Ethical Marketing of
Ophthalmic Practices
Prof.Dr.
Ashok Thiakarajan Ph. D., Prof. Dr.R. Chandrasekhar Ph.D., *
Bioethics
is quite broad and has a background that combines various disciplines such as
medicine, philosophy, law, sociology, and theology. Internationally there are
many institutions, committees, and courts charged with identifying ethical
principles to underpin the activity in the medical field, principles, which
take into account values such as human dignity, right to life or autonomy. This
write up attempts to explore the nuances of marketing ethics in the light of
current complexities in the world of marketing especially in the eyecare
practices
Hyper competition
The evolution of medical activity
performance forms has inevitably led to the emergence of chronic and hyper
competition, which in turn led to the emergence of healthcare marketing. Thus,
a health institution requires the application of various marketing strategies
in order to maintain itself on the market field. Advertising and promotion are
part of the strategy aimed at developing and maintaining relationships with the
targeted audience (patients).
To regulate this activity, it was
necessary to develop ethical rules and regulations of healthcare marketing. More so when the worst hit services are
the hospital services wherein the normal process of OPD, elective surgeries and
radiological procedures are completely left to a great uncertainty gripping the
fear of incessant infections which goes unscathed.
The ever-changing evolution of life has
inevitably affected the healthcare systems pushing to significant changes and
imposing healthcare marketing as an indispensable element of health care
facilities, in particular hospitals, be it clinic, Nursing homes, single
speciality hospitals and Multi-speciality corporate hospitals. Healthcare is a
segment in a constant evolution, the plethora of opportunities stimulating
creativity, enthusiasm, and will exploit the specialists in the field. The
emancipation of different types of health care services like Single or primary
health services, Tertiary care services and recently the super speciality
hospitals with high end interventions are being performed.
Healthcare Marketing
As the philosophy and marketing
techniques in other fields is hard to find applicability in the hospital
segment as they need their own approach and present certain features that are
scarce in the marketing of healthcare services differs primarily through the
nature of demand for health services. Secondly, the beneficiary may not be the
target of the marketing campaign, the physician being the one who decides what,
where, when, and how much will be provided for a particular service. The
decision-maker may be the doctor, the health plan representative, a family
member.
Ethical marketing
One of the most frequent discussions
that arose with the development of healthcare marketing was due to the concern
that advertising will lead to a situation in which the medical activity will
turn into an overly commercial one. Of course, this is quite difficult to
avoid, considering that the medical units providing services and healthcare
have the right to make their own activities known and inform consumers on the
health services they provide. In the past, it was considered that advertising
and promotion were below the dignity of the medical profession and that the
only way to gain new patients was by recommendation from satisfied patients and
other clinicians’ positive assessments. Such thinking is no longer compatible
with the current patients’ requirements, which want to be more and more
informed
Today, it is considered ethical for
health institutions or individual clinicians to promote their work as long as
the information is truthful, honest, non-discriminatory, and not misleading.
The biggest challenge is often represented by the message sent, which is not
sufficiently detailed because of the selected multimedia format. In advertising
purpose, various media can be used, such as newspapers, Internet, billboards,
brochures, audio-visual means, etc. In any case, it must be kept in mind that
ethics requires that any paid advertisement should be identified as such.
Conventional promotion tools in Eyecare
Over the past years, hospitals have
experienced many marketing trends that have fundamentally altered the basic
characteristics of the conventional marketing. These trends are the follows:
1. Mass marketing approach to a 2 Ps
approach.
2. Service Marketing to Servitude
3. The General approach to product bundling
and disease-specific.
4. Mere visit of a patient to an
establishment of a long-lasting relationship
5. From “ignoring” the market, to ‘market
intelligence’ or Market analytics.
6. Switching over from conventional to
Conceptual (Digital)
Very often these two concepts are being
misunderstood and the proper sales apparatus was not developed for several
years. It was always the decision of the promoter or owner of the
clinics/nursing home or the hospital to decide on the marketing instead of a
professional to manage the same. The role of Service Line Managers who plays a
defining role to convince the customers for a specific procedure or surgery
based on the recommendation of the treating physician.
The doctors are generally finding it
difficult to spend more time due to the various clinical engagements like OPD,
procedures, surgeries, ward rounds, writing down clinical notes and then
academic activities. In this context, the role of service line managers who are
well trained about the various technical details and data are put in to the
task of providing confidence to the patients who are often confronted with fear
and expenses incurred in the treatment process.
