Of the topics discussed, one that really resonates with me are some of the complications surrounding the reimbursement challenges of our third party payor system. For those of us who work in that part of the industry it can be easy to be lulled into forgetting how complicated the system is. Ask any patient who has been denied after seeing a doctor and they can remind you about the challenges.

The Interval crew also delved into a question posted on Health Leaders Media: “If You Could Tell the CEO One Thing About Marketing, What Would it Be?” My comment on that post was, “marketing is dead”. As ambiguous and inflammatory as that comment sounds, the Interval team did a great job of interpreting my meaning. One of my favorite concepts is the idea of the “experience economy”. The term comes right from the title of a book by Pine and  Glilmore. The essence is that we live in a time when ubiquitous connectivity and real time communication (IE social media) enable consumer to discuss products and experiences in real time. To put that in context, I do not need to see a billboard about a hospital in town, I can see what people are saying about that hospital right now online. Those experiences will have a much greater impact that marketing.

Chris makes an eloquent counter point about marketing. When applied as the “art and science  of [retaining and growing a customer base]” it is not far afield from the experience economy. I would argue that under that definition the onus (and effort) moves off of traditional marketing and is placed on operations, customer service and clinical outcomes. In that sense, the need for billboards and print ads becomes superfluous – marketing, at least in that sense, is dead.

I have had the recent pleasure of some deep conversations with a friend who knows a lot more about these concepts than I do. Without a doubt those who “get it” understand that the future of healthcare marketing is not about a bigger watermelon truck. Business development has to be strategic and tied to the proverbial bottom line. When service and the patient experience are approached with the same attention, the results are surprisingly affirmative in advancing that bottom line number.

Enough of my drivel, have a listen to Chris and the Interval team here on their site, or subscribe via iTunes

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I will admit to some bias about true cost centers, particularly in healthcare organizations.  My “day job” is all about maximizing revenues. To many of my colleagues it would be anathema have a personal interest in what is traditionally called marketing and communications. “Do you have any idea what they spend on phone book ads?”. And its true, some of their spends are costs that may be well intentioned but have probably outlived their usefulness. So why not crowd source it? Why not let your patients and staff create the marketing materials – or at least some of them? It is a way to reward your most loyal fans, it has much lower costs and is about as interactive as it gets.

The typical experience goes like this:

Maybe its a little different. Maybe its all done in house, or with one firm. Regardless, there is a lot of effort and expense involved. As I have written previously, most hospitals would be happy to have a 2% operating margin. 2%! So before you scoff at $10,000 being so low compared to hospital bills, think about what happens when each service line needs to incur $10,000 or more of expense. Its hard to eschew those kind of figures and how they effect the bottom line.

The solution is simple. Ask for help. Just asking your constituents to be your friend. Arn’t we supposed to be able to ask friends for help? Start simple. Lee Aase, the guru behind Mayo Clinic’s social media program, has turned to crowd sourcing to help pick a logo for his SMUG site. Lee maintained some editorial control by offering readers a limited number of choices on which to vote. The same model could be applied to branding a service line. Ask your read/write web friends to submit some rough samples of logos. Post them to a site like Flickr and then setup a Tweetpoll. Let your patients and staff and physicians vote on which sketches they like best. Once you have a direction, engage the artist to complete the job. I do not pretend to know the world of graphic arts, but my guess is that many of submissions  will come from part-timers or artists who are simply interested getting their name out there. In other words, they will be a lot less expensive than a big firm.

The same plan of attack can be used for all manor of creative work. Run a contest for the best web design. Let users submit designs, express some editorial control and narrow the list to the top 3-5 and let your constituents vote. Billboards, despite my feelings about their relevance, may be an even greater gold mine. What photographer would not jump at the chance to get a shot on a billboard? Start a Flickr pool for your healthcare organization and accept submissions for a billboard shot. Pair the best photo, with the best tag line from twitter submissions and presto, instant ad campaign. Just make sure to include credit to the artists too. As an amateur photographer, I would gladly give a shot away in exchange for seeing it in a large format in my town. I’m probably not alone.

Now, before the marketing and communications folks feel like crowd sourcing puts them out of a job remember this: someone has to make sure the messages are on track. Someone has to pitch the idea to your friends and fans. Someone has to then sell the crowd-sourced project back to organization. You have your work cut out for you. What you have in your back pocket is an army of friends via the read/write web on whom you can lean for favors. As long as you return the favor (crediting, using their work in a public forum, etc) then the cycle is endless.

What do you have to lose? Try it on a simple project – an internal flier. Give employees the chance to create some materials showcasing a wellness program. Let other employees vote on what you feel are the top three options. Flip video cameras are cheap. Windows Movie Maker is free (yep, I’d rather see everyone get an iMac on their desk, but the reality is what it is). Ask teams to create 30 second spots for their department. Gwinnett Medical Center in GA did just that. Share the best ones on your intranet and facebook and youtube and flickr and…well you get the point. These folks are already on your side and will forgive any imperfections in the process. Put that good will to use and you will be paid back in droves.

Mr. Rogers got it. Here was a man that kicked off every show by asking the audience to be his neighbor. He was literally genuflect when asking us all to be his friends (he was also clearly a fan of comfortable footwear). Fred Rogers may have understood social media and the importance of relationships in brand building long before any of us. And he also clearly understood that being humble and earning the friendship he asked for paid much greater dividends than telling his audience what to think. So why are healthcare organizations and physicians not doing the same thing?

