a book for a premium price. With the help of this the companies

can then take a call about their marketing strategies against a competitor,

to what extent market share needs to be increased viz a viz the

competitors, which new products are doing well and the acceptance by the

target audience. This helps in launching new products.

Marketing is essentially about parading the resources of an organization so

that they meet the changing needs of the customers on whom the

136
o rg a n iz a tio n depends. As a v e rb , m a rk e tin g is all about how an

o rg a n iz a tio n addresses its m a rk e t.

5.2 M arketing as a Process

T ill n o w w e have seen m a rk e tin g as a c o n c e p t n o w w e w ill see m a rk e tin g

as a process. T h e process o f m a rk e tin g in v o lv e s exch an g e tra n s a c tio n s

b e tw e e n the bu yers and th e sellers, th e exchange o f p ro d u c ts w ith

c o m p en s a tio n . Exchange in v o lv e s o b ta in in g a d e sire d p ro d u c t o r s e rv ic e

fro m so m eone by o ffe rin g s o m e th in g in re tu rn .

T h e co m p en s a tio n p a id is g e n e ra lly in m o n e ta ry te rm s . T h e essence o f th e

process is; T h e re a re at lea s t 2 p a rtie s , th e re could be m o re Each has

s o m e th in g o f valu e fo r th e o th e r Each is c ap ab le o f c o m m u n ic a tio n and

d e liv e ry Each is fre e to accept o r re je c t th e exchange Each b e lie v e s th a t it

is a p p ro p ria te to deal w ith th e o th e r. T h u s b o th th e b u y e rs and s e lle rs and

if th e re are any o th e r p a rtie s , give s o m e th in g to each o th e r and a re

b e n e fite d th ro u g h th e exchange process. It sh o u ld re s u lt in lo n g te rm

satisfyin g re la tio n s h ip b e tw e e n b o th o f th e m , w h ic h w ill re s u lt in re p e a t

p urchase o f the p ro d u c t.

137
5.3 Marketing as a Managerial Function

Marketing as managerial activity involves following activities:

• Environment scanning and market opportunity analysis

• Understanding the customer needs

• Developing the right products and services with the right

quality and features, design, sizes, variety, etc

• Targeting the right markets and customer segments

• Development of competitive market plan and strategy

• Developing the right price and value offering, promotions,

packaging, payment and credit terms, etc.

• Public relations and advertising, managing the sales force

• Employing the right marketing channels, inventory management,

transportation, logistics, ensuring the right supply chain

• Development of control mechanism.

• All other needs that may be required

Thus employing the right marketing mix, which means using all those

marketing tools, such that an organization is able to supply not only

consumer needs but also achieve its objectives. Thus marketing can be put

as an important organizational function.

138
W hat is Marketing Orientation?

A look at successful marketing organizations in India and abroad reveals

that the marketing organization involves the following dimensions:

Consumer Orientation: Traditionally companies focused from their

viewpoint and assumed that they knew what the customer requires.

Successful marketing companies take efforts to continuously monitor

consumer needs, wants and preferences, both stated and unstated, again

fulfilled and unfulfilled. Unfulfilled customer needs drive their new product

development efforts.

An integral approach to exploiting the market opportunities: successful

marketing companies integrate all the elements of the marketing mix, and

not just merely advertising and selling into a sound business plan that

could successfully help them to fight the competition. That the entire

company would integrate the other functions like research and

development, finance, production, operations, materials, etc. This integral

approach is important for the success of the company.

Futuristic approach: These companies strategize and compete not only for

today's market, but also proactively create markets for tomorrow. So these

companies look at money spent on marketing not as expenditure, but as an

139
investment. For example, they would look at the market from a future

perspective; say a three to ten year perspective when they look at

maximizing their returns from an advertising campaign or tactical price

reduction over these years just than in 1 year.

Highly developed marketing systems: Strong marketing information

systems which will act as Barometer in the market.

Market culture pervades the organization: an important characteristic of

organizations is everybody, from the CEO to the sales executive, everybody

is market-oriented.

Thus Marketing orientation is different from selling orientation, which tries

to dominate many India.

5.4 Custom er Satisfaction an d M ark etin g Mix:

A person's feeling of pleasure or disappointment resulting from comparing

a product's perceived performance in relation to the expectation from the

product. Important here to note is perceived performance and

expectations. For example you hear from a neighbor about a good doctor,

the cleanliness about his hospital, courteous staff, reasonable rates and

above all good treatment. You go to this doctor and let's assume that all this

turns out to be true. Then since there was an expectation the satisfaction

140
w ould be just about met. But if there is even something that does not get

fulfilled, say a mistake in the billing, there will be low satisfaction in spite of

the fact that you had good treatment. On the other extreme, you go to a

hospital in an emergency. The hospital is not sophisticated at all, but just

the fact that you may have been given a lot of importance and attention

may make you ignore everything else, even the high bill, and make you a

very satisfied customer. Customers form their expectations from

advertisements, information from other companies, own past experiences,

even from names of companies. Companies need to target high levels of

satisfaction because customers will switch to other offerings if they are not

just satisfied or just about satisfied. Highly satisfied customers will not

switch easily and their bond is more than just rational, it is often emotional.

Thus you gain loyalty. The key to generating high customer loyalty is to

deliver high customer value.

5.5 Attracting and R etaining Custom ers

Companies need to get customers to seek profits, and attracting new

customers requires considerable amount of time, effort and money. Next is

converting this attraction into business, which leads to acquisition of new

customers. In the above process, the first step is to generate leads for all

possible customers, by various methods. Popularly, this is known as

141
suspecting. The next step would be screening this hst, based on various

parameters and come down to the Hst of prospects that need to be

concentrated upon.

But it is not enough to acquire new customers only to lose them. So a

company must measure its retention rate say for a hospital how many

patients would come back when there is a need or say in the case of a

travel agency, how customers may keep on booking through you. Next is to

see the reasons for losing customer. There are many cases, where nothing

can be done; the company in spite of its best efforts would have lost these

customers. There may be some customers, where it would be better not to

have them at all, because there may be a loss, trying to retain and serve

these customers. In other cases, quite often the reasons are manageable

and the company should correct their mistakes. The reasons are obvious if

the company calculates the profits lost from existing customers and also

looks at the cost of acquiring new customers, it would be very large. The

cost of retaining customers is far significantly low er than acquiring new

customers. The unfortunate part is most companies focus on attracting and

acquiring new customers than retaining old customers. Customer loyalty

comes from customer satisfaction, which in turn leads to customer

retention. This leads to higher profits, more consumption from same

142
customers, talks and advertises about our company at no extra cost and is

tlien willing to try new products and services offered in the future by your

company.

5.6 M arketin g Mix

Marketers use numerous tools to elicit desired response from their target

markets; these tools constitute a marketing mix. Marketing mix can be

defined as a set of tools that the firm uses to pursue its marketing

objectives in the target market. McCarthy classifies these tools into four

broad groups that he called as the 4 Ps of marketing; product, price, place,

and promotion.

Marketing mix decisions are made for influencing the trade channels as

well as the final customers. Typically a firm can change its price, sales force

size and advertising expenditures in short run. It can develop new products

and modify its distribution channels only in long run. Thus the firm

typically makes fewer period-to-period marketing mix changes in the short

run than the number of marketing mix variables might suggest.

The term "marketing mix" was coined in 1953 by Neil Borden in his

American Marketing Association presidential address. However, this was

actually a reformulation of an earlier idea by his associate, James Culliton,

who in 1948 described the role of the marketing manager as a "mixer of

sometimes prepares his own recipe as he goes along, sometimes adapts a

recipe from immediately available ingredients, and at other times invents

new ingredients no one else has tried. The marketing mix (price, product,

distribution, promotion) forms the entire promotional campaign. As stated

in "Management of a Sales Force” by Rosann L. Spiro, Gregory A. Rich,

William ]. Stanton, "when these are effectively blended, they form a

marketing program that provides want-satisfying goods and services for

the company's market." The term became popular in the article written by

Niel Borden called, "The Concept of the Marketing Mix," as explained on the

site netmba.com. He started teaching the term to many after he him self

learned about it with an associate of his. The marketing mix is a broad

concept which includes several aspects of marketing which all inquire to

obtain a similar goal of creating awareness and Patient loyalty. The

marketing mix is not only an important concept, but a guideline to

reference back to when implementing the price, promotion, product, and

distribution. Those are the four main ingredients of the marketing mix, but

there are other components not already mentioned includes planning,

branding, packaging, display, distribution channels, personal selling,

advertising, servicing, and physical handling. All in all the current

description of the marketing mix is accurate, but missing some vital pieces

144
of information which will allow individuals to gain a better understanding

and implement a more effective marketing mixJi] A prominent marketer, E.