Internal ‘promotions’ in the hospitals
especially the Eyecare institutions
Eye care institutions take care of the
patients more emotionally while compared to other specialities by virtue of its
applications and scope. The effectiveness of this approach depends on how the
hospitals has an effective communication with patients, exhibit a correct image
of the health service, and delivers the promised service properly, and portrays
a permanent concern for the continuous improvement of the service provided to
exceed the expectations of the patients. In a nutshell this process is known as
“SERVITUDE” (in short, service with a positive attitude) and the entire gamut
of the hospital staff should be trained to focus on this area.
The counsellors or service line
managers are able to explain the duration, quality of life post procedure or
surgery, the various types of medical devises with the cost and benefits and
finally the tariff. Multiple modes and options like insurance, TPA, state
Government and central Government schemes and for those needy patients the free
surgeries like cataract is also being recommended by these managers. This
important process helps the customers to arrive at the decision based on the
facts provided to them and also minimise the precious time of doctors to concentrate
on their mainstream of work i.e. patient care. In short, the hospital becomes
customer centric.
‘Payor Mix’ and ‘Market intelligence’
The word ‘payor mix’ depicts the
various routes or channels through which customers are stepping in to the
hospital. It is broadly classified as cash patients, insurance and TPA
patients, Corporate patients, from Government schemes and finally the
international sources. The contribution of each segment on the above segments
vary from area to area, hospital to hospital and market to market. Better the
understanding on the changing market dynamics, economics and socio-political
situation by a sales and marketing manager would be able to navigate the
revenue streams in order to get the steady flow the patients.
Leveraging the ‘feedback apparatus’
For hospital administrators, the use of
informative blogs or service feedbacks reported in the website or social media
can be effective to get the pulse of the customers. Though there are always
some negative comments from the irritated customers due to the cost or the
delay in the services, which should also to be addressed in a diligent manner.
The promotions through the social media like FB, twitter and Instagram are to
be the effective ways to stay relevant to patients, especially to update them
with the latest campaigns, health days and the important milestones achieved in
the medical technology.
The positive feedback on response from
the patients after receiving the wonderful service is sacrosanct for the
organisation. Moreover, continuous efforts to upgrade or modernise the SEO by
infusing targeted keywords into the content would be of greater significance
for the marketing “star burst”. For making the branding to be effective, the
digital platforms in which the hospital and the patients’ interface or will
operate on must be identified, the target audience will have to be segmented
correctly, and tailormade communication will have to resonate.
Target Marketing or disease profiling
Focus should be towards building a
sustainable relationship, then in ensuring a single transaction. Major aim is
to create a high level of consumer satisfaction in terms of service deliverance
(servitude) so that they return to the same service provider i.e.
hospital/clinic. Sales and Marketing heads are incorporating many methods that
include marketing research, product design, Target marketing, pricing,
advertising, promotional sales, social media marketing and most importantly the
sales management.
These methods are often supported by
the modern tools related to new technology and new concepts, to attract
customers through strong brand promotions and classification of target groups
and market segmentation.
Ethical communication to the customers
A special attention should also be paid
to the used language. The available advertising space is often limited. This
leads to the need of shortening and compressing the message and it can lead to
an extremely different version of the original message, thus, advertising
misleading by providing information that is different from that intended.
The content of promotional messages
must be truthful and should not create unjustified expectations. The doctor or
the healthcare unit must be able to provide the services claimed in the
advertisement. A special attention should be paid to experimental procedures
that have not yet proved the desired results in order not to misinform the
patients
Ethical Promotion
Vouchers offering various services at
reduced prices or even given for free are included in the category of marketing
strategies designed to promote healthcare units, in order to attract patients
and retain them. Based on this, an ethics dispute raised because it was
possible that this practice undermined the medical component of the unit favouring
the commercial aspect. Also, in such cases, the quality of services at a lower
price should not be inferior to those offered at the initial price.
In the same context of commercial
appearance of the medical activity, the public perception of the medical
profession should also be mentioned. This perception can easily be negatively
influenced by unethical marketing strategies. Doctors and healthcare units have
an important duty of practicing marketing with responsibility.
Ethical Marketing communication
From an ethical point of view,
marketing communication should be more consistent with reality, even if its
purpose is to shed light on more attractive issues. In this context, the
categories and groups vulnerable to certain content of the advertising message
should be mentioned. A patient with a serious suffering will be easily
influenced and will tend to trust any promise easily, with the desire to heal.
