Focus

Is Your Brand Top-of-the-Mind?

After establishing them as well known brands, corporate hospitals are now adopting effective strategies to create a good brand-recall, finds out Nancy Singh

Fortis, your caring hospital - the moment you read this, you are bound to recollect the caller tune which you must have heard on the mobile phone of a Fortis Hospital employee. In a very unique manner and rather effectively, Fortis passes on the message of its brand-essence to create a long time impression in the minds of millions. Says Sudarshan Mazumdar, Director-Marketing and Corporate Communications, Fortis Healthcare, "It's a very strong part of our brand-recall space. It's a reminder of the vision of a brand. So, anyone who calls in Fortis, automatically or instantly articulates with the values of your brand. I think it is the most unique exercise in this healthcare space." Communication or rather 'right communication' is the key, vouch market pundits and this is what Fortis has attempted to do. Agrees Mazumdar, "The way you communicate is very important. This strategy serves the purpose of internal marketing as well as external marketing. As even the employees who are within the premises and interact with each other, this tune acts as a constant reminder to the brand ethos." Not to be left behind is Max Healthcare, which incidentally was the winner of Express Healthcare Excellence Awards in the 'Innovative Marketing Practices' category. Apart from regular marketing activities like CSR and many corporate programmes, it has collaborated with a media giant and publishes a health supplement called Max Health Line. Elaborates Sanjay Suri, Director-Marketing, Max Healthcare, "It is a pioneering initiative in healthcare marketing. It is a quarterly media marketing initiative in collaboration with Hindustan Times paper which circulates to 4,80,000 households in Delhi NCR. It is a four page supplement covering a wide range of medical issues related with seasonal ailments, diet and physiotherapy, surgeries, medicine, mother and child care/ emergency programmes."

Max and Fortis are not the only ones who have a robust branding / marketing plan. In today's complex and competitive healthcare industry, brand and reputation are more important to organisations than ever before.

Brand-Recall in Healthcare

"We remain in constant touch with the patient even after discharge. Satisfactory service is the best brand recall" - Ashoka Varma Head, Department of Branding Yashoda Group of Hospitals

Often called top-of-the-mind awareness, brand-recall is normally defined as the extent to which a brand name is recalled as a member of a brand, product or service class, as distinct from brand recognition. Brand-recall can be segregated into aided and unaided recall. 'Aided recall' measures the extent to which a brand name is remembered when the actual brand name is prompted. For instance a question like - 'are you aware of 'abc' brand?' becomes an aided recall. So, what does brand re-call mean with reference to healthcare? "Simply put, brand-recall is recognition and memory of a brand. In the healthcare space, unaided and aided recall has equal importance. For new brands 'aided recall' is a good measure of marketing and communication effectiveness. For a mature brand, being top-of-mind within category is instrumental to its success, therefore 'unaided recall' becomes a good benchmark," informs Sohan Shah, Associate Vice President, Strategic Planning, McCann Healthcare. Considering that healthcare service is based on an intangible quality like trust, it also means that the marketers need to weave a lot of feelings and that too without making them sound too commercial.

Brand-Recall vis-à-vis Brand-preference

After taking years to gain momentum and win confidence as a strong brand, hospitals have to sustain that loyalty or brand preference and that is where the ordeal or the challenges start. But the question that arises is what precedes first - brand-recall or brand-preference?

It is difficult to fathom if a brand is recalled because it is preferred, or is recall the first stage and preference comes later. Vishal Bali, CEO, Wockhardt Group of Hospitals avers, "Brand-recall comes only after when you create a brand-preference. If the customer does not prefer the brand you obviously cannot create a brand-recall. It is more on word-of-mouth that Wockhardt relies on. Ideally, we are very focused and we will continue to brand ourselves as a destination for high-end tertiary care in specialty services like cardiac care, neurology, critical care. We have tried to create a synonymity between our services and brand-recall." However, there are others who feel that preference does not precede brand-recall. "Recall is easier, but preference goes far beyond. Recall is the first stage. An unrecalled brand will never be preferred. Preference involves getting it higher on priority list and that involves not just brand awareness but involvement on the part of the customer in the brand," says Ujjwal Chowdhury, Director, Symbiosis Insitute of Media and Communication.