Jerome McCarthy, proposed a Four P classification in 1960, which has seen

w ide use.

5.6.1 Four P ’s

Elements of the marketing mix are often referred to as the "Four 'P's", a

phrase used since the 1960's

The basic major marketing management decisions can be classified in one

of the following four categories, namely Product, Price, P lace

(distribution) and Prom otion.

145
 T h e F o u r P C o m p o n e n t s o f t h e M a r k e tin g M ix

P ro d u c t P r ic e
P r o d u c t v a r ie ty L is t p n c e
Q u a lity D is c o u n ts
D e s ig n A llo w a n c e s
F e a tu r e s P a y m e n t p e r io d
B ra n d n a m e C r e d it te r m s
P a c k a g in g
S iz e s
S e r v ic e s
W a r r a n tie s
R e tu r n s

T a rg e t m a rk e t

P la c e P r o m o t io n
C h a n n e ls S a le s p r o m o tio n
C o v e ra g e A d v e r t is in g
A s s o rtm e n ts S a le s r o r c e
L o c a tio n s P u b lic r e la t io n s
In v e n to ry D ir e c t m a r k e tin g
T ra n s p o rt

Product - It is a tangible good or an intangible service that is mass

produced or manufactured on a large scale with a specific volume of

units. Intangible products are service based like the tourism industry &

the hotel industry or codes-based products like cellphone load and

credits. Typical examples of a mass produced tangible object are the

motor car and the disposable razor. A less obvious but ubiquitous mass

produced service is a computer operating system. Packaging also needs

to be taken into consideration. Every product is subject to a life-cycle

including a growth phase followed by an eventual period of decline as

the product approaches market saturation. To retain its

competitiveness in the market, product differentiation is required and

is one of the strategies to differentiate a product from its competitors.

146
 Price - The price is the amount a Patient pays for the product. The

business may increase or decrease the price of product if other stores

have the same product.

Place - Place represents the location w here a product can be

purchased. It is often referred to as the distribution channel. It can

include any physical store as well as virtual stores on the Internet.

Promotion represents all of the communications that a m arketeer

may use in the marketplace. Promotion has four distinct elements:

advertising, public relations, personal selling and sales promotion. A

certain amount of crossover occurs when promotion uses the four

principal elements together, which is common in film promotion.

Advertising covers any communication that is paid for, from cinema

commercials, radio and Internet adverts through print media and

billboards. Public relations are where the communication is not directly

paid for and includes press releases, sponsorship deals, exhibitions,

conferences, seminars or trade fairs and events. W ord of mouth is any

apparently informal communication about the product by ordinary

individuals, satisfied Patients or people specifically engaged to create

word of mouth momentum. Sales staff often plays an important role in

word of mouth and Public Relations (see Product above).

147
Any organization, before introducing its products or services into the

market; conducts a market survey. The sequence of all 'P's as above is very

much important in every stage of product life cycle Introduction, Growth,

Maturity and Decline.

In recent years the addition of a 5th P has become common place. The 5th P

being people, this is to represent the people w ho you are targeting but also

the people who will physically conduct each part of the campaign. Some

people even go up to as many as 10 P's.

5.6.2 Extended M ark etin g M ix (4 P 's )

More recently, three more Ps have been added to the marketing mix

namely People, Process and Physical Evidence. This marketing mix is

known as Extended Marketing Mix.

• People: All people involved with consumption of a service are

important. For example workers, management, consumers etc. It also

defines the market segmentation, mainly demographic segmentation. It

addresses particular class of people for whom the product or service is

made available.

148
• Process: Procedure, mechanism and flow of activities by which

services are used. Also the 'Procedure' how the product will reach the

end user.

• Physical Evidence: The marketing strategy should include effectively

communicating their satisfaction to potential Patients.

"Posture" it represents a friendly behavior with people and make a

relation.

5.6.3 Four Cs

(CONSUMER, COST, CONVENIENCE and COMMUNICATION , CULTURE )

Robert F. Lauterborn proposed a four Cs classification in 1993.[2] The Four

Cs model is more consumer-oriented and attempts to better fit the

movement from mass marketing to niche marketing.

• Product part of the Four Ps model is replaced by 'Consumer' or

Consumer Models, shifting the focus to satisfying the consumer needs.

Another C replacement for Product is Capable. By defining offerings as

individual capabilities that when combined and focused to a specific

industry, creates a custom solution rather than pigeon-holing a Patient

into a product.

149
 Pricing is replaced by 'Cost' reflecting the total cost of ownership.

Many factors affect Cost, including but not limited to the Patient's cost

to change or implement the new product or service and the Patient’s

cost for not selecting a competitor's product or service.

Placement is replaced by 'Convenience'. W ith the rise of internet and

hybrid models of purchasing, Place is becoming less relevant.

Convenience takes into account the ease of buying the product, finding

the product, finding information about the product, and several other

factors.

Promotions feature is replaced by 'Communication' which

represents a broader focus than simply Promotions. Communications

can include advertising, public relations, personal selling, viral

advertising, and any form of communication between the firm and the

consumer.

150
5.7 H o w does a m ark eter strategize to attain success in a m a rk e tin g

pro gram , using these 4 P ’s?

PRODUCT P R IC E
• dot's IhK • ih n o f ifu*
tmrrt t
iep
rodij
rt" p r o d u c t o r » r / i c » co t h o
• wtiat « navefo tuivw*
• Ittrrf l^rttr
• flC?ASftCVvtXTo'' thk' powttu fo* ( rc C u . ik o r ^rtm.
aiit7iT«T thfamrt^*
• W»tcrf docvIt Ux?k • IstN? f pncc
• Wtwr HUi*??.). cc4u«<%},
It t i » ' • ciscn,ims fihoufc b«
• I* Tflwftfl tQ trac*i c-uElrrrriMf*! ,'
• th/A' II hr^ifK#irU* • Ht/vu A«|l yf»(iT
• MtrtVi& rjlf^rrmtMle-J ve»%uv rtMn yiJur IUir%*
v n u r c o r^ o tit- v r a

TARGET
MARKL- T

P tA C E P R O M O T IO N
W f w r do kH * fof your • 3I1C wfwn can you gar Acroac
proCoU or yvr»ui tr-.wiK<f1>ni3 vvmw
J ciMv took ir- a atM». Mliat
kmc' • <.VjM ttoxJ rc o r.ti > p j r au d W m cn t r r
Hctm<jmyou(tocr^^tHr >9
j d '/ « e t i v r in t h « o i' a n Tv or
t^rwis* ra
dio
,r#
i.i
nb«
tt»
ck>
rdR
Oo YOU n e ^ t o u « e a « a le s • \V t«rii M. ♦ t ir Uev> i# T w tji
• MOW d a v c * jr -c4upctifnr‘. <X3 t^w ru
Wi»<* CO r9u comp«titons da. anc p r o n v n e io f t^ * A n d c-ae« t h a t
\ hem can y t u frrm* t t u i ftin u e fu ^ * v n iu r (tk JA -e -jf p x o riu tJ ijru U '

The 4 Ps represent the seller's view of marketing tools available for

influencing the buyer. From the buyer's point of view, each tool is designed

to give the customer benefit. Some authors have suggested that the 4 P's of

a seller correspond to the 4 Cs of a Customer Viz: Customer Solution,

Customer Cost, Convenience and Communication

151
5.8 M a rk e tin g M ix for Services

One w h o buys a service offering probably takes a decision based on the

fo llo w in g factors;

H o w easy w o u ld it be to b u y it?

W illin g n e s s to pay fo r th e s erv ice

In flu e n c e o f the p r o m o tio n c am p a ig n

The m a rk e te rs c a re fu lly p la n th ese fa c to rs and m ake an a tte m p t to

c o n vin c e the custom ers to b u y th e ir p ro d u c ts . T h e tra d itio n a l m a r k e tin g

m ix has m e n tio n e d above co n tain s: P ro d u c t, P rice, P ro m o tio n and P h ysical

D is trib u tio n , i.e. Place In case o f services.

5.8.1 M arketing o f H ealthcare Services

M arketing in Healthcare i

H e a lth c a re a d o p te d m a rk e tin g a p p ro a c h e s w e ll a fte r m o s t o th e r in d u s trie s ,

a nd th e m a rk e tin g era w a s n o t c o n s id e re d to b eg in in h e a lth c a re u n til th e

1 9 8 0 s . T h is does no t m e a n th a t c e rta in h e a lth c a re o rg a n iz a tio n s in th e

re ta il and s u p p lie r sectors had n o t been in v o lv e d in m a rk e tin g a c tiv itie s .

