|  Scott Regan

If you don’t think hospital advertising will ever be banned, think again. In Vermont, State Representative Steve Maier has proposed legislation that would prohibit hospitals from using money for advertising and marketing. Does it have any chance of passing? Doubtful, as the State would have to prove that such expenditures actually add to healthcare costs, and most economists would argue that advertising spurs competition, which actually leads to cost reductions instead.

But let’s play through on this one and assume Vermont passes legislation banning hospital advertising and the other 49 states follow suit. I, for one, relish such a scenario, as we will quickly see which hospital brands are built from a house of cards and which are built from brick.

No more smoke-and-mirror branding that lures in patients and physicians alike with false promises. No more hollow adjectives claiming to be the biggest, best, lovingest, most advanced, newest, most specialized, smartest, top-rated, and preferred hospital around. No more five stars this, Leapfrog that, JD Power here, Press Ganey there, Magnet praise, and Thomson Reuters accolades.

The brand for every hospital in America would rest solely, entirely, and 100 percent on the patient experience.

But that’s where the brand has been all along.

Savvy hospital communications executives have known for quite some time that what happens inside the walls of the institution is infinitely more important than what is communicated externally. Sure, a good brand communications campaign gives the organization a strong brand voice, but the voice can never be stronger than the brand experience itself.

And in the end, an organization that spends zero dollars on advertising, but has a great brand experience, will trump a poor-performing organization that funnels hundreds of thousands of dollars into marketing. Certainly, the most powerful brands do both – they invest in creating and maintaining a strong brand experience, and they also invest in communicating that brand to their stakeholders.

Still, I relish the day when we strip away all the gloss and let hospitals battle it out on brand experience alone. Only then will the truly brilliant marketers in healthcare get their due.

In case you missed it, in its March 1 issue, Time magazine reported on Martin Lindstrom’s groundbreaking research into neural advertising. This is important reading for anyone in marketing, but particularly for those of us in healthcare.

Lindstrom, a leader in neuromarketing research, has spent the better part of a career trying to ascertain which sounds evoke the most powerful emotional responses. And he believes he has figured it out. The sound that leads the pack – actually, the sound that blows all the other sounds away – may forever change the way hospitals approach television advertising production.

So what sound surpassed all the rest for its ability to generate viewer interest and positive feelings? A baby giggling, which far exceeded the positive responses generated by the distant runners-up, which included the hum of a vibrating cell phone, an ATM dispensing cash, a sizzling steak, and the sound of a soda can being opened and poured.
But let’s stick with the baby.

What hospital hasn’t used a baby in its advertising? In fact, if you go back to the birth of hospital adverting (no pun intended) in the early 1980s, it was mostly a race to see which hospitals could put the cutest babies on the most trafficked billboards. Babies were the kingpin of hospital marketing then, and to some degree, they still are now.
But after reading the Time magazine article, it dawned on me that I couldn’t recall a single time that I actually heard a baby in a hospital TV ad. At least not giggling. This is not surprising, as hospitals are notorious for overlaying soundtracks on their ads that are so syrupy sweet, they could make a diabetic wince.

We have tried so hard to evoke an emotional viewer response through our TV spots with powerful visuals, crisp copy, and heavenly music beds, yet the sound that is the most powerful of all has been masked. As we build our collective brands, it is important to use the tools that can help us craft the strongest, most sustainable brand possible. Who would have thought that the giggle of a baby’s voice would be the strongest sound of all?

There’s a lot of effort being wasted these days by healthcare marketers who are putting some very cool and sophisticated brand creative in the marketplace, all aimed at either creating a brand or changing a brand.

Here is a little bit of marketing heresy for you (and, no less, from folks who have made a career in healthcare marketing): All that money being spent on brand communications isn’t doing a thing to create or change your brand.

The sad reality is, you can’t decide what you want your brand to be today, and then change your brand tomorrow.
Brands don’t work like that. They are complex, intricate things. They are influenced by many factors, shaped by every customer encounter, and given a personality by every employee memo, patient billing inquiry, physician-nurse-patient interaction, and so on.