Thus, brand preference not only depicts the name, term, sign, symbol or design. It is more than all these factors and depends on the expertise and the success rate. Says V Ramesh, Deputy General - Marketing, Dr Moopen's Healthcare Management Services,

Dubai, "One should clearly understand the brand acceptance by a particular segment. Branding is not about getting your target market to choose you over the competition, but it is about getting your prospects to see you as the only one that provides a solution to their problems. That is brand preference."

In the development of a healthcare brand, the first task is to give an identity through a name. The second task is to enhance its recognition by the provision of a symbol of identity, and the third task is to develop a unique image for the brand and to build its personality over the long term. "Brand recalling is the result of the former two tasks and brand preference is of the third one which is not very easy to achieve," states Jerry Philip, Manager-Business Development and Quality Systems, Kerala Institute of Medical Sciences, Trivandrum.

Consumer is the King

"Beneficiaries won't remember what we say. They will forget what we do. But they will never forget how we make them feel comfortable" - V Ramesh Deputy General - Marketing, Dr Moopen's Healthcare Management Services, Dubai

"Hospitals often make the mistake of focusing more on the tangible part of branding" - Jerry Philip Manager - Marketing, Kerala Institute of Medical Sciences, Trivandrum

Research, research, research! Predictably enough, this is a routine exercise/ strategy followed by the groups, be it an already established one or the one which is still positioning itself in the market. You obviously need to know what the customers want. Developing a brand requires a careful assessment of customers, programme, competition, market, and position in that market. The marketing conducts a thorough SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) on competition, combined with a careful assessment of customer impressions and preferences. Frequency and consistency of the brand's message also contribute to the branding strategy, but only when the message is firmly tied to an emotional anchor. In addition, to identifying what your customers think of your programme (and your competition), one must also review all of business and service activities to ensure that they consistently and frequently support the branding strategy. Besides frequency, consistency, and clarity, other elements that play into the branding strategy are the brand name, brand mark (distinctive colors, choice of font, symbols or logo), trademarks, and copyrights. "At KIMS we believe that patients are our brand ambassadors and we try to make them feel special when they come to our hospital with our patient friendly practices. We lay a lot of emphasis on quality and safety aspects to ensure that our patients receive the best of care. At KIMS, we ensure the behaviour and attitude of each employee contribute towards building confidence and trust of our patients," states Philip. Similar is the case with Yashoda Group which time and again reviews and analyses the customer feedback. "We remain in constant touch with the patient even after discharge. Retention of patients is a big challenge in the present scenario. We maintain a good feedback and follow-up system with patients and their attendants. Satisfactory service is the best brand recall we feel," informs Ashoka Varma, Head, Department of Branding, Yashoda Group of Hospitals . But eventually it is internal branding that they really concentrate on. Yashoda Hospital mainly believes in internal branding alias patient care and service. Even though obvious external branding is a regular activity in the Hospital its belief that a satisfied patient is the best brand ambassador makes it take utmost care in patient handling right from the moment he or she comes to the hospital for consultation or admission and till the time he/ she gets discharged. Moving beyond the regular paper based feedback, Max Healthcare has a pioneering form of qualitative market research aimed at customer feedback in audio-visual format which is periodically undertaken by the marketing department. No doubts over the fact that it is the consumer voice that matters and time and again hospitals keep on renewing their services depending on consumer demands. Informs Mazumdar, "One of the measures we did was replacing paper glasses as one of the customers was uneasy with it. It may seem a small gesture but in the end it does make a difference." Rightly said, that it is indeed the smaller attention to details that make all the difference. In this industry, solely based on hopes and beliefs, in the end it is the experience that the patient or relatives would reminisce. As Ramesh sums it up, "Beneficiaries won't remember what we say. They will forget what we do. But they will never forget how we make them feel comfortable. They will recall only with quality and committed service. Hence, brand-recall is more so established through word-of- mouth."

Looks Do Matter

Though as clichéd as it may sound, if a hospital does not look good, the consumer/ patient would not 'feel' good. Hence, predictably enough, hospitals do not compromise in this arena whatsoever. Right from the logo to the interiors and color schemes are carefully designed so as to create a long-term impression in the minds in the customers.