152
Pharmaceutical companies, consumer-product vendors, and health plans

have a long history o f marketing activities; indeed, some o f these

organizations devote an inordinate proportion of their budgets to

marketing. These types of organizations are addressed throughout this

book, although the emphasis is on marketing on the part of healthcare

providers. While marketing was noticeably absent from the functions o f

most healthcare providers until the 1980s, precursors to marketing had

long been established. Every hospital and many other healthcare

organizations had well-established public relations (P R ) functions. PR

involved disseminating information concerning the organization and

announcing new developments (e.g., additions to staff, purchase of

equipment). The main interface for PR staff w as with the media. They

disseminated press releases, responded to requests for information, and

served as the interface with the press should some negative event occur.

Large provider organizations also typically had communication functions,

although they were often carried out under the auspices of the PR

department. Communications staff w ould develop materials for

dissemination to the public and the employees of the organization. Internal

(and, later, patient-oriented) newsletters and patient-education materials

were frequently developed by communications staff

153
Some of the larger organizations (and certainly the major retail firms and

professional associations) established government-relations offices. These

staff members w ere responsible for tracking regulatory and legislative

activities that might affect the organization. They served as the interface

with government officials and provided lobbying efforts as appropriate.

The government-relations office frequently became involved in certificate

of- need activities. This function has historically been critical for many

healthcare organizations because of the constant pressure on not-for-profit

healthcare organizations to justify their tax-exempt status. In addition to

these formal precursors of marketing, healthcare organizations of all types

w ere involved in informal marketing activities to a certain extent. This

occurred when hospitals sponsored health education seminars, held an

open house for a new facility, or supported a community event.

Hospitals marketed by making their facilities available to the community

for public meetings and by otherwise attempting to be good corporate

citizens. Physicians marketed themselves through networking with their

colleagues at the country club or medical-society-sponsored events. They

sent letters of appreciation to referring physicians and provided services to

high school athletic teams.

Ultimately, low-budget PR departments w ere transformed into

multimillion- dollar marketing programs. This did not happen overnight,

154
and a number of developments had to occur before healthcare came to

appreciate the relevance o f marketing.

5 .8 .2 H ospitals are offering th e follow in g se rv ic e s u n d er h ea lth ca re

se rv ic es to the com m on man:

1. Emergency Medical services - Emergency Medical services and care at

most of the hospitals is unique and advanced. The hospitals have state-of-

the-art ambulances. The Cardiac Care Unit's on wheels under supervision

by medical and para-medical staff. There is hi-tech telecommunication

available to a patient in an emergency at any given time. These em ergency

Medical services personnel are certificate to give first aid in case of

emergency. Support from these experts could be in the form of medication

or simply resuscitation by providing mouth to mouth breathing exercise.

2. Ambulance services - Hi-tech ambulances linked by state-of-the-art

telecommunications are fully equipped with doctors that are available to

render medical attention and assistance in case of emergencies at the

patient's doorstep. Example if ECG is taken in the ambulance the same can

be read by the consultant sitting in his consulting room provided the

relevant connections are installed at his place / the computer or simply on

his mobile.

3. Diagnostic services - Modern Hospitals are multi-specialty and multi-

155
disciplinary, that can handle any kind of ailment, they offer a w ide range of

facilities for instance, Dermatology, Infertility, Oncology, Orthopedics such

as Hip replacement or the joint replacement. Neurology, Organ

Transplantation, Plastic surgery and so on.

4. Pharmacy services - Most of the hospitals also have a pharmacy which is

open 24 hours. It caters to the needs not only of the inpatients and

outpatients, but also patients from other hospitals w ho require em ergency

drugs.

5. Casualty services - Casualty service are meant for a 24 hrs X 7days

service. Casualty department which attends to the accident or emergency

cases consists of a set of people which includes a resident doctor,

emergency medical service expert, nurse and a w ard boy.

Sooner Emergency and Casualty case occurs if it is of a very serious nature

CODE BLUE is announced.

Hospital Emergency Codes are used in hospitals w orldw ide to alert staff to

various emergency situations. The use of codes is intended to convey

essential information quickly and with a minimum of misunderstanding to

staff, while preventing stress or panic among visitors to the hospital. These

codes may be posted on placards throughout the hospital, or printed on

employee/staff identification badges for ready reference. Back o f a hospital

156
ID badge shows disaster codes. Hospital emergency codes are frequently

coded by color, and the color codes denote different events at different

hospitals and are not universal

The fact that different hospitals, even those in close proximity to one

another, do not utilize a consistent coding system leaves room for

confusion in the event of an emergency or disaster. Many physicians have

privileges at more than one facility, and the expectation is that he or she

would be well versed in the emergency doctrines of each. However, it

seems that without due diligence in regular review of the codes for each

hospital, it would be very possible for confusion to ensue in the event o f a

code announcement. The standardization of codes, however, w ould

diminish the secretive "code" aspect of these announcements, thereby

defeating the purpose of using the codes.

Apart from the above mentioned services, hospital also offers "Health

Diagnosis Programme" which is a complete, comprehensive, periodic

health check up offered for busy executives, professionals, business

persons and so on. The health diagnosis programme comprises o f the

following:

1. Master health check up

2. Executive Health check up

157
3. Diabetics health checkups etc

Generally, the service offering in a hospital comprises of the following

levels:

1. Core level - it comprises of the basic treatment facilities and services

offered by the hospital like diagnostic services, emergency services,

casuality services etc.

2. Expected level - it comprises o f cleanliness and hygiene levels

maintained in the hospital.

3. Augmented level - it comprises of dress code for staff, air conditioning of

the hospital, use of state of art technology, services of renowned

consultants.

Understanding the role of the additional 3 Ps for healthcare services:

People unlike in products, in services it is the people w ho deliver the

services. The success of delivering services depends on the quality of the

people, the staff and their skills along with their attitude. In a hospital, the

receptionist, the doctors, the nurses, the administrative staff all put

together deliver the service. Their skills and attitude along with w hat they

deliver becomes important.

Physical Evidence: Services delivered are at the moment of delivery. If the

receptionist forgets to greet a customer or does not satisfy queries of a

158
customer, the moment is lost. Thus the evidence of such acts determ ines

the quality and delivery of service. Process as detailed earlier, there are

many aspects to a service that have to be done in the proper sequence, at

the right time and in the proper way, and thus the process is important.

Hence the seven Ps of services are Product, Price, Promotion, Place, People,

Physical evidence. Process. An integrated approach to all the seven P's

determines the marketing of the service.

Six P's add value to the services. Out of the 7 P's of marketing mix for

services 6 P's of the mix calculate for the 7 P, that is value for money, price

paid by the customer.

5.9 Considerations fo r P ro m o tin g M ark etin g o f H ealth care Services

A nalysis o f the en viron m en t

Factors to be con sidered fo r En viron m en tal Study:

• Events are important and specific occurrences taking place in

different sectors

• Trends are the general tendencies / courses of action along which

events take take place

159
 • Issues are the c u rr e n t c o n c e rn s th a t aris e in re s p o n s e to e v e n ts a n d

tre n d s

• E x p e c ta tio n s are th e d e m a n d s m a d e b y in te re s te d g ro u p s in th e lig h t

o f th e ir co n c e rn fo r issu es

In s tu d y in g the e n v ir o n m e n t, th e follow ^ing a c tio n s w o u ld be the re :

In scrutinizing, o ne w o u ld try a n d id e n tify early signs o f e n v ir o n m e n ta l

changes and tren ds. T hus, s c a n n in g th e e n v ir o n m e n t, m eans f in d in g

in fo r m a tio n , data, tre n d s w h ic h w ill affect y o u r c o m p a n y , d ir e c tly a n d

in d ire c tly , in the p re s e n t a n d also p o s s ib ly in th e fu tu re . Screen in g th e

e n v ir o n m e n t, k e e p in g tr a c k o f th e ch a n g e s a n d in te r r e la tio n s h ip s b e tw e e n

v a rio u s factors. In m o n ito r in g , o n e de te cts m e a n in g th r o u g h o b s e r v a tio n s .

P redicting w h a t p o s s ib le e v e n ts a n d ch a n g e s m a y b e o c c u r r in g in th e

fu tu re th a t w ill have an im p a c t o n th e c o m p a n y . In fo re cas tin g , o n e w o u ld

d e v e lo p p ro je c tio n s b a s e d o n a n tic ip a tio n o f o u tc o m e s th r o u g h s c a n n in g

a n d m o n ito rin g . Evaluating th e im p a c t, y o u w o u ld d e te r m in e th e a c tio n ,

im p o r ta n c e a n d tim in g fo r th e c o m p a n y 's strateg ies.

