The Healthcare Marketing Structure Hamster Wheel

By Patricia Montgomery

Over time, marketers may develop a specialty within one industry or another, but all share the skills of creativity and initiative, as well as understanding perspectives and analytics.  After all, a marketer must understand their consumer to effectively connect with them to achieve results.  What happens after years of mastering these skills? Marketers not only place their focus on the consumer but begin to analyze the processes and systems within the companies and industry they have worked in.

Large healthcare systems and what may be termed “mom and pop” healthcare systems (those fairly new to the concept of healthcare as a large business and have not yet mastered systems and approaches) have been recycling the same corporate and departmental marketing structures for years bringing to mind the vision of a hamster on an wheel, never fully realizing long-term success and growth. The organizations follow the same patterns not acknowledging, realizing, or sustaining the most effective approaches.  It could be because of money, the level of personnel they are willing to employ at the facility level or corporate level, it may be the personality of the person in charge of corporate marketing or the company, or it could also be because those determining the structure and processes do not have experience in the field of marketing.  Those individuals may not understand best practices or how to employ them to achieve desired results.  

The pattern for marketing department structures, initiatives, and processes that have been repeated over and over – total corporate controlled marketing, partial corporate controlled marketing, hospital-controlled marketing.  And then the cycle starts again – total corporate controlled marketing, partial corporate controlled marketing, hospital-controlled marketing. And, it seems that not all hospital systems are in the same cycle at the same time.  All the advantages and disadvantages of each approach could be a novel, but below are just a few of the advantages and disadvantages of each. With all these approaches, we must remember one thing:  Although many marketers have a special interest or a strong skill sets within their field, they are truly a jack of all trades. 

Total Corporate Controlled Marketing

Some advantages that quickly come to the forefront with this approach can include the following:

• Corporate marketing can assist the local marketer by establishing the corporate brand.
• They can step in during a media crisis.
• Help with non-marketing initiatives such as providing a reservoir for patient education or recruitment efforts.
• Assist with templates and standard pieces for a variety of internal project requests such as those that develop from the human resource and patient experience or registration requests.
• Organize and present local marketers with education on the latest best practices.
• Keep a library of materials developed by other hospitals within the system as a resource.
• Provide a manageable pricing structure when it comes to initiatives such as direct mail efforts and printing.
• Allows the local marketer to focus on local efforts such as community lectures, events and sponsorships. 
• Corporate web services keep branding consistent across all facilities within the system and can take on the responsibility of the constant day-to-day maintenance and big web projects.  Typically, minor edits and additions are kept at a local level.
• Provide support for digital marketing efforts.  Corporate marketing may have the personnel dedicated to finding the latest and best digital practices, as well as oversight to evaluating the digital practices for effectiveness, and can share those results across the system.
• This approach can also assist the marketer at the local level.  Departments within the local facilities become aware of what marketing can do and where “their hands are tied.” This often removes the marketer from becoming a target when individuals are not happy or satisfied with efforts controlled corporate.

Unfortunately, the disadvantages to this approach can have a devastating effect on marketing efforts and cause dissention among local leadership and physicians.  