Says Mazumdar, "At Fortis, we assure that we look the same across all centers in India, so that the consumer does not feel a disconnect. We focus a lot on green, which is the most prominent color even in our logo, as it is considered as the color of healing." Though healthcare as an industry is based entirely on intangible qualities like trust, faith and loyalty, the Hospitals focus upon these tangible qualities to build upon faith in the brand and many groups are effectively using these strategies to create a good brand-recall. Opines Philip, "There are tangible qualities like infrastructure, designer rooms, interior design and décor, spacious and comfortable lobbies which can be used in creating brand recall. But I feel, hospitals often make the mistake of focusing more on the tangible part of branding, whereas it is the intangible part that enhances the brand recall. A balanced blend is the mantra for an effective brand-recall. We can provide world-class facilities and infrastructure but if the delivery of services is not done in the right patient focused manner the patient may neither come back nor may refer any case to the hospital in future," feels Philip.

CSR

This is the most common as well as one of the most powerful strategies used by all healthcare groups. CSR is an important ingredient for most private and corporate hospitals in India. And it has moved beyond a hospital engaging in charity and providing some free health check-ups. Corporates interact and engage directly with society and communities. The ambit of CSR now includes regular health check-ups for people both in the urban and semi-urban areas, free treatment, check-ups for traffic police, and awards for patients and extra curricular activities for students. "CSR is indeed a very integral and important part of branding. For example, in Dubai the temperatures soar phenomenally high, so we provide health tips through talk-shows on how to prevent from heat-stroke . We also conduct regular programs like disaster management, mock exercises." explains V Ramesh. While in other industries prime business houses go in for CSR to advance their self interest, maximise profits, sustainability and give their brand a 'competitive advantage' it is not the case in healthcare. The main motive is to sow the seeds of 'feel-good factor' as it helps a hospital to connect with different segments of society and thereby build a strong brand.

One of Max Healthcare's major brand-preference initiatives - the 'Max Healthy Neighborhood Programme' is a Customer Relationship Management (CRM) initiative with a focused objective of becoming the 'preferred healthcare provider' for Residents Welfare Associations (RWAs) and established clubs. "Through this programme our emergency services get promoted by placing branded gate signage. We have periodic health engagement with communities through regular health check-up camps at the onset of every season, health related talks in designated colonies," says Suri. Max Healthy Neighborhood beneficiaries are entitled to certain exclusive benefits by virtue of possessing the ‘benefit card’ and on-going database marketing/ direct mailers on special promotions." The Group has a tie-up with 15 Resident Welfare Associations- in Delhi NCR in the pilot stage and it highlights Max Healthcare key specialties in the camps organised. Similarly, with all hospitals setting up telemedicine initiatives in rural and semi-urban areas, adds another dimension to the broad spectrum of CSR.

Media Exposure

Innovative healthcare advertising is slowly creeping in with most hospitals moving beyond the traditional forms of media like print or hoardings. It is indeed the web-based media that has attracted the attention of many. Hospitals cannot do hard marketing. This is why brand of a hospital will be built more through word-of-mouth, buzz marketing, media visibility and testimonials by beneficiaries. And this is where internet media gains prominence. Hospitals who have established themselves as brands highlight their services to the maximum with creative web designs. Especially, notable is the fact that groups which are targeting foreign patients make it a point to update their websites consistently and focus on the designing aspect as well. Wockhardt is one of the best examples of how it is exploiting web medium to the fullest. Its website recently was adjudged the best 'International Hospital Website for Patient Information' by Consumer Health World Awards. The award was presented at the Healthcare Globalisation Summit held at Las Vegas. The idea was to showcase the complete range of treatments, clinical and surgical services offered by the Wockhardt Hospitals Group in India. The Hospital has tried innovative moves to connect to the consumer. Hence, apart from adding some truly unique features like live webchat, they have uploaded testimonial videos of patient experiences, a query option to get a no-obligation second opinion from expert doctors, a credit card payment gateway for easy money transfer. Since one year, the website has received more than 45,000 patient queries for opinion. Apart from the website, Wockhardt has invested in sophisticated web-based customer relationship management software. Moving beyond the conventional modes, the group has also set up a video channel on popular broadcasting sites like 'Youtube' where more than 40 videos about the hospital group, patient testimonials and media stories can be viewed. Says Bali, "In other industries there are so many tangible qualities that influence branding and brand-recall. But healthcare is a sensitive place where trust is the element. Trust gets built over time and experience. People remember the positive experience. People not only talk about their treatment, but the way they were treated and dealt by the staff. It's the entire experience that they remember. In context of all this, website is one the most powerful and cost effective medium for enabling our potential patients to make an informed choice." However, currently this medium has its limitations as the internet penetration in India is quite low and most consumers still do not seek the net to be aware of the services available in their vicinity. Added to this is the fact that apart from just a few organisations, a larger chunk has not yet concentrated on this medium. Nevertheless, just fast forward a few years and undoubtedly this medium would definitely be ruling the roost in the healthcare marketing. As of now, healthcare groups are more than happy providing free health check-ups.