T he ex ternal e n v ir o n m e n t e n c o m p a s s e s th e fo llo w in g :

a) M a rk e tin g e n v ir o n m e n t

b) F in ance e n v ir o n m e n t

160
c) E c o n o m ic e n v ir o n m e n t

d) D e m o g r a p h ic e n v ir o n m e n t

e) P o litic a l a n d Legal e n v ir o n m e n t

g] S u p p lie r a n d T e c h n o lo g ic a l e n v ir o n m e n t

h) Social a n d C u ltu ra l e n v ir o n m e n t.

A ll o f th e m are in te r re la te d a n d c a n n o t o p e ra te in is o la tio n .

M arketing Environm ent

It is c o n c e rn e d w ith th e m a r k e ts in w h ic h th e c o m p a n y o p e ra te s a n d th e

lin k a g e b e tw e e n th e c o m p a n y , c u s to m e rs a n d c o m p e titio n . T y p ic a l s tu d y

w o u ld be g ro w th rate, d e m a n d v / s s u p p ly , c o m p e tito r s , c u s to m e rs , n e e d s

o f c u sto m e rs, price p e r fo r m a n c e ra tio o f v a r io u s p r o d u c ts a v a ila b le ,

c u s to m e r choices a n d p re fe re n c e s etc.

Financial Environm ent

It is c o n c e rn e d w ith th e d e m a n d / s u p p ly o f m o n e y , c a p ita l m a rk e ts ,

in te rm e d ia rie s , in te r e s t rates, te n u r e o f lo a n s , s e c u ritie s a s k e d fo r lo a n s ,

v a rio u s fin a n c ia l in s tr u m e n ts , a n d o th e r facto rs in th e fin a n c ia l sector.

Dem ographic Environm ent

161
It is c o n c e rn e d w ith th e p o p u la tio n 's size a n d g r o w th rate , ag e a n d sex w is e

d is tr ib u tio n a n d c lassificatio n , s tr u c tu r e a n d size o f fa m ilie s , g e o g r a p h ic

d is tr ib u tio n , a n d e th n ic m ix a n d in c o m e d is tr ib u tio n , etc.

Econom ic Environm ent

It is c o n c e rn e d w ith in f la tio n rates, G DP, s av in g s rate, tr a d e d e fic its ,

b a la n c e o f p a y m e n ts , tr a d e g ap , tr a d e cycles, in fr a s tr u c tu r e lik e e le c tric ity /

c o m m u n ic a t io n / ro ad s / ra il / a ir / etc., a n d o th e r s u c h fa c to rs t h a t a ffe c t

th e e n tire in d u s try .

Political/L egal Environm ent

It is c o n c e rn e d w ith govt, p o licie s, s ta b ility , p h ilo s o p h y o f g o v t , v a r io u s

la w s, in fra s tr u c tu r e fo r im p le m e n ta t io n o f v a rio u s la w s and p o lic ie s ,

a ttitu d e to w a rd s la b o r, b ila te r a l r e la tio n s a n d o v e ra ll factors t h a t m a y

a ffe c t in d u s tr y clim ate .

Social/Cultural Environm ent

It is c o n c e rn e d w ith a ttitu d e s a b o u t w o r k / q u a lity , c o n c e rn s , ethics, v a lu e s ,

re lig io n , c o rr u p tio n a n d o th e r su ch factors.

It is c o n c e rn e d w ith th e q u a lity a n d n u m b e r o f s u p p lie r s , la b o r a n d p e o p le

as s u p p lie rs , the logistics, r a w m a te r ia l, tr e n d s a n d ra te o f c h a n g e o f

162
te c h n o lo g y , a p p r o p r ia te te c h n o lo g y , c o s t/b e n e fit o f te c h n o lo g y a n d o th e r

s u c h factors.

Internal Environm ent

H e re th e a n a ly s is is of;

a) R esources

b) Capabilities

c) C om petencies

a) Resources: the re are ta n g ib le a n d in ta n g ib le re sources.

b) Tangible resou rces can b e q u a n tifie d a n d are id e n tifia b le / v is ib le

b a s ic a lly 4 ty pe s - financial re so u rce s - o r g a n iz a tio n a l re so u rce s - p h y s ic a l

re sou rces - te c h n o lo g ic a l resources.

c) Intangible resources are less v is ib le - lik e h u m a n re so u rce s - in n o v a tio n

resources - r e p u ta tio n . T he re so u rce s o f th e fu n c tio n a l d e p a r tm e n ts lik e

finance, a d m in is tr a tio n , o p e r a tio n s , etc.

d) Capabilities are th e c o m p a n y 's c a p a c ity to d e p lo y re s o u rce s th a t h a v e

b e en p u rp o s e ly in te g ra te d to a ch ie v e a d e s ire d e n d state. C a p a b ilitie s

e n a b le the c o m p a n y to cre ate a n d e x p lo it e x te rn a l o p p o r tu n itie s .

163
An O pportunity is a fa v o ra b le c o n d itio n in g th e o r g a n iz a tio n 's

e n v ir o n m e n t w h ic h e n ab le s it to c o n s o lid a te a n d s tre n g th e n its p o s itio n .

A n e x a m p le o f an o p p o r t u n it y is g r o w in g d e m a n d fo r th e p r o d u c ts o r

services th a t a c o m p a n y p r o v id e s

A T hreat is an u n fa v o ra b le c o n d itio n in th e o r g a n iz a tio n 's e n v ir o n m e n t,

w h ic h creates a risk for, o r causes d a m a g e to, th e o r g a n iz a tio n . A n e x a m p le

o f a th r e a t is the e m e rg e n c e o f s tro n g n e w c o m p e tito r s w h o a re lik e ly to

o ffe r s tiff c o m p e titio n s to th e e x is tin g c o m p a n ie s in an in d u s tr y .

T he Strength is an in h e r e n t cap acity , w h ic h an o r g a n iz a tio n can use to g a in

s tra te g ic a d v an tag e . A n e x a m p le o f s tre n g th is s u p e r io r re s e a rc h a n d

d e v e lo p m e n t so th a t th e c o m p a n y can g a in a s tra te g ic a d v a n ta g e is an

in h e r e n t capacity, w h ic h an o r g a n iz a tio n can use to g a in a s tra te g ic

a d v a n ta g e .

A W eakness is an in h e r e n t lim it a t io n o r c o n s tra in t, w h ic h creates s tra te g ic

is a d v a n ta g e s. A n e x am p le o f a w e a k n e s s is o v e r d e p e n d e n c e o n a s in g le

p r o d u c t line, w h ic h is p o te n tia lly ris k y fo r a c o m p a n y in tim e s o f crisis.

B ased o n the above a c o m p a n y w o u ld e v a lu a te th e S W O T a n aly sis. T h e re

w o u ld be th re a ts an d o p p o r tu n itie s in th e e n v ir o n m e n t. To tak e a d v a n ta g e

164
o f th e o p p o r tu n itie s a n d m in im iz e th e th re a ts , a c o m p a n y w o u ld r e q u ir e a

few c ritic a l success factors.

The Critical Success Factors or CSFs are th e r e q u ir e m e n ts to be

successful in th a t b u s in e s s area. F o r e x am p le , a s u p e r s p e c ia lty h o s p ita l

re q u ire s e x perience d a n d q u a lifie d d o c to rs a n d s u rg e o n s ; a p h a r m a c y

c o m p a n y ne ed s a g o o d sales te a m a n d e x ce lle n t d is tr ib u tio n sy ste m s, etc.

If th e se CSFs are a v a ila b le w ith th e c o m p a n y in a m e a s u r e la r g e r th a n

o th e rs hav e it th e n o n ly it is s tre n g th . So if a s u p e r s p e c ia lty h o s p ita l has

th e b e st d o cto rs a n d if th e se ty p e s o f d o c to rs are n o t a v a ila b le w ith th e

c o m p e titio n , th e n it is s tre n g th . If all th e o th e r h o s p ita ls also h a v e s im ila r

p a n e l o f d o ctors th a t y o u have, it is a n e u tra l factor. So s tre n g th h a s tw o

c h a ra c te ristics one, it is r e q u ir e d fo r success a n d se co n d , y o u h a v e it m o r e

th a n the others. If s o m e th in g is n e e d e d fo r success, b u t is a b s e n t in y o u r

o rg a n iz a tio n it is a w e a k n e s s , b e c a u se y o u w ill n o t be a b le to c a p ita liz e o n

th e o p p o r tu n itie s a n d th e c o m p e titio n w ill e ro d e y o u r p o s itio n . T hus,

stre n g th s a n d w e ak n e sse s a re re la tiv e to th e e n v ir o n m e n t.

T he strategy w o u ld be th e n to c a p ita liz e o n th e o p p o r tu n itie s th r o u g h y o u r

stre n g th s a n d m in im iz e th e th r e a ts th a t a rise d u e to y o u r w e a k n e ss .

