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    Branding your practice starts from inside

    Focus, hard work, and lots of support from employees are the keys to controlling how patients perceive you

    A study released earlier this year by the market research firm Millward Brown showed that Apple Inc. is the world's most valuable brand. The value of this recognition goes beyond bragging rights; the Apple brand is estimated to be worth more than $153 billion, based on an analysis of financial data and consumer measures of brand equity, according to Millward Brown.

    What does it take to achieve this level of brand equity? Focus, hard work, and consistency.

    Of course, building and reinforcing a brand for a tangible product is less complex than building and reinforcing a brand for a service, such as providing healthcare. For primary care practices, branding is exceedingly more complex and is affected by factors as seemingly innocuous as the tone of voice of the receptionist answering the phone, the color of the office's walls and carpet, and the comfort of the chairs in the waiting room.

    Although many marketers understandably focus on how they convey their brands through communication vehicles ranging from television ads to Web sites to billboards, they may overlook the intricacies of the brand experience. Arguably the greatest impact in any service organization, but particularly in healthcare, comes through interactions that patients, their family members, and others have with your staff.

    Jeff Rechler, a branding consultant with Braithwaite Communications in Philadelphia, Pennsylvania, says, "All too often, marketers wrap up their company brand in their graphic identity—their logo, Web site, presentation materials, product packaging, etc.—and stop there." For a brand to endure, Rechler says, it must be "easily understood, internalized, and acted on by employees at all levels."

    Put another way, words must match deeds. It's not enough to tout that you're patient-oriented, says Ann Maloley, MBA, a lead consultant with Barlow/McCarthy Hospital Physician Solutions in Omaha, Nebraska. A practice that claims to be patient-oriented, but then leaves patients on hold for 2 minutes as they attempt to make an appointment isn't living up to its brand claim.


    One of the first steps in aligning employees with the practice brand is conveying to them what the brand really means, Maloley says. Most practices have an opportunity to help staff understand the brand and what it means in very concrete ways, she says. So if the practice says that extraordinary care is its key brand attribute, what does this mean in terms of a day-to-day perspective? What actions will employees exhibit to reflect this brand? How and what will they communicate?

    "The brand needs to be broken down into very real and manageable terms for practice staff," Maloley says. "To say you're patient-focused or to say you provide extraordinary care or exceptional service doesn't mean a whole lot to staff unless they can see it in what they do day to day."

    Employees can play an important role in making the brand "real" to the patients and family members they encounter every day. They have, in addition, the opportunity to play an important brand ambassador role as they interact with people in their personal lives—friends, family, neighbors, etc.

    Brand ambassadors are "employees or customers who are advocates for a company and its products or services," says Gerard Corbett, chair-elect of the Public Relations Society of America. Corbett has more than 30 years' experience leading branding and marketing efforts for Fortune 500 companies. Advocacy works both ways, he says.

    "You want employees to advocate for the practice and its services, but you also want employees to advocate for the patients. If you trust your employees and allow them to be your ambassadors, that can do a whole lot for the brand," he says.

    Chances are you understand already the brand concept and your employees' effect on it, Maloley says. You know that employees are the access point of service, answering patients' phone calls, and being the first to see patients when they come to your office.

    Knowing employees' role in branding gives you the opportunity to understand what the key access and service differentiators are for a good brand, Maloley says. "What does exceptional clinical expertise mean? What does extraordinary care mean?"


    Wanda D. Filer, MD, MBA, is a family practice physician and healthcare expert and speaker based in York, Pennsylvania. She recounts a conversation with a manager in a multisite practice who is repositioning her community group practices based on the high quality of their care to be seen as more than the provider of last resort in their communities. "Their brand has been as a safety net practice, and she knows that she needs to have her staff embrace this change internally, and accept this new brand and position in the market, as they broaden their appeal to a larger group of patients," Filer says.

    The spillover benefit of the rebranding effort, Filer adds, is that the economically disadvantaged patient receives care in a physical plant that has been refreshed, working with reenergized office staff, and is receiving care in a high-quality practice with a passion for providing quality care to all patients.

    "This is the core of the family medicine ethic, and it is a joy to see a rebranding initiative that reinvigorates the passion for solid, patient-centered medical care in an organization that also results in a stronger bottom line," she says.