So while you can’t change your brand, you can change the things that can change your brand: the wait time in the E.D., the discharge process, the agendas for your management meetings, how you reward and recognize your staff, management involvement in the patient care process, pre-surgical testing, post-discharge follow-up, leadership training programs, employee orientation … well, you get the idea.

While brand communications are essential to your brand, brand communications are not the brand. All that very cool and sophisticated brand marketing is, indeed, necessary to communicate your brand to your stakeholders. Essentially, the brand communications are the external manifestation of the internal voice. And your brand voice needs to be heard.

However, the brand is what the brand is. And, ultimately, your customers will determine what the brand is and is not. If your brand communications reflect that reality and convey the true brand experience, and the brand experience is driven by how well you manage those dozens – hundreds – of brand factors, then yours will be a strong brand indeed.

So, change the things that can change your brand, and let the brand communications be used to project a brand voice that is heard loud and clear in the marketplace.

The Achilles heal for most hospital brands these days is the fact that they are built upon statistics. The two most common brand platforms – customer service and clinical outcomes – are often reliant on patient satisfaction scores, core measure data, Healthgrades rankings, and the like. And why not? Objective, third-party data is always better than hollow claims of superiority.

But what happens when the market shifts? What is the impact to your brand when patient satisfaction falls, or the competition’s scores surpass your own? Where do you turn when your brand – based on clinical outcomes and medical staff performance – is suddenly under attack because of a headline-raising event?

These are issues faced by every company that built its brand around celebrity endorsements. Pepsi-Cola with Michael Jackson. Hertz with OJ. Kmart with Martha Stewart. And, most recently, Accenture, Nike, Gillette, and Gatorade with Tiger.

And they will eventually be issues faced by every hospital built around market data. At some point, the market changes, and your brand has to high-tail it out of town.

So how do you prevent this likely brand demise?

Simple. Build a brand that transcends market forces.

Sounds mystical, doesn’t it? But it is relatively quite easy. If the brand is built upon the organization’s personality, values, operational philosophy, or some other organizational attribute, it can make itself immune to market conditions.

Take, for instance, a hospital brand not build on clinical superiority, but on the experience and commitment of its people. This was a strategy deployed by Avis, which built a brand on its “we try harder” mantra. It didn’t matter whether Avis was No. 1 or No. 2 in the market, nor did it matter if it was ever awarded a single J.D. Power customer satisfaction trophy. Avis was laying claim to an organizational value that was elevated to a brand position. Only Avis could sabotage its brand, and it never has. The “we try harder” brand was launched in 1962 and will soon celebrate its 50th birthday. How’s that for market transcendence?

Now, imagine your own hospital brand being wrapped around the experience and commitment of your staff. No one – and no organization – can strip you of these attributes. Commitment and experience are yours to own or give away. They do not rely on market superiority to succeed, or volume supremacy, Magnet hospital status, nationally leading patient satisfaction statistics, or any other measure that the competition might claim.

Certainly, you have to deliver on the brand. But if you do, yours will be a brand that really does elevate itself out of reach of market forces.

With the beginning of a new year upon us, many hospitals are in the throes of developing new marketing communications campaigns. After all, it’s a new decade, so why not a new brand? But launching a brand initiative begs the question, just how strong is our brand today?

The truth is, very few hospitals can quantify the strength of their brand. Over the years, we have used consumer preference surveys, market share reports, patient satisfaction studies, and communications audits to extrapolate our respective brand positions. But even collectively, these tools only tell a part of the story.

If you believe, as we do, that branding is an inside-out process, beginning with the hospital’s mission, vision, and values, being parented and raised by the hospital’s leadership, and extending through every operational touch-point (we call these touch points “moments of truth”) in the organization, then any brand study that ignores the internal workings of the hospital will provide you with incomplete information at best, and a false reality at worst.

Is there a way around this issue?

Yes. And as our gift to you as we enter a new decade, we give it to you free.