Identifying Target C ustom ers

165
T arg e t c u s to m e rs can be d iv id e d in to tw o ty pes:

1) External to the organization:

T hey a re n o t d ire c tly as so c ia te d w ith th e o r g a n iz a tio n

2 ) Internal custom ers:

W ho w ork for the o r g a n iz a tio n and need to be g iv e n c o n s id e r a b le

a tte n tio n

D ifferentiation and P osition in g

D iffe re n tia tio n is the act o f d e s ig n in g a set o f m e a n in g fu l d iffe re n c e s to

d is tin g u is h th e o r g a n iz a tio n 's o ffe rin g fr o m th a t o f th e c o m p e tito r . In

p r o d u c ts o ne can use fo rm , e.g. a m e d ic in e by d iffe re n t doses, size, c o a tin g ,

a c tio n tim e, s u s ta in e d release, etc o n e can d iffe re n tia te by fe atu re s o n e can

use p e rfo r m a n c e q u a lity , d u r a b ility , re lia b ility , style, etc to d iffe re n tia te .

In services o ne can d iffe re n tia te b y o r d e r in g ease o r a c ce s s ib ility , d e liv e ry

o f th e service, g iv in g c u s to m e r's in fo r m a tio n , tr a in in g a n d c o n s u lta n c y , a n d

a w h o le lo t o f such services. O ne can cre ate a d iffe re n c e b y g iv in g a n im a g e ,

b y u s in g sy m b o ls a n d p e rs o n a lity .

T he d iffe re nce cre ate d m u s t be im p o r t a n t to a c u s to m e r, d is tin c tiv e ,

s u p e r io r to c o m p e titio n , cannot be e a s ily c o p ie d , a ffo rd a b le to th e

c u sto m e r, a n d p r o fita b le to th e c o m p a n y p r o v id in g th e d iffe r e n tia tio n .

166
O n c e th is is d o n e , y o u th e n n e e d to p o s itio n y o u r o ffe r in g fo r th e ta r g e t

m a r k e t id e n tifie d .

T he o rg a n iz a tio n s m u s t carv e o u t a "P O S IT IO N " fo r its e lf a n d its se rv ice s /

p r o d u c ts in th e m in d o f th e c u s to m e r.

A dvantages o f P osition in g

• C reate a d is tin c tiv e p la c e in th e m in d s o f th e p o te n tia l c u s to m e rs e.g.

A p o llo s u p e rio r q u a lity o f h e a lth care, J o h n s o n & Jo h n s o n safe

p ro d u c ts

• P ro v id e s a c o m p e titiv e ed g e

• In ta n g ib ility gets ta n g ib ility

• Gives th e ta rg e t m a r k e t a re a s o n fo r b u y in g y o u r services

T here is q u e s tio n o f h o w m a n y d iffe re n c e s to p r o m o te . E ach c o m p a n y m u s t

create s o m e "U n iq u e S e llin g P r o p o s itio n s " p r o m o tin g k ey c e n tra l b e n e fits

a n d try to be the b e s t o n th o s e a ttr ib u te s a n d b e n e fits . T h e re s h o u ld b e

b a la n c e o f try in g to p r o m o te o n ly o n e b e n e fit, w h ic h m ig h t b e to o n a r r o w

a n d o n th e o th e r h a n d p r o m o tin g to o m a n y b e n e fits th a t d o n o t s e e m

cre dib le . T here are ty p ic a lly th e fo llo w in g erro rs in p o s itio n in g :

167
 • Under position in g : g iv in g o n ly a v a g u e idea, c u s to m e r c a n n o t

d e c ip h e r th e be n e fit; e.g. a h o s p ita l s a y in g it is re lia b le , b u t n o t

b e y o n d that.

• Over position in g : h a v in g to o n a r r o w a n im a g e e.g. h o s p ita l g iv in g

d iffe re n t services p r o m o te s m a y b e p e rc e iv e d b y c u s to m e rs as o n ly a

p r e v e n tio n centre.

• Confused position in g : to o m a n y c la im s , c h a n g e in p o s itio n m a y

lead to co n fu s io n in th e m in d s o f th e c u s to m e r

• Doubtful p osition in g : la c k o f c r e d ib ility d u e to u n te n a b le c la im s

In p o s itio n in g a service, th e re is an im a g e t h a t is cre ate d. Im a g e is th e s u m

o f beliefs, a ttitu d e s a n d im p r e s s io n s t h a t a p e rs o n o r g r o u p h as o f a n o b je c t.

Im a g e is created th r o u g h an id e n tity th a t a c o m p a n y trie s to p r e s e n ts its e lf

to c u sto m e rs. T here are d iffe r e n t ty pe s o f im a g e s c u r r e n t im ag e , th e w a y

as seen n o w m ir r o r im a g e w a y th e c o m p a n y th in k s it is seen w is h im a g e

th e w a y a c o m p a n y w o u ld lik e to be seen. T he a im is to m a k e th e c u r r e n t

im a g e a n d w is h im a g e to m a tc h . F o r effe ctiv ely p o s itio n in g services th e

fo llo w in g hav e s ig n ific a n t in flu e n c e e m p lo y e e a ttitu d e c u s to m e r a n d

c o n ta c t e m p lo y e e in te r a c tio n p o lic ie s a n d p r o c e d u re s o f th e c o m p a n y

168
re s p o n s iv e n e s s to s o lv in g p r o b le m s a n d c o m p la in ts th e e x p e rie n c e o f th e

c u s to m e r.

The process of p osition in g is twofold:

M a rk e t p o s itio n in g w h e r e y o u id e n tify a n d se le ct m a r k e ts b a s e d o n

k n o w le d g e o f th e ne e d s a n d b e n e fits o f th e service o ffe re d e.g. E s c o rts

h e a r t h o s p ita l. T he n e x t s te p is to u se p s y c h o lo g ic a l p o s itio n in g to c re a te a

im a g e u s in g e ith e r o b je c tiv e o r s u b je c tiv e p a r a m e te r s . F in a lly y o u lo o k a t

p o s itio n in g a p p ro a c h e s w h ic h ca n b e b y a ttr ib u te s , p rice , q u a lity , etc.

Pricing

S e ttin g th e rig h t p rice is c ru c ia l fo r service s a n d th e m o s t c h a lle n g in g . I f th e

price s are to o hig h, y o u m a y n o t g e t c u s to m e rs , if th e y are to o lo w , y o u m a y

n o t m a k e profits.

Factors Affecting Pricing:

Fixed costs th e co st y o u h a v e to in c u r irre s p e c tiv e o f th e v o lu m e s /

bu sin e ss, lik e rent, s alarie s, etc

Variable costs: th e c o sts o f your in p u ts that are directly p ro p o rtio n a l

to your business, e.g m ed icin es given, bandages, etc.

• Positioning

169
 • Prom otions

• T axes

• Custom er's p ercep tion ab ou t price and quality

• Image

• Elasticity o f dem and

O n e c o u ld use cost as a b a s e fo r p r ic in g ty p ic a lly

• Cost plus m ethod

• Target return on in v estm en t pricing

O r o n e c o u ld use a d e m a n d as a b a s e fo r p r ic in g ty p ic a lly

• D iscrim inatory pricing:

C harge a fflu e n t p a tie n ts m o r e a n d p o o r e r p a tie n ts less, o r d if fe r e n t

prices fo r d iffe re n t tim e s / seaso ns, m o r e fo r a n e m e rg e n c y , less

w ith a p p o in tm e n ts , etc

• Backward pricing

Assess w h a t c u s to m e rs are w illin g to p a y a n d th e n p ric e a c c o r d in g ly

to th e ir w illin g n e s s

• Market p en etration pricing

170
 Set th e in itia l p ric e lo w w .r.t. e x p e c ta tio n o f c u s to m e rs , so as to

a ttra c t c u s to m e rs to try o u t y o u r services, cre ate v o lu m e s a n d

a w a re n e s s a n d th e n s lo w ly in c re a s e a fte r w a r d s , ty p ic a lly u s e d fo r

n e w h o s p ita ls n e w e q u ip m e n ts a n d d ia g n o s tic m e th o d s , etc

• D iscount pricing fo r la rg e q u a n tity , e.g. o ffe r in g c o r p o r a te

d is c o u n ts as th is m a y le a d to h ig h n u m b e r o f p a tie n ts c o m in g in , o r

fo r re p e a t visits, lo w e r y o u r c h arg e s fo r s u b s e q u e n t v isits, o r o ffe r in g

seaso nal d is c o u n ts .