    Once the desired brand identity has been established, physicians must ensure that brand is reinforced by all members of the practice. Every employee who interacts with patients has an impact. Even those employees who don't interact directly with patients interact with friends, family, and community members.

    Employees have to understand and accept the brand identity. "I think the role of the employee is critical. If they're not brought in, then they may be sending subtle messages that conflict with what you're trying to accomplish," Filer says.

    "A lot of communication happens between employees and patients in the exam room, before I go in there, so I think it's important for everyone on the team to be on board and understand what you're trying to accomplish—and why," Filer adds.


    Even the look of employees can have brand impact, notes Karen Zupko, principal of Karen Zupko Associates Inc., a practice management consulting and training firm based in Chicago, Illinois. "Would you go to a dentist whose chair-side assistant had one large front tooth missing? If you're a bariatric physician and your staff are all 80 pounds overweight, it sends a mixed message, doesn't it?"

    Attitude also comes into play, she says. If potential patients call and are greeted with someone with an annoyed tone of voice and a big sigh, it doesn't send a strong brand-reinforcing message. All of these issues need to be considered in developing a strong brand, beginning with hiring and continuing through training and establishing expectations for employees and their interactions with patients.

    Creating or reinforcing a brand identity, Rechler says, requires a balanced combination of:

    • Culture infusion, which he defines as efforts to provide tangible and visible everyday reminders of your brand promise. Tactics might range from distributing culture cards for employees to keep in their wallets for easy reference, to making culture a key aspect of new employee orientation.
    • Scheduled communications, consisting of regular internal communications to reinforce the brand. Examples might include communications from the practice's leadership to reinforce key messages, hosting practice-wide "culture days," or finding ways to recognize brand ambassadors and their stories.
    • Credibility initiatives addressing key barriers to achieving the desired brand identity. Ultimately, this involves a willingness to adjust longstanding processes and a commitment to hire and fire based on the company's values and culture.


    Training and education are important to the process of ensuring that employees can serve effectively as brand ambassadors. "The best companies that have the best brand ambassadors are companies where training is built into the culture," Corbett says. "You want to be giving employees the tools they need to do the best they can."

    Strengthening the brand through your employees doesn't have to be difficult, Filer notes, but it requires engagement and buy-in. "It can be a team effort that creates excitement. If staff members understand why, and that they are part of that process, then they know they're being dealt with more respectfully and they're more likely to come along with the vision."

    Few people, she says, want just to blindly follow instructions, the ramifications of which they don't believe in. "The last thing you want is staff who are not on board to be sending subtle messages that might sabotage your efforts," she says.

    Now is a particularly good time for medical practices to explore and strengthen their brand images, Filer says. "My suspicion is that as we see more patients stepping into private care because of the Patient Protection and Affordable Care Act, there are going to be opportunities, but there are also going to be stressors on practices."

    Thinking about the desired brand image and how it can be supported through employee interactions with patients before those new patients start to call, Filer says, can transform healthcare reform from a challenge into an opportunity.

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    Living the brand promise

    Leslie Michaelson is chairman and chief executive officer of Private Health Management, a network of medical doctors coordinated by a physician-led personal care team. He points to five areas where employees of primary care practices can affect the practice brand, either in a negative or positive fashion:

    1. Create a culture of service. Help callers avoid voice mail. "People hate voice mail," Michaelson says. Another suggestion: Schedule appointments to minimize waiting times. "Clearly one of the principal complaints of all patients is that they wait too long to see their physicians," he says. "It's really not necessary."

    2. Check in on sick patients. Michaelson calls this practice "transformational." He notes that practices can embrace current communications tools here, such as email, texting, and the use of mobile phones to access information and stay updated on a patient's progress.

    3. Provide more information on specialists to whom you refer your patients. "Most primary care physicians tend to refer the bulk of their patients to a relatively modest number of specialists," Michaelson says.He recommends that physicians prepare biographical sheets for each specialist with their photos, background information, contact information, and a map to their offices. Providing this information can reduce the anxiety patients often feel when seeing a new specialist.

    4. If you haven't already done so, convert to an electronic health record (EHR) system. An EHR creates a more streamlined patient experience.

    5. Consider evolving the practice to become a Patient-Centered Medical Home. "Be the practice that patients look to for the coordination of all of their care, he says. "Help them navigate this complex, rapidly changing maze of medicine."

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