Ebook: Health Care Marketing

About the guest editor. Benn Greenspan has been the President andCEO of the Sinai Health System since January 1991. He heldnumerous positions within the growing Sinai Health System for 15years before he became the CEO. During his tenure as CEO, MountSinai Hospital won the Foster McGaw prize – the industry’s nationalaward for creative and effective community health service. The SinaiHealth System is widely recognised for its tenacity in serving allpatients regardless of ability to pay, in an environment of significanteconomic challenges. It has become nationally known for thedevelopment of a comprehensive fully integrated delivery system inthat environment. Benn has a PhD in Public Health Sciences from theUniversity of Illinois at Chicago. He is Adjunct Assistant Professor atthe Graduate School of Public Health – University of Illinois – Chicagoand holds an adjunct Faculty appointment at the Philadelphia Collegeof Osteopathic Medicine. He was the 2000 recipient of the ACHERegents Senior Executive Award. Marketing is a term that generally causes confusion among health careprofessionals. It sometimes even draws derision in the world of health careproviders. When it is applied in health care services it is often met withdistrust. And, it is almost always misunderstood by management throughoutthe health care service delivery industry. The health care market is typically characterized as imperfect; confusing;out of control; overly competitive; not competitive enough; monopolized byprofessionals through licensing and regulation; monopsonistic (driven by ahandful of government and private payers); and perverted by the imbalancebetween consumer and provider. The ‘‘disadvantaged consumer’’ is a termfrequently summoned to explain why health care cannot and should not beconstructed in a free market model. What role has marketing played in changing the US Health Care System? Doconsumers benefit from the application of marketing sciences and tools to theindustry? Is there something so immutably different about health care thatwe should want to preserve it as a ‘‘marketing-free’’ zone? Can we evenagree about what the health care industry includes?In the presence of such confusing perceptions and basic (but unanswered)questions, it should be no surprise that marketing theory and practice havebeen slow to assert a positive presence in health care. Assessing the level of marketing impact on the delivery of health care in theUSA must be undertaken in the context of the widely different segments thatexist in the industry. Personal services by clinical professionals, theprovision of institutional technical and professional services, home basedclinical services, long term custodial care, diagnostic testing (both ininstitutions and at home), therapies services, medical equipment, orthotics,prosthetics, pharmaceuticals, vitamin and other supplements, and healthfoods, are just some of the traditional and emerging segments of the industry.Each has its own set of traditions and rules pertaining to how it is deliveredand sold to the public. Some of these endeavors have emerged fromtraditions of other supply and commodity industries. Some still arestruggling to understand how best to move toward a dynamic model thatimproves the quality and value that consumers (clearly, and almostreligiously, identified here as ‘‘patients’’) receive. In this special issue, we are privileged to read about the efforts of severalindividuals from a variety of these segments. Their work to understand andsupport the application of professional marketing principles in the variedendeavors of the health care industry provides interesting and currentinformation about the state of marketing in some of the important segmentsof health care. More important, they provide insight that may be helpful inanswering the questions about consumer benefit and the ability of marketingsciences to bring health care closer to that elusive dynamic model thatimproves quality and value for patients. Introduction of the highestprinciples of Marketing to Health Care Delivery has the potential toprofoundly rebalance the roles of consumer and provider in ways that willimprove quality and value.Cooley (‘‘Loyalty strategy development using applied member-cohortsegmentation’’) raises the possibility that measuring and attempting toimprove customer satisfaction may not be the most effective route toimproving customer retention. He presents us with an unusual opportunity tolook in on the internal efforts of one of North America’s premier healthinsurers, as it develops and applies information about its members in anorganization-wide initiative to come closer into coincidence with their needs.He offers up a fine example of the scientific method in proposing a newmodel for thinking about member retention, evaluating the hypothesis,testing it and using the informational tools available to most efficientlyimplement plan services and health care services informed by the newparadigm. Paul, Handlin and Stanton (‘‘Primary care physicians’ attitudes towarddirect-to-consumer advertising of prescription drugs: still crazy after allthese years’’) have refined previous studies of the dissatisfaction of primarycare physicians with the impact of pharmaceutical industry advertisingaimed at consumers. It is no surprise that the physicians sampled continue toexpress concerns ranging from worries about overstated claims of efficacy tothe failure to offer information about non-medical, or lifestyle, alternativesto drug therapy. Primary care physicians also expressed their frustrationwith the need generated to ‘‘re-educate’’ patients. This disconnect with thephysician population may signal further problems in the context of thefindings of the next article in this issue. Braunsberger and Gates (‘‘Patient/enrollee satisfaction with healthcare andhealth plan’’) has looked at the satisfaction of health plan members withtheir health plan and with their health care. They give us the results of asurvey of 76 health plans covering all regions of the USA, and in all of thetop 25 major metropolitan areas of the USA. This rare national examinationvalidates some of the earlier research about peoples’ relationships withhealthcare and insurance. It also shows that whether it is satisfaction withthe care, or with the insurance plan, it is still the underlying relationshipwith the physician that drives outcomes.Bhaskaran and Hardley (‘‘Buyer beliefs, attitudes and behavior: foods withtherapeutic claims’’) present the findings of focus group studies indicatingthat consumers are not likely to adopt ‘‘functional foods’’ as a major diseaseprevention vehicle. While there has been much investment in the rapidgrowth of the ‘‘nutraceuticals’’ market, and in the concomitant developmentof regulatory information panels, consumer skepticism is still a powerfulforce in decision making. Rafalski (‘‘Using data mining/data repository methods to identify marketingopportunities in health care’’) has taken the common retail technique of datamining and shown us how it can be applied to the delivery of health careservices to enhance the quality of care, as well as to elevate theorganization’s revenue. He suggests that as in other consumer markets,health care can effectively learn to improve its product not only throughtechnological innovation, but also through patient researched and drivenservice improvement. Mullner and Chung (‘‘The American Hospital Association’s Annual Surveyof Hospitals: a critical appraisal’’) point out in their commentary that thesearch for market intelligence in health care is not without its risks. Theyremind us that the most commonly available sources of data, often voluntarysubmissions, may have intrinsic problems of consistency, accuracy andmethodology that must be accounted for. Benn Greenspan Previously published in: JOURNAL OF CONSUMER MARKETING, Volume 19, Number 7, 2002