Use p e rce iv e d v a lu e q u a lity / p r ic e p r ic in g . H ere y o u p r ic e on

p e rc e p tio n . O n e c o u ld h a v e th e fo llo w in g o p tio n s p r e m iu m p r ic in g ,

o ffe rin g h ig h q u a lity w ith h ig h p ric e s u p e r v a lu e p ric in g , o ffe r in g h ig h

q u a lity a t lo w p ric e g o o d v a lu e strate g y , o ffe rin g g o o d / m e d iu m

q u a lity a t a lo w p ric e e c o n o m y p ric in g , o ffe rin g lo w q u a lity w it h lo w

prices. T here c o u ld b e even n e g a tiv e m e th o d s lik e o v e rc h a rg in g ,

o ffe rin g lo w q u a lity a t a h ig h p r ic e ju s t b e c a u s e o f s h o rta g e , w ill n o t

la s t lo ng.

Prom otion and Com m unication

In c o m m u n ic a tin g th e services to th e c u s to m e rs , p r o m o t io n e le m e n t

o f th e services p lay s a v ita l role. T his also h e lp s in c o m m u n ic a tin g

171
services to o th e r key r e la tio n s h ip m a rk e ts . P r o m o tio n is a d e s c rip tiv e

te rm fo r th e m ix of c o m m u n ic a tio n a c tiv itie s , vuhich service

o rg a n iz a tio n s carry out in o rd er to re ach to th e ir c u s to m e rs .

G e n e ra lly a m ix o f follov^/ing e le m e n ts is u se d fo r p r o m o t io n of

services. T he m e th o d s u se d c o u ld b e A d v e rtis in g , P e rs o n a l se llin g .

Sales p r o m o tio n , P u b lic ity , P u b lic re la tio n s . W o r d o f m o u th . D ire c t

m a il, T ele- m arketing, E- m a r k e tin g , etc

Why Prom otion?

It creates im a g e o f th e service o r g a n iz a tio n such as:

1. Prestige, te c h n o lo g ic a lly a d v a n c e d , in n o v a tiv e .

2. It creates r e p u ta tio n a n d re d u c e s p e rc e iv e d risks. C u s to m e rs

are c o n fid e n t w h ile d e a lin g w ith th e service p ro v id e rs .

3. It a d d s d ire c t p r o m o tio n a l valu e.

172
Prom otion for H ealthcare O rganization

Advertising:

K o tle r a n d A r m s tr o n g d e fin e s A d v e rtis in g , 'as any paid form o f n o n ­

personal presentation and prom otion o f ideas, g o o d s or services by an

identified sponsor’. A d v e rtis e rs n o t in c lu d e o n ly b u s in e s s fir m s b u t

also m u s e u m s , c h a r ita b le o r g a n iz a tio n s a n d g o v e r n m e n t a g e n c ie s

th a t d ire c t m essage s to ta r g e t p u b lic . A d v e rtis e m e n ts a re th e co st

effective w ay to c o m m u n ic a te w h e th e r it is b u ild in g o f a b r a n d , o r to

e d u cate p e o p le to a v o id h a r d d ru g s. B ecause o f th e d iffe re n c e s in th e

n a tu r e o f H e alth C are Services w ith o th e r in d u s tr ie s , th e re is h u g e

d iffe re nce in a d v e r tis in g o f th e se tw o s tre am s. T he codes o f eth ics fo r

a d v e rtis in g H e a lth C are Services O r g a n iz a tio n re s tric t th e ty p e o f

a d v e rtis in g .

Media available for A dvertising

A n o v e rv ie w o f all th e m e d ia a v a ila b le fo r m a rk e tin g , a n d th e n th e ir

relevance in th e m a r k e tin g o f h e a lth care services.

• Press a n d n e w s p a p e rs : D a ily n e w s p a p e rs , lo cal m e tr o a n d

n a tio n a l. A d v a n ta g e s in c lu d e s h o rt le ad- tim e , h ig h re a d e rs h ip ,

173
 b r o a d accep tance , h ig h b e h e v a b ih ty , w h e r e th e d is a d v a n ta g e s

in c lu d e heavy 'a d ' c o m p e titio n a n d s h o r t hfe.

• P e rio d ic a l n e w s p a p e rs : w e e k ly , fo r tn ig h tly or m o n th ly . T he

a d v a n ta g e s in c lu d e b r o a d a c ce p ta n ce , p r o v id e s ta r g e t a u d ie n c e a n d

g ra p h ic s a n d text can be re p re s e n te d in b e tte r w ay.

• T elevisio n: n a tio n a l, re g io n a l o r local. T he a d v a n ta g e s in c lu d e a

b r o a d e r class; c o m b in e s h ig h m o t io n a n d s o u n d th u s effective as

c o m p a re d to p r in t m e d ia . T he d is a d v a n ta g e s in c lu d e v e ry h ig h

n e tw o rk charges a n d v e ry p o o r ta rg e t a u d ie n c e selectiv ity . T he

ex am ples are, n atio n al- D D l, re g io n a l DD M a ra th i, local- C ab le TV

N ew s lines.

• O u t d o o r m e d ia: th e y can b e d iv id e d in to s in g le lo c a tio n a n d m u lti

lo c a tio n . The a d v a n ta g e s in c lu d e c o lo r o p tio n s , size to su it, a n d

p e rm a n e n t, re p e a t e x p o s u re and ta rg e t lo cal m a rk e t. T he

d is a d v a n ta g e s in c lu d e lo w im p a c t as c o m p a re d to o th e r a u d io v is u a l

m ed ia.

• D irect m ail: th e a d v e rtis e r h e re selects th e m a rk e t. A d v a n ta g e s

in c lu d e cap acity to go to ta rg e t a u d ie n c e directly , p e rs o n a l c o n ta c t

174
 a p p r o a c h w h e re th e d is a d v a n ta g e s in c lu d e lo w c r e d ib ility a n d h ig h

th r o u g h a w a y rates.

• T e le m a rk e tin g : th e a d v e r tis e r h e re selects th e m a rk e t. A d v a n ta g e s

in c lu d e c a p a c ity to go to ta r g e t a u d ie n c e d ire c tly , p e rs o n a l c o n ta c t

a p p r o a c h a n d c o n v e r s a tio n w it h th e lik e ly c u s to m e r w h e r e th e

d is a d v a n ta g e s in c lu d e c o n s u m e r fe e lin g o ffe n d e d if n o t c o n d u c te d in

th e p r o p e r m a n n e r is m a n d le a d s to n e g a tiv e im p re s s io n .

• D irectories: can b e T ra d e d ir e c to r ie s o r y e llo w p ag es o r te le p h o n e

d ire c to ry M a rk e te rs c o v e r th e a re a c o v e re d b y th e d ire c to ry . T he

a d v a n ta g e s in c lu d e p e r m a n e n t, a c tio n o r ie n te d m e s s a g e a n d lo w

cost w h e re th e d is a d v a n ta g e is lo w a p p e a l a n d c lu tte r effect o f "a d ".

• In te rn e t: in c lu d e s th e n a t io n a l and in te r n a tio n a l m a r k e t. T he

ad v a n ta g e s in c lu d e a d a p ta tio n of service s to in d iv id u a l

re q u ire m e n ts a n d g lo b a l p r o x im ity . T he d is a d v a n ta g e s in c lu d e lo w e r

p e rc o la tio n in th e In d ia n society, n o t m u c h p e o p le are c o m p u te r

literate.

T he w id e ly used m e d ia in H e a lth care services a re o u t d o o r m e d ia , w h e r e

th e n a tio n a l program s in c lu d e m e d ia lik e te le v is io n w here m any

a d v e rtis e m e n ts are p r o d u c e d in th e p u b lic in te re s t.

175
T here are five m a in stages in a w e ll- m a n a g e d a d v e r tis in g c a m p a ig n :

Stage 1: Set A dvertising O bjectives

A n a d v e r tis in g o b je ctiv e is a s p e cific c o m m u n ic a tio n ta s k to b e a c h ie v e d

w ith a specific targ e t a u d ie n c e d u r in g a s p e c ifie d p e r io d of tim e .

A d v e r tis in g o bjectiv e s fall in to th r e e m a in cate g o ries:

(a) To inform - e.g. tell c u s to m e rs a b o u t a n e w p r o d u c t

(b ) To persuad e - e.g. e n c o u r a g e c u s to m e rs to s w itc h to a d iffe r e n t b r a n d

(c) To rem ind - e.g. r e m in d b u y e r s w h e r e to fin d a p r o d u c t

Stage 2: Set the A dvertising B udget

M a rk e te rs s h o u ld r e m e m b e r th a t th e ro le o f a d v e r tis in g is to c re a te

d e m a n d fo r a p ro d u c t. T he a m o u n t s p e n t o n a d v e r tis in g s h o u ld b e r e le v a n t

to th e p o te n tia l sales im p a c t o f th e c a m p a ig n . T his, in tu r n w ill re fle c t th e

c h a ra c te ristic s o f the p r o d u c t b e in g a d v e rtis e d .