Anderson Healthcare has developed the Hospital Brand Assessment, the only brand study of its kind that evaluates both your brand position and the impact that internal operations has on your brand. Through this online survey of your board of trustees, senior management, middle management, front-line staff, and medical staff, you will be able to identify the brand strengths and weaknesses in your organizational strategy, organizational structure, and organizational execution. And you will be able to pinpoint exactly those operational processes that are keeping your brand from reaching its full potential.

What’s more, you will also identify which of the eight most common hospital brand platforms your organization is commonly associated with and whether this is the most appropriate brand platform for your marketplace.

All pretty heady stuff — especially if you are about to embark on an entirely new brand campaign.

And did I mention that we are giving you this assessment for free?

For complete information on the Hospital Brand Assessment, download our electronic brochure by clicking here. Then, call us at 888-950-3555, and we’ll walk you through the details.

Until then, happy New Year.

I struggled with whether I wanted to venture into these waters, but there are so many brand lessons in the Tiger Woods saga that I finally decided to jump in feet first.

Tiger Woods is, arguably, the world’s biggest brand. On any level. In any country. In any industry. Period. Even if you want to debate that point, it’s hard not to agree with the premise that his brand is sizeable and robust.

And infallible. Or so we thought.

As the first athlete to earn $1 billion, his brand was once sterling. He was a Golden Boy. And now, his brand is fast approaching rubbish. Accenture has already severed ties with Woods. As the scandal continues to unfold, there will certainly be others. So what can you learn from this debacle that might save your own brand? Plenty. Here’s five lessons that will serve you well.

1. Brands are often tied to people, as organizations take great strides to personify their brands. Your hospital’s brand is inexplicably intertwined with the CEO, the physicians on your medical staff, and your employees. Woods only needed to manage himself. You have to manage 500 to 50,000 individuals, depending on the size of your brand. And any one of them can destroy your brand as quickly as Woods destroyed his. If you are going to manage your hospital’s brand, you have to also manage the reputation of your team — because they are a critical component of your brand.
2. Hubris almost always sinks a brand. It certainly sunk Woods. Because of his own arrogance and overbearing presumptions, he believed that he could behave badly without retribution. When hospital CEOs begin believing their own press releases, trouble is on the horizon. And when those same CEOs believe they are bigger than the organizations they serve, trouble is just around the corner. Hubris has killed many an executive — as well as the brands they were charged to protect and oversee.
3. It takes five to 10 years to build a brand. It takes five to 10 minutes to destroy it. We need brands. They serve as a trust mark, a sorting device. We make conscious and subconscious decisions all day long based on brand trust. Ever purchase Advil for $9.99, when the generic next to it sold for $3.49 and had identical ingredients? Maybe it wasn’t Advil. Perhaps it was Philadelphia Cream Cheese versus the generic. Or maybe it was the physician who was the recent subject of a Medicare fraud investigation that you passed by in favor of a doctor a mile further away. My point is this: The next time Tiger Woods talks about the values that was inculcated in him as a child (although I can’t believe this will happen anytime in the near future), how much of his rhetoric will you actually believe? Now take your answer and apply it to your collective community next time your hospital is trying to defend its brand and the values associated with it.
4. Even in times of utter and total brand turmoil, brands can survive. However, pulling this off takes skill. And speed. Tiger Woods displayed neither as he cocooned in his home, forgoing an appearance at his own charity golf tournament and hiding behind the “private matters should stay private” comment. Had Woods stepped forward into the white hot spot light and bared his soul, showing remorse for what he had done, and pledging to take steps to rectify his sins, many would have raised his pedestal even higher. We all fall at some point. Individuals and institutions. It’s not the fall that is unforgiveable. It is not rising up after the fall and soaring even higher.
5. It’s better to take all of your medicine in one dose, that have it administered to you over several weeks or several months. Woods is learning this lesson the hard way, as new stories emerge nearly every day. With each new story, the Woods brand continually erodes, and Woods has more to answer for. When your brand is in trouble, it is better to assume that the things you are hiding will eventually emerge, rather than hope they are never uncovered. Step forward, put it all on the table, and be done with it. Not only is this brave, it shows that you have taken responsibility for your actions — even those that have yet to be disclosed. It’s easy to forgive someone who tells the whole truth, shows remorse, and pledges to do better. It’ hard to forgive someone who does otherwise.