• The local marketing has no control or very little input over local campaigns and advertising efforts.  Corporate level individuals are looking at the company creating campaigns at the top level, not fully understanding, and digesting the unique needs of the local markets. They may not even be asking for or listening to the input being brought to them. Local marketers know this process leads to meetings with hospital leadership and physicians explaining why the campaign did not produce the desired results.  In another scenario, where the true power of marketing does not reside within the corporate marketing department, the vice president of marketing is being held accountable for something they knew would not work.  
• Local marketers are handed canned campaigns.  Often graphics and messaging cannot be altered to for the local markets making them ineffective leading to the uncomfortable meetings referenced above.  Let’s review and example:  Two hospitals in the same system, are within an hour’s drive of one another.  At first, sounds good – one campaign, less work.  But what local marketers fully understand – demographics can change dramatically within that one-hour drive and a one-size-fits-all approach will fail. 
• At times, corporate control of media can result in more harm than good.  It can void the relationship of the local marketer with their media sources. The local person – even if they are qualified or experienced in media relations – is not permitted to craft a statement or may not even be permitted to have contact with the media in a crisis.  They must send the initial media inquiries up through corporate then they sit and wait for an approved, official response, which is not quick. Then once it is received, the local leadership needs to review the response as well, so they are not caught off guard or do not have any strong objections. If there are objections, the process is delayed even longer.  The media does begin to realize the structure after the first few interactions and will sometimes just stop going to the hospital for comment.  This backfires on the local marketer when they are trying to get a positive story published.  
• Social media should always stay managed at the local level. In the world of social media, although you can touch people world-wide, many stay within local groups whether that is family, friends, towns or cities and businesses – and that is where local hospitals need to be.  Total control of social media at the corporate level takes away the local marketer’s ability to connect with their consumer, connect with the community at large, and manage situations as they occur.  

Partial Corporate Controlled Marketing

This approach can really muddy up the waters or it can be the balance to achieve results.  This tends to work best when you have a smaller corporate based marketing structure and more control is released to local facilities.  The corporate structure typically has a vice president, an experienced digital marketer, a web person or team, a graphic designer or two for local facilities that don’t have the budget to contract with outside designers, and a single communications person.

The advantages for this structure are strong and this list is not all inclusive.  

• Corporate marketing is responsible for establishing brand guidelines that can be utilized at local levels.  Branding is a major undertaking and could easily become a burden for local or inexperienced marketers.  Once involved in this process, it is truly difficult to dedicate time to other marketing activities.
• Relationships with overarching marketing agencies can be solidified at the corporate marketing level, eliminating the need for the local marketer to meet with several agencies to find the perfect one.  They can also provide additional resources for the local facilities.
• The local marketer has a certain level of local customization on creativity and messaging. The local marketer can choose to work with the corporate agency or local designers for market customization. This approach may also help to control costs associated with large agencies and creates messaging and approaches that resonate with local communities producing satisfaction among local leadership and physicians.
• Media is handled at the local level.  Media statements can be developed and reviewed at the local level, then sent up to the corporate marketing structure for the final blessing or minor changes.
• Corporate marketing can secure good pricing structures with vendors allowing smaller facilities to be able to participate in projects that may be costly like web redesign and direct mail.
• Corporate level web services can keep branding consistent across all facilities within the system and can take on the responsibility of the constant day-to-day maintenance and big web projects. 
• Often the local marketer has the flexibility to decide on asking corporate marketing for assistance with digital marketing or can work with local digital vendors.  In this structure, corporate marketing often communicates best practices being seen in the industry and other facilities within the system.  

This approach can be a double-edged sword. The disadvantages can be overwhelming for those new to healthcare marketing or those with limited staffing. 

• Corporate marketing is often not local.  They cannot assist with large events such as health fairs, screenings and clinical presentations. These activities, on top of the other responsibilities, can be overwhelming especially if the facility is in an area that relies on a lot of home-grown efforts to connect with the community.
• If a local marketer is working with a corporate obtained agency, there must be an understanding on the part of the agency.  The agencies may have guidelines and concepts, but they really need to acknowledge that each market is unique, and ads need to be tailored to fit that market.  This may sometimes create conversations riddled with tension.
• The local marketer must still satisfy the endless requests that come in from internal departments on a regular basis depending on what has been standardized at the corporate marketing level and what has not.  Many times, not as much is standardized at the corporate marketing level in this situation.

Hospital Controlled Marketing

When you speak with a marketing person bursting with energy or someone new to the field, this is the approach – really in any industry – that sometimes gets them most excited.  Local healthcare marketing existed long before corporate became so finely integrated into day-to-day operations. During that time, marketing activities were not as strategically driven, and many leaders were not asking for the ROI.