F o r ex am ple, n e w p r o d u c ts te n d to n e e d a la r g e r a d v e r tis in g b u d g e t to h e lp

b u ild a w a re n e s s an d to en courage co n sum e rs to tr ia l th e p r o d u c t. A

p r o d u c t th a t is h ig h ly d iffe r e n tia te d m a y also ne e d m o r e a d v e r tis in g to

h e lp set it a p a r t fr o m th e c o m p e titio n - e m p h a s is in g th e p o in ts of

difference.

176
S e ttin g th e a d v e rtis in g b u d g e t is n o t easy - h o w can a b u s in e s s p r e d ic t th e

r ig h t a m o u n t to spen d. W h ic h p a r ts o f th e a d v e r tis in g c a m p a ig n w ill w o r k

b e s t a n d w h ic h w ill h a v e re la tiv e ly little effect? O fte n b u s in e s s e s u se "rules-

o f- th u m b " [e.g. a d v e r tis in g /s a le s r a tio ) as a g u id e to set th e b u d g e t.

Stage 3: D eterm ine th e k ey A d vertising M essages

S p e n d in g a lo t o n a d v e r tis in g d o e s n o t g u a r a n te e success ( w itn e s s th e

in fa m o u s Jo h n Cleese c a m p a ig n fo r S a in s b u ry ] . R e s e a rc h su g g e s ts t h a t th e

c la rity o f th e a d v e rtis in g m e s s a g e is o fte n m o r e im p o r t a n t th a n th e a m o u n t

sp e n t. T he a d v e rtis in g m e s s a g e m u s t b e c a re fu lly ta r g e te d to im p a c t th e

ta r g e t c u s to m e r a u d ie n c e . A succe ssful a d v e r tis in g m e s s a g e s h o u ld h a v e

th e fo llo w in g ch aracte ristics:

[a) M eaningful - c u s to m e rs s h o u ld fin d th e m e s s a g e r e le v a n t

[b) D istinctive - c a p tu re th e c u s to m e r's a tte n tio n

[c) B elievable - a d iffic u lt task , since re s e a rc h sug g ests m o s t c o n s u m e r s

d o u b t th e tr u th o f a d v e r tis in g in g e n e ra l

177
Stage 4: Decide which A dvertising Media to Use

T h e re are a v a rie ty o f a d v e r tis in g m e d ia fr o m w h ic h to chose. A c a m p a ig n

m a y u se o n e o r m o r e o f th e m e d ia a lte r n a tiv e s . T he k ey fa c to rs in c h o o s in g

th e r ig h t m e d ia includ e:

(a ) Reach - w h a t p r o p o r tio n o f th e ta r g e t c u s to m e rs w ill b e e x p o s e d to th e

a d v e rtis in g ?

(b ) Frequency - h o w m a n y tim e s w ill th e ta r g e t c u s to m e r b e e x p o s e d to

th e a d v e rtis in g m essage?

(c) Media Impact - w h e re , if th e ta r g e t c u s to m e r sees th e m e s s a g e - w ill it

h a v e m o s t im p a c t? F o r e x a m p le d o e s a n a d v e r t p r o m o t in g h o lid a y s fo r

e ld e rly p e o p le h av e m o r e im p a c t o n T e le v is io n ( if so, w h e n a n d w h ic h

c h a n n e ls] o r in a n a tio n a l n e w s p a p e r o r p e r h a p s a m a g a z in e fo c u s e d o n

th is s e g m e n t o f th e p o p u la tio n ?

A n o th e r key d e cisio n in re la tio n to a d v e r tis in g m e d ia re la te s to th e t im in g

o f th e c a m p a ig n . Som e p r o d u c ts are p a r tic u la r ly s u ite d to seasonal

c a m p a ig n s on te le v is io n (e.g. C h ris tm a s ham pers) w hereas fo r o th e r

p ro d u c ts , a re g u la r a d v e r tis in g c a m p a ig n th r o u g h o u t th e y e a r in m e d ia

s u c h as n e w s p a p e rs a n d s p e c ia lis t m a g a z in e s (e.g. co tta g e h o lid a y s in th e

Lake D is tric t) is m o re a p p r o p r ia te .

178
Stage 5; Evaluate the results of the Advertising Campaign

T h e evaluation of an a d v e rtis in g c a m p a ig n sh o u ld focus on tw o key areas:

(1) The Com m unication Effects - is t h e intended m essage being

c o m m u n ic a t e d effectively a n d to th e i n te n d e d a u d ie n c e ?

[2) The Sales Effects - h a s t h e c a m p a i g n g e n e r a t e d t h e i n t e n d e d s a l e s

g r o w t h . T h i s s e c o n d a r e a is m u c h m o r e d i f f i c u l t t o m e a s u r e

C o m m u n i c a t i o n is a n i m p o r t a n t e l e m e n t o f p r o m o t i o n a n d a l s o p l a y s a v e r y

vi ta l r o l e in M a r k e t i n g o f h e a l t h C a r e S e r v i c e s .

C r i t e r i a f o r s e l e c t i n g e m p l o y e e s in a h e a l t h s e r v i c e o r g a n i z a t i o n :

• Com petence

• Courtesy

• Credibility

Responsiveness

Com m unications

Communications:

G r o n o s [ 1 9 9 0 ] i d e n t i f i e s six g u i d e l i n e s f o r e f f e c t i v e c o m m u n i c a t i o n in a

Health service O rganization.

179
a) Direct com m unication efforts to em p lo y ee s : ta rg e t e m p lo y e e s are

in te r n a l c u sto m e rs in m a r k e tin g c o m m u n ic a tio n s . T a rg e tin g b o th in t e r n a l

and ex te rn al c u s to m e rs h e lp s e n s u re a c o n s is te n t p o s itio n in

c o m m u n ic a tin g to b o th p a r tie s p a r tic ip a tin g in service e n c o u n te rs .

b) Capitalize on word-of m outh endorsem en t: h e a lth services are d r iv e n

la rg e ly by w o rd - o f m o u th c o m m u n ic a tio n s in te r m s o f re a ch a n d im p a c t.

H e a lth services m a n a g e rs s h o u ld b e a w a re th a t in service in d u s tr y , in

h e a lth care in d u s tr y w o r d o f m o u th p lay s a b e tte r ro le th a n b e s t o f th e

sales p r o m o tio n m e th o d s.

c) Provide tangible clues: h e a lth services a re o n e o f th e m o s t in t a n g ib le o f

p ro d u c ts . H o w e v e r th e y can b e m a d e c o n c re te th r o u g h m a n a g e r ia l a n d

a d v e r tis in g actions. F o r e x a m p le c o m p a r in g h o s p ita l r o o m w ith p a tie n ts

h o m e a n d th e c o m fo rt th e p a tie n t gets a t h o m e w ill b e p r o v id e d in h o s p ita l

w h ile m a k in g sure th a t e m p lo y e e s are neat and clean, can in c r e a s e

c u s to m e r's p e rc e p tio n to w a r d s q u a lity

d) Ensure com m unication continu ity

e) P rom ise what is possible: as n o tic e d earlie r, c u s to m e r s a tis fa c tio n is

ac h ie v e d w hen p e rc e p tio n s o f service fir m p e r fo r m a n c e exceed th e

180
s a tis fa c tio n th u s , if m a r k e t in g c o m m u n ic a tio n s e s ta b lis h c u s to m e r

e x p e c ta tio n s th a t c a n n o t b e m e t, it w ill r e s u lt in u n s a tis fie d c u s to m e rs .

f) O bserve the long-term effects o f com m unication: c o m m u n ic a tio n m ix

Prom otions: T he p r o m o t io n o f th e h o s p ita ls h a s to b e e x tre m e ly lim it e d

b e c a u se o f th e p r o fe s s io n a l eth ics o f th e d o c to rs . T he p r o m o t io n a l g o a ls o f

h o s p ita l m a r k e tin g can b e lis te d as u n d e r.

• O rg a n iz in g p e r s o n a l a n d fo r m a l m e e tin g s to d is c u ss th e service s. T he

fo rm a l m e e tin g s c a n b e w ith o th e r d o c to rs o r fo r a g r o u p o f p a tie n ts

o r custom e rs. E.g. d is c u s s io n a b o u t th e fa c ilitie s th e p a tie n ts w ill

re q u ire in r a d ia tio n th e ra p y , w ith th e c a n c e r p a tie n ts .

• In fo r m in g a n d e d u c a tin g p u b lic a b o u t th e v a rio u s services, say a b o u t

th e p re v e n tiv e h e a lth .