Challenges

Healthcare advertising is a unique entity in itself with its sensibilities completely different from other service oriented industries. In today's complex and competitive healthcare industry, brand and reputation are more important to organisations than ever before. Hence, the first challenge that exists in this space is that the healthcare organisation has to carefully advertise in a manner that it does not make them sound too hungry for business. Agrees Suri from Max Healthcare, "Healthcare in India has a philanthropic connotation. Customers expect healthcare providers to extend some charitable services. The risk with an aggressive branding strategy is that customer perception of such healthcare providers gets skewed towards being viewed as overtly commercial." Hence, the marketers need to generate outcomes which assure what their brand recalling strategy is trying to convey. The executive leadership should concentrate on operationalising the brand strategy. Another important challenge is to understand clearly the consumer needs, market dynamics, healthcare innovation and view of future. "Successful brands are built from the 'outside in.' They are based on a solid understanding of the target audience, not on internal conventional wisdom, organisational ego, or what physicians or other internal stakeholders say the brand should be," reacts Philips.

Another challenge is when a doctor becomes larger than the brand. In this physician driven industry it is difficult to actually differentiate whether it is the renowned physician who is pulling in the patients or it is the brand. The prominence of a physician’s name in this industry is an important influencing factor for customers, and therefore the management concentrates to attract the best physicians to aid brand re-call. But when that person chooses to leave that organisation, wouldn't it impact the brand-recall? Yes as well as a no, feel experts. "It is a chicken-egg situation. No doubt that the doctor pulls the patient, but overtime, it is not just one man show. Fortis has been able to build the brand over-time. For example, when it comes to Dr Naresh Trehan's exit from Escorts, everyone perceived him as a brand. But, ultimately the brand Escorts prevailed. Hence, brand remains the focus," states Mazumdar. One more key concern faced by groups is re-branding a hospital after its take-over , especially if it is a strong brand. Then, the Group would have to evaluate its strengths and act accordingly. For instance, when Forits took over Escorts, it was in a dilemma over changing its brand name because Escorts as a brand is almost considered as the mecca for cardiac services and its services are not only considered the best in India but the world as well. Hence, in Delhi after the take-over, they did not re-name the brand and kept the original identity. But outside Delhi and in cities like Faridabad, Amritsar, it is branded as a joint entity - Escort-Fortis. "As a joint effort, the brand strengthens its value. Since both are a recognised brand, it works great for the brand. If the brand that is taken over is not really a well-known, then it not such a daunting task. All you have to do is apply the standard operating systems and inculcate the brand in the Fortis umbrella," feels Mazumdar.

Killing a Brand

One key area which healthcare organisations are weary of is high customer expectations. In that entire competitive spirit, industry czars warn of not over-promising and under-delivering as they feel that is a sure-shot way to kill a brand. With the informed consumer on the rise and their escalating expectations, groups need to maintain a fine balance between their promises and delivery. Agrees Ramesh, "You definitely need to give real facts and figures to the patient. For example in case of In Vitro Fertilisation (IVF), the success rate is just 30 per cent. You need to tell a patient this reality; otherwise you will end up raising their expectations too much."

Branding or re-branding, it is a fact that with the rising era of corporatisation, healthcare marketing is here to stay. Having said that, it is still in its nascencey. As Vivek Shukla, Marketing Consultant aptly points it out, "Many have yet not understood the power of a brand. I often ask- If Pepsi was given a choice to either lose all its bottling units overnight or its brand name -Pepsi, what would it choose? Further, there is too much focus on short-term results. For them giving commissions to GPs or lowering the prices is an easy way out, as it brings short-term gains, even though it harms the profits and the brand in the long run." While some providers have benefited from a branding strategy, this business tactic has largely been under utilised by the industry, mostly because the majority of healthcare managers have not been educated in brand management. But positively speaking, as Varma points out, "With the advent of corporate hospitals and increase in competition to deliver the best, the scenario is changing fast and most of them are aggressively pursuing to create a brand recall."

nancy.singh@expressindia.com