Marketers developed ads for a variety of mediums for local markets.  The local facilities held and participated in a variety of community events, developed newsletters, worked directly with human resource departments on employee initiatives, were sponsors of many local events, and took advantage of physician lecture opportunities.  Then healthcare marketing shifted.  Budgets began to rule.  Healthcare marketing moved into the age of being held accountable for the money they were spending.  The local marketers now took on the added responsibility of tracking ROI from all advertising and community relations efforts. They became pros at presenting stats and tracking referrals to physicians and the hospital after lectures and events.  

Now enter the age of digital marketing in healthcare.  The web and digital advertising were now being applied to healthcare enabling marketers to see an immediate return from their efforts.  Social media and public reviews then added more accountability to the mix.  

All this development, accountability, and added responsibility, in most cases, did not completely take away any of the early marketing responsibilities listed above. The result?  The fading out of hospital-controlled marketing.  It is a structure that overwhelms even the most experienced marketer and unless the large budgets are in place to support contracted individuals and agencies, this structure struggles to produce effective results for facilities.  In recent years, this structure can mainly be seen in small, privately owned outpatient facilities, independent hospitals, or physician practices.  

Moving Forward for Results

Healthcare organizations need to take a long hard look at their marketing structure and make every effort to get off the hamster wheel. Leadership needs to value the experience and opinion of the marketing professionals within their organization as much as they value and respect the opinion of their leadership teams, physicians, and outside experts.  Experienced healthcare marketers are a wealth of knowledge.  Their experience may include working within a variety of structures and knowing the positive and negative of each.  They can take that information, understand their current company, get input from local marketers and then work to build a structure that is most effective.  

I respect everyone who has made a commitment to their profession, especially in healthcare and the current challenges, but to be honest, we all went to school for a specific specialty and for specific training, as did marketing professionals.  Marketing individuals are open to ideas.  From those ideas come new paths to be chartered, but to make these ideas a reality and achieve set organization and facility goals, the systems and processes need to be designed, structured, and implemented by the marketing professionals.  

Deciding which structure – total corporate controlled marketing, partial corporate controlled marketing, or hospital-controlled marketing – is best for your organization will not be a quick decision but it is crucial to involve those it affects and those with the expertise.  It needs to be thought out by a team comprised primarily of experienced marketing professionals from the corporate and local levels, a few corporate leaders that have full knowledge of the financials and goals of the organization, and CEO’s from local facilities.  The next step is to use some of the questions below as a guide and have discussions realizing that more questions and concepts will be generated for consideration.

• Review and consider the marketing structure of your healthcare system and other healthcare systems, and the theories above. List the positive and negatives of each.
• How do your CEO’s and physicians feel about those structures listed from the prior bullet?
• What is the comfort level of corporate marketing releasing control to local marketers? Are measures in place to ensure brand identity remains consistent? 
• If more resources were placed at the corporate level, what would those resources be and how effective will they be to the local marketer? 
• Is designating services at the corporate level making it more difficult to achieve results?  Will processes be too complicated?  Will there be “too many hands in the pot” creating inefficiencies, delays, and poor results? 
• Where does the marketing budget live – at the corporate level or facility level? Will budget be a mixed model?
• If the marketing structure is a mixed model, what skillset should the local marketers have?  This will depend on some of the answers to the questions above. Experience level must be considered.  Placing an experienced individual in a model that is corporate controlled can lead to job dissatisfaction and high employee turnover.
• Non-marketing corporate leaders must be open to new ideas and approaches, they must listen and value the opinion of those who have experience in the field of healthcare marketing (including their own employees), and they must realize their expertise is not marketing but they can offer guidance on company policies, budgets, and organizational goals.

Once the structure has been decided, it is imperative that a periodic checks and balances system is in place.  Make sure you are pulling together your teams – corporate and local – to decide what is working, what is not, and what needs modifications.  This will keep your healthcare marketing structure off the hamster wheel and will generate consistent results.

Patricia Montgomery is a marketing executive with 27 years’ experience in strategic healthcare marketing, communications, public relations, staff management and execution of small- and large-scale initiatives and campaigns. More information can be found at https://www.linkedin.com/in/patricia-montgomery-1b4a3a36/