You’ve worked hard to develop a strong hospital brand. Take a minute to think about how fast it can come tumbling down, should your hospital accidentally kill a patient, the Justice Department launches an investigation into billing fraud, your purchasing manager is accused of taking bribes, or your CEO is charged with sexual harassment. Now think about what you will do to save your brand from ruin. The time you spend planning now could save your brand in the future.

Last week, we conducted a poll on the eight most common brand platforms for hospitals, and 135 of you responded. The results: 60% of respondents listed “customer service” as their hospital’s primary brand platform, followed by medical staff reputation (13%), clinical outcomes (13%), teaching and research (7%), and facilities (7%).

Those categories without a single mention: Technology (surprise!), physician relationships, and financial stewardship. So maybe the Big Eight is really the Big Five, although every category with the exception of teaching and research was considered to be a secondary brand platform by at least six hospitals.

Quite a few hospitals also provided their own secondary brand platforms that were not on the list of eight. Among those that were included were compassion, affordability, accessibility, trust, and world-class. The question is, are these really brand platforms? Or are they brand values?

Dictionary.com lists the sociological definition of values as is “the ideals, customs, institutions, etc., of a society toward which the people of the group have an affective regard. These values may be positive, as cleanliness, freedom, or education, or negative, as cruelty, crime, or blasphemy.”

If you are searching for a home, the home itself has a certain brand platform: wealthy, poor, urban, rural, etc., depending on where the home is. And depending on the location of the home and how it is constructed, it can also carry specific values: clean, cost-efficient, warm, drafty, and secure, to name just a few. But these are attributes of the home that help convey the home’s brand. They are not the brand platform itself.

You can purchase a home in a down-trodden neighborhood whose brand platform is under-class by virtue of the neighborhood that surrounds it, and elevate the brand platform by adding a Florida room, re-landscaping the yard, and adding exterior lights. By focusing on the brand’s values, you can strengthen, weaken, or even change the brand platform.

A hospital I worked with a few years back focused on clinical outcomes as its primary brand platform and customer service as its secondary brand platform. It had a single brand value it wanted to own in the marketplace, that value being “trust.” The hospital felt that unless the community really trusted the hospital, it would never fully develop their brand platforms.

That single value of “trust” was imbedded in every internal and external communication. Hospital executives obsessed on this value. The external marketing communications conveyed images of trust and had the word unobstrusively included in every message that was released into the marketplace. Within five years, the percent of people who mentioned this hospital by name when asked what hospital they trusted the most went from 32% to 74%.

And market share went from from 37% to 51% during this same time.

All by understanding their brand platforms, brand values, and interweaving them together.

Take our three-question survey on brand platforms by clicking here.

When was the last time you gave any thought to the platform your hospital’s brand was anchored to? Was the brand platform a deliberate choice, or did it “just happen”? Even more important, do you know what your brand platform is and whether that platform is effective?

After conducting extensive research over the past 10 years, I have found that 95% of all hospitals anchor themselves to one or more of the following eight brand platforms.

1. Customer Service
2. Clinical Outcomes
3. Teaching and Research
4. Technology
5. Medical Staff Reputation
6. Physician Relationships
7. Financial Stewardship
8. Facilities

The two that dominate hospital marketing is customer service and clinical outcomes. Hospitals usually make up their minds to win the war for patients either by providing excellent personalized attention and creature comforts or by leading the marketplace in clinical indicators. It’s a fight between “we’ll love you” and “we’ll save you.”