In Social Pulse, I suggested that healthcare organizations might actually ask their patients, staff and physicians to be their friend. It sounds easy and perhaps even a tad juvenile (medicine is far too serious work for such pedestrian language). But without that invitation healthcare organizations will never gain the traction with social media that thought leaders are touting today.

Jumping into the world of social media is often a splash of cold water to the corporate face. Just because you build it does not mean they will come. As Steven Barley, head of internet services for Riverside Health System in Norfolk Virginia, states frankly: The reality is not everyone in your market is on FaceBook and even fewer still are on Twitter. So how can healthcare organizations encourage the conversation to take place online when only a fraction of their markets are online? Borrow a page from Mr. Rogers – and ask very simply “will you be our friend?”

Imagine a campaign that asks that very question, “Will you be our friend?” on billboards around town, on flyers in staff break rooms and in an email to physicians. Maybe its nebulas, “join the discussion at GenericHospital.com/friends” which directs your new amis to the CEO’s blog and the hospital’s twitter account. It could also be more overt – “Generic Hospital is on FaceBook, look us up and tell us how we are doing”. Does it mean taking off the jacket in favor of the cardigan (proverbially speaking)? Yeah, it does, it also means speaking to people they way conversations occur, not in the vernacular of a press release. It requires healthcare organizations to humble themselves; indeed the first step is admitting that you may not be as important in your constituents’ lives as you think. But if your organization believes that you truly serve your community (including employees and physicians) then why not ask on bended knee – “will you be our friend?”

Fortunately it may not take getting your entire market online to be a success. A critical mass may be as little as 2-5% of a market (1,600-4,000 patients for an average 80,000 vist/year hospital). Malcom Gladwell, the author with a genius for making commonsense sound extraordinary, has written about the power of influencers in The Tipping Point. Gladwell tells us what marketers have known since the dawn of time: nothing beats word of mouth.  Most social media early adopters fit the mold for what Gladwell calls “connectors” and “mavens”. The former are people who have a natural ability and pride in facilitating relationships. We all know them. They are the ones who answer anything with “oh, you should talk to my friend So-and-so about that, I’ll arrange a lunch.” The later, mavens, are our friends who always seem to know about the best meal in town, or which computer has the best bang for the buck. If you have spent any time ‘crowd sourcing’ on Twitter, then you have seen both personalities in action. If a healthcare organization reaches 2-5% of its market through social media, and that 2-5% are mostly connectors and mavens, then imagine the conversations they may have on your behalf. All of the sudden you have an army of powerful influencers in your community who are ready to help you own the perception.

Healthcare organizations (and I’m counting physician practices in that group), starting thinking “What would Mr. Rogers do?”. Invite your communities and constituents to join you in a conversation. As patients, and we are all potential patients, see out ways to engage with your care providers. If your provider is not interested in a two way dialogue consider what that says about them as an organization. A neighborhood is, by definition, a community and a community cares about one another.

I hope you will be my neighbor – twitter.com/nickdawson

The Manifesto consists of four discussions surrounding 95 theses; the crux of which is that “markets are conversations”. In a world were the internet gives everyone a voice, its time for organizations to listen to and participate in those conversations or be left behind. The authors argue that the internet has tipped the scales in favor of the consumer. Connectivity has given a everyone a chance to shout as loudly as they can how wonderful, or how poor a product is. They challenge institutions to learn the parlance of the new market place and become an active, and most importantly, genuine participant. The penalty for non-compliance is simple, they get left behind and become afterthoughts or lessons of failure.

The book was written in 1999.

1999, that is 4 years before MySpace, 5 years before FaceBook and 6 years before Twitter. The Cluetrain authors already knew what most businesses are still coming to grips with. “Markets are conversations.”

A few weeks ago I posted my own white paper on the use of social media in healthcare. The terms and tools are newer, but the ideas are rooted in the work of Levine, Locke, Searls, and Weinberger (though I did not know about the Manifesto when I drafted Social Pulse).

Here in Richmond, VA we have a stretch of interstate that I have dubbed “Healthcare Highway“. There are five hospital billboards in less than one mile. “We are the best carido program on the East coast…”, “We treat you faster in our ER…”, or “Best place to have a baby…” there is nothing wrong with that type of marketing. A friend describes it as being a good neighbor, reminding the community that you are there. But it serves little purpose past that.

This is the time to stop littering the skyline with superlatives and start having conversations. As healthcare providers we need to ask our employees, patients and physicians how we can best help them. What do you want out of a relationship with your local hospital? How can we serve you better, and when we don’t live up to your expectations, how can we make it right?

The good news is that its not too late. Unlike what we are seeing with the automotive and credit industries, the unique nature of healthcare has afforded us a chance to slip under the radar. But it will not last long. Look at the scrutiny and criticisms leveled at the for-profit insurance industry. Sure there will always be services where we have a captive audience: OB, the ER, etc. But as modern medicine makes traveling with an health issue easier and recovery time faster will we start seeing people leave our markets and travel for their care? And when that happens, patients will not beat down your door because of your billboard on 64-W, they will come because you cultivated a real and meaningful relationship.

The Cluetrain Manifesto
can be found on Amazon, the authors has also made the entire book available online for free here.