• In fo r m in g th e co n su m e rs how to o b t a in services e a s ily and

c o n v e n ie n tly , as m e n tio n e d a b o v e in th e se s s io n o f c o m m u n ic a tio n s ,

th e fr o n t office s ta ff m u s t b e c u s to m e r fr ie n d ly a n d s h o u ld d e liv e r

th e re q u ire d in fo r m a tio n .

181
5 .1 0 P roblem s in M arketing of H ealthcare Services in Indian Context

The factors, which affect th e H ealth Care services:

1. Indian m arket is still a se lle r s m ark et and not a bu yers m arket:

but th is is s lo w ly c h a n g in g w ith in c r e a s in g c o m p e titio n and

c u s to m e r aw are n e ss. F o r th e size o f th e m a rk e t, in m a n y b a s ic a re a s o f

h e a lth c a re , th e re are n o t e n o u g h s u p p lie r s in c o m p a r is o n to th e p o te n tia l

d e m a n d , w h e th e r it is d o c to rs , h o s p ita ls , p r e v e n tiv e h e a lth c a re , etc.

2. D isparities in the pop u lation / p oten tial cu stom ers are high: in

r u r a l area th e reach o f h e a lth services is v ery p o o r. W h e r e as in u r b a n

areas, th e re is in te n s e c o m p e titio n and th e y do e x p e rie n c e th e

a d v a n c e m e n ts in m e d ic in e a n d e n tr a n c e o f n e w e r te c h n o lo g ie s . T h u s th e

levels o f h e a lth c a re services v a ry d r a m a tic a lly across th e c o u n try .

3. No effort in m arketing in the health sector: m a r k e tin g e ith e r w a s

c o n s id e re d u n n e ce s s ary o r ev e n u n e th ic a l. O fte n p e o p le w h o h a d n o fo r m a l

tr a in in g o r p r io r e x perience in m a r k e tin g o u ts id e the h e a lth care in d u s tr y

c o n d u c te d tho se m a r k e tin g fu n c tio n s th a t w e re p e r fo r m e d a t all u n d e r th e

a u s p ic io u s d e p a r tm e n t w ith title s lik e " d e v e lo p m e n t” and "P u b lic

r e la tio n s ”. T here w as n o c o n c e rte d e ffo rt c a rrie d o u t to w a r d s M a rk e tin g .

182
4. Illiteracy: o u r p r o b le m o f illite ra c y is lin k e d w ith h ig h p o p u la t io n

g r o w th , lack o f a w a re n e s s a b o u t h e a lth services. T he fe m a le p o p u la t io n

n e e d s special a tte n tio n , as p e rc e n ta g e o f illite ra c y is m o r e in th is s e g m e n t.

5. Poverty: In d ia 's p e r c a p ita in c o m e is o n e o f th e lo w e s t in th e w o r ld .

M o re th a n 3 0 % o f the p o p u la tio n is b e lo w p o v e rty lin e, w h ic h affects th e

a ffo rd a b ility as h e a lth services are c o n c e rn e d . S im ila r ly it le a d s to

m a ln u tr itio n a n d p o o r h e a lth .

6. Strong d o m in a n c e o f q u ack s; th e ru r a l a re a s h o w s th e d o m in a n c e o f

u n a u th o r iz e d o r illeg al m e d ic a l p r a c titio n e rs . T hey c an b e b r o a d ly d iv id e d

in to tw o types, tho se w h o try to cure w ith s o m e d iv in e p o w e r o r th o s e w h o

are n o t q u a lifie d i.e. th r o u g h m e d ic a l r e g is tra tio n , b u t do p la y w ith

a llo p a th ic m ed icin es.

7. Ignorance: p e o p le in In d ia are n o t a w a r e a b o u t th e d e v e lo p m e n ts in

m e d ic in e a n d n e w e r te c h n o lo g ie s a v a ila b le , so th e y c a n n o t go t h r o u g h th e

p r o p e r c h a n n e l to c o n s u m e th e h e a lth care services.

8. Unaffordable p rices o f the sp ecialty consultants; th e tr e a t m e n t

fees are u n a ffo rd a b le b y m o s t classes o f p e o p le in In d ia , as th e y a re

a v a ila b le in only m e tr o cities, a n d w ith v e ry few in s titu tio n s

183
9. Enforcem ent of the con su m er p rotection act: th e a w a re n e s s a n d

tr a n s p a r e n c y is ris in g afte r th e e n fo r c e m e n t o f c o n s u m e r p r o te c tio n act.

5 .1 1 D evelop in g Suitable m arketing Strategy for H ealthcare Industry

Suitable Model for D evelop in g a User Friendly Quality Enhanced

H ealthcare Service Model for H ospitals in Pune City:

T he h o s p ita l services can be d iv id e d in to tw o p a rts M e d ic a l & N o n M e d ic a l

A] M ed ical Services: In c lu d e h a r d c o r e tr e a tm e n t b y th e D o c to rs .

D octors can be e ith e r F ull T im e o r P a rt tim e . It is sug g e ste d t h a t o n ly

E m e rg e n cy a n d h ite r v e n tio n a l C a rd io lo g is t b e full tim e . R est all can

be H o n o ra ry D o cto rs a n d n o stress o n M a n a g e m e n t e ith e r re la te d to

salary o r re ta in e r sh ip . B u t all R M O s s h o u ld b e M BBS to h a n d le a n y

case o f em e rg en cy.

A p a r t o f M ed ical Services in c lu d e s p a th o lo g y w h ic h s h o u ld be

c o m p le te ly o u ts o u rc e d to a v o id a n y c o m p la in ts o f th e p a tie n t re la te d

to the re p o rt o r c a rry in g o u t a c c re d ita tio n . In fact m o r e tim e can be

d e v o te d in tr a in in g th e C u s to m e r I'e latio n officers, N u rse s and

M a rk e tin g to e n s u re m a x im u m fo o tfa lls in the h o s p ita l th e re b y

in c re a s in g the re v en ue .

184
 B] N o n M edical: T his service in c lu d e s M a rk e tin g , A m b u la n c e se rv ice .

H o u s e k e e p in g , S e cu rity , F o o d & B everage, G ift S h o p , A T M etc.

It is sug g este d t h a t th e fo llo w in g services s u c h as A m b u la n c e service .

H o u s e k e e p in g , S e c u rity , F o o d & B everage , G ift S h o p , A T M etc. b e

o u ts o u rc e d so t h a t d a y to d a y a d m in is tr a tiv e issues are n u llifie d a n d

H o s p ita l can th e n c o n c e n tr a te o n in c r e a s in g P a tie n t F lo w to th e

H o s p ita l an d e n s u re Q u a lity S ervice to th e P a tie n ts. T his w ill h e lp

e n h a n c e C u s to m e r R e la tio n s h ip M a n a g e m e n t.

References:

1. M a rk e tin g H e a lth Services: R ic h a r d K T hom as pg 6-7 H e a lth

A d m in is tr a tio n Press, C h icag o A U P H A Press, A r lin g to n , VA

2. M a rk e tin g M a n a g e m e n t b y P h ilip K otler, K ev in K eller, 12^^ E dn,

[Pearson P re n tic e H a ll)C h a p te r 1: p g 5-6 : 2 0 0 6

3. M a rk e tin g d e fin itio n a p p r o v e d in O c to b e r 2 0 0 7 b y th e A m e r ic a n

M a rk e tin g A s s o c ia tio n :

4. h ttp : //tu to r2 u .n e t/ b u s in e s s / m a r k e tin g / p r o m o tio n advertising.asp

185
5. Larry Steven L o n d re M a rk e tin g , IMG, A d v e rtis in g , P r o m o tio n , M e d ia

a n d M ore. 2 0 0 9

6. http://en.vvikipedia.orp/w iki/H ospital e m e rg en c y codes

Reading

1. D on E. S chullz, S ta n le y 1. T annenbaum , R obert F.

L a u te r b o r n [ 1 9 9 3 )"In te g r a te d M a rk e tin g C o m m u n ic a tio n s ,”NTC

B usiness Books, a d iv is io n o f NTC P u b lis h in g G ro u p .

2. h ttp ://w w w .e x p re s s h e a lth c a re m g m t.e o m /2 0 0 4 1 2 1 5 /m a rk e tin R 0 1 .

shtm l

3. Chaffery, Dave. 2 0 0 8 , P a tie n t c e n tric m a r k e tin g d e fin itio n , fr o m ;

http://w w w .davechaffey.com /E-m arketing-G lossary/Patient-centric-

m arketing.htm

4. Source: D e fin in g an E n te rp r is e w id e P a tie n t G o n ta c t S trate g y ,

F orrester, R esearch, Inc., O c to b e r 22, 2 00 8.

5. w w w .crm in fo lin e.com

6. h t t p :/ / e n .w ik ip e d ia .o r g / w ik i/ M a r k e tin g _ m ix

186