The second tier of brand platforms includes teaching and research, technology, and medical staff reputation. Often, two of these are naturally coupled together. Teaching and research hospitals tend to migrate toward their strength, laying claim to the belief that because of their status, they are simply better and more sophisticated. But it’s not uncommon in markets where there is a major teaching institution to see a community hospital build a brand around technology and medical staff reputation. Consistent messaging is the key.

Finally, the third tier consists of physician relationships, financial stewardship, and facilities. While not as likely brand platforms as the first five on the list, they are still common, and are often a secondary brand platform for hospitals. The difference between medical staff reputation and physician relationships is that the latter is grounded in the collective pedigree of the medical staff (board certifications, fellowships, specialized training, awards and recognition, etc.) while the latter uses the medical staff to provide professional references for the hospital (physician testimonials, physician practice patterns, where physicians receive their own care, etc).

Financial stewardship is — and will probably always be — a stronghold of sorts for safety net hospitals, which must maintain a public dialogue about the need foir public funding. Integrated delivery systems, on the other hand, have given rise to the facilities brand platform, as they try to win market share by having a hospital, physician’s office, urgent care center, and/or imaging facility on every corner in town.

Any one of these brand platforms can be successful, if executed correctly. Where hospitals get into trouble is moving from platform to platform, creating diffusion as well as confusion. To create a strong, sustainable brand, define your platform — whether it’s on the above list or not — and use it to create a strong foundation for everything that you do, from operations to communications.

For nearly two decades, I have heard hospital marketing executives complain about their exclusion from discussions of hospital operations. Either they are invited to their organization’s ops council to listen and learn, or they are excluded from these meetings altogether.

Smart hospitals are realizing that the people charged with watching over and protecting the brand must be included in operational discussions, because the brand and hospital operations are one. And, in an effort to better marry the brand experience with the brand promise, the really, really smart hospitals are going one step further by including marketing executives in ongoing quality improvement efforts.

Sound crazy? Think about it.

Every day, hospital brands are being more defined around quality. Report cards are everywhere: CMS, Leapfrog, HealthGrades, and J.D. Power, to name just a few. Top hospital lists are abundant, including rankings published by Modern Healthcare, Hospitals & Health Networks, and U.S. News & World Report. And then there is the high-profile quality curriculums offered up by The Joint Commission and Institute for Healthcare Improvement, which are constantly in the news.

That’s not all. Payers are moving toward reimbursement models that reward quality and penalize mistakes. Patients can look up readmission rates, infection rates, and mortality rates. And detailed physician information is available with the click of a mouse.

Quality is fast becoming the most dominant brand platform in healthcare. Which is exactly why marketing executives must get involved in quality improvement. As guardians of the brand, marketing executives represent the brand promise in the marketplace – which means they are now obligated to help fix the brand experience. As such, marketing executives must now, more than ever, roll up their sleeves and dig their hands into the muck of mire of hospital operations.

The brand should not be left to chance. And marketing executives should not be left on the outside of hospital operations looking in.

Advertising is sexy. Advertising is emotional. Advertising is necessary.

But advertising, by itself, will never create a brand. And advertising, by itself, will certainly never sustain a brand.

Why?

Because creative campaigns, no matter how clever and how precise the execution, are simply vehicles for communicating the brand; they are not tools for actually developing the brand.

No matter how irked you are but what you just read, go back and read it again. And again. Until it really sinks in and settles into your gut. Because it is true.

In actuality, the brand is merely the sum total of all the individual parts – how the organization recruits talent, the cleanliness of the emergency department, the manner in which physicians and nurses talk to patients, and how the patient financial services department collects overdue accounts.

The brand is born out of the culture of the organization, not out of some slick television spot running during the evening news. This means that your leadership team lives the brand, the brand experience is aligned with customer expectations, and the brand is managed.

If you do these things, you will have a brand worth advertising your brand. Your brand will be ready for primetime, and the promises your brand makes will be easily surpassed by the experience provided to all of your customers and stakeholders.

But if you fool yourself into believing you can create a brand with an appealing logo, a cool tagline, and warm colors, then you are certainly doomed to experience great aggravation, angst, and stress.