Ethically, the information presented must not alter the reality and should not
give false hopes to patients.
Also, promotion by mentioning the
success rates is considered unethical in general because, most often, these
results are not representative when the selection/ exclusion criteria of
eligible patients are unknown. These criteria could lead to a high success rate
only for some selected patients. Prospective patients are easily impressed by
such high rates and could form inaccurate expectations.
Finally, yet importantly, the attitude
towards other colleagues should be mentioned. When a doctor or a health
organization promotes its competence by denigrating the work of other
physicians through marketing material, the marketing activity becomes unethical.
Contemporary views on ethical practices
But good business and good ethics don’t
have to be mutually exclusive, argues Penny A. Asbell, MD, MBA, professor of
ophthalmology at Mount Sinai School of Medicine and director of its Cornea
Service and Refractive Surgery Center. Her case commentary tackles the
challenges ophthalmologists face in defending their practices from the
encroachment of online contact lens purveyors and other practitioners; she
advises physicians to focus on improving and expanding the services they
provide to attract and retain patients.
Thomas A. Oetting, MD, professor of
clinical ophthalmology at the University of Iowa, also emphasizes the
importance of going above and beyond to provide high-quality care in his case
commentary about how residents can work to offset the elevated risk they bring
to patient surgeries. Helping keep the physician informed about the latest
developments in the care of the eye are Usha Rao, MD, senior resident in
ophthalmology at Baylor College of Medicine, who provides an overview of the
recent advances in understanding and treating glaucoma, and Michael Hughes,
BCO, who introduces the reader to artificial eye makers—ocularists—and how they
tailor their creations to the patient.
Ophthalmologists’ duties to society are
explored in the health law and medicine and society sections. Paul Steinkuller,
MD, of Baylor College of Medicine and Texas Children’s Hospital discusses the
physician’s responsibility to impaired drivers to protect them and others on
the road. Dr. Steinkuller cites and we reprint the AMA Code of Medical Ethics
opinion on the physician’s duty to impaired drivers and society. Kiran
Motaparthi, MD, from the department of dermatology at Baylor College of
Medicine, raises questions about the social and ethical import of cosmetic
blepharoplasty to alter the characteristically Asian eyelid.
In conclusion,
To improve the competitive advantage,
by increasing the visibility in order to create an undisputed reputation among
patients and to understand the service deliverables and gaps from the patients.
The customer experience management is
going to be only difference which could be felt by the patients and can make
them to revisit the hospital for all diseases, at all times.
Understanding the customer experience
journey
The customer journey includes interactions
and touchpoints through traditional channels, such as website purchases, phone
calls and live chat as well as social media, text and other emerging
communication mediums. With more communication channels comes greater
complexity. A customer journey map allows companies to identify customer
touchpoints throughout the customer lifecycle. This helps a company to create a
customer experience based on predictable customer needs and behaviours. This
approach also enables a business to review and streamline its processes
throughout the customer journey, which can improve customer satisfaction.
Those responsible for marketing in the
healthcare field must keep in mind the ethics code of the medical profession,
must maintain an honest marketing communication, which does not create
inaccurate expectations, must not denigrate other colleagues, and must use a
message whose content should respect the dignity of the profession.
Today
advertising has become a field with an unprecedented dynamism; therefore,
marketers must recognize trends and understand them correctly. The media today
uses the audience measurement techniques, which are much more efficient, more
interactive and therefore experience a similar condition.
Executives
empowered with advertising in order to attract the targeted audience should be
aware of the new trends, should be ready to apply them, should be malleable,
but regardless of established goals, should have an ethical attitude and
conduct.
Authors
Prof.
Dr. Ashok Thiakarajan is a student of Prof Philip Kotler and a versatile health
care administrator with hands international on experience in the field of
sales, marketing and operations with leading multinational organisations like
Johnson & Johnson, Beiersdorf AG, Fortis Health care, KIMS group, HCG
cancer hospitals and currently the CEO of Westminster health care, London a
part of Lyca health care based at Chennai.
Prof.
Dr.R. Chandrasekhar Menon is a distinguished academician and the Founder
Director of “SERVITUDE” a training organisation exclusively dedicated to
healthcare soft skill training and carrying international experience in working
with top notch institutions like B. Braun AG over 40 years. He is now based out
in Coimbatore and a regular invitee to various management schools like IIMs and
international forums in this domain.