Trade off Analysis for decision makers

Philip Kotler says, Trade-off analysis explores the cost of relaxing one goal in order to achieve another goal. Explaining the diagram he says when you are making decision you have to take care about all three (from diagram) points in the mind. One can’t make product or service by satisfying all three points. It is equally applicable for healthcare. You cannot give best quality care with lowering the cost and also giving total solution to your patient. Other example, if you are looking for best quality product then it will not come in low cost, or vice-verse. Similarly, if you are looking for total solution kind of product then and also in low cost then you have to compromise with the quality. Like china made product, we all knows, they produce cheap, and low cost product but in the term of quality you can’t say any things. Look at high end BMW cars they know for their best cars with good quality but you can`t get this car with very low cost.

You have to compromise at any point out of three to achieve other goal.

Mind your Head

I am not going to talk about mind here. I am going to give you a very simple tip on How to build a good relationship while listening to someone; it may your customer, patient or anyone.  Body language plays an important part in communication or building a relationship, although it is a non-verbal communication but it speaks a lot. 

How your head play an important role in communication?

Just tilting your head slightly when you are listening to your customer, patient, or anyone communicates that you are giving them your undivided attention. Tilting your head very slightly to one side comes across as friendly and ope.

Yes, you can try it.

Are you a Velcro Organization?

We all know hierarchical organization then concept came of Flat Organization which is less hierarchy, faster reaction, less formalities. Now a new kind of organizational structure is coming up that is “Velcro Organization” This term was coined by management guru Late Mr. C.K Prahalad. As we know the Velcro which is being used in many house hold product “easy to detach and easy to attach” this new Organization structure we can say vacillate from Hierarchical based to Flexible based structure of organization. The Velcro organization asks manager to shift their roles depending on the tasks they performing.

A “Velcro” organization provides a firm, clear connection for managers to work with when appropriate, but permit rapid shift in configuration so that manager can exploit different connections when those are needed. Like Velcro fasteners, the relationship should be tight when managers are in operation modes, but be capable of being loosened quickly for reassembly, when managers have to work in temporary groups on project, studies, or task like new business development with strategic horizons.  Ego probably comes when in a way of changing or shifting role. “Ad-hoc” management is always required in Velcro type organization.

In healthcare or hospital many time situation comes when one has to do lots of other role or work in multiple project or work in different department in association with different people. For example in case of patient transition from ICU to other department head nurse has to work with other department nurses. Other example when manager of the hospital work with marketing department or other department in formulating the strategies for upcoming services or project at that time one manager roles shift from their core responsibility to work with other department and again return to their own responsibility.

  

4 A’s approach in Healthcare Marketing

When hospital and healthcare thing about the new marketing strategies for their services, they must do it step wise process. Marketing executive must include Doctors when they formulate marketing strategies. How doctor play important part in marketing strategies? For example if your hospital want to do to marketing campaign for newly started heart centre, then doctor can easily tell you what would be your target segment. Doctor can tell you which age groups are mostly getting most heart problem so marketing person can define their market segment.  Then marketing person must rely on state health data, this data also helps you to formulate target positioning. Health Data can tell you the current health status of your area, like what kind of disease is prevailing in your area, what age group is mostly getting affected by disease so you can easily target your marketing campaign to that area so you will get maximum response.   

Combining the above concept you can now determine the 4 A’s approach.

Awareness: 

Your community must have full awareness about what is your hospital offering with this new marketing campaign. Hospital should use good source of media to reach target group or community. It can be any things like TV, radio, social media and road show etc.

Acceptable: 

 What you are offering in new services must be acceptable to your target people. Costing should be done in strategic manner so it can be accepted by the community or target audience. If possible hospital can give customize kind of services, like in case of dental services all person don’t need all dental procedure so you can customize it according to demand. Some services are only for high income group but not for low income group so your offering should be in such a way that all income groups can utilize it effectively.

Available:

What you are offering to target group must be acceptable and available at right time and right place. For example to if you are targeting in far flung area then you can tie-ups with the local clinic and physician for OPD facility for short period of time or for fix day visit for regular.

Affordable: 

Last approach is Affordable it tell that what you are offering must be acceptable, available and affordable to target group.  So, you target people can afford your service in case of out of pocket also. For example: some service in hospital can only be affordable by high income group but not to low income group.

How commission based patient referral system tarnish the name of Hospitals in the community?

In India Commission or cut based patient referral system s very common.  Indian hospital generally depend on this commission based doctors or physician.  

How this commission based system works in India?

In India it is not necessary that hospital has marketing department but they always have 4-5 employee fully working as a marketing department. Most important job is to go area to area, place to place or even in rural area just to find and meet doctors and negotiate the commission if they would like to send the patients to their hospital.Doctor without verifying all available facilities, they just think about their commission which they will get after referral they send their trusted patient to hospitals which they have per-negotiated the commission.  

  

Now see how non-medical professional get commission – Bareilly, (India, UP) a small and having very high population density. Once Bareilly was knows as Doctor Capital of Asia, due having large number of doctors lives here. You go there you can see name plate outside almost every home start with Dr. Let me tell you geographic location of this city this is near to Nepal, and also most of the hill area of north India. Due to large number of doctor’s presence and competition is also very high, so to get patient these doctors do very unethical marketing. They used to give commission to all those people who refer patient to their clinic and hospitals. It doesn’t matter whether you know patient or not just get the patient in hospital and collect the commission from front desk. I was amazed to see when the bus conductor was insisting one patient to visit hospital. After little verification I came to know that not only bus drive, conductor, even small shop owner, auto driver all are in same business of referring patients to their known hospitals and clinic. 

Worse situation 

Future verification I came to know more bad information about the referral systems. Hospitals, doctors and clinic here go one step ahead to get patient by taking away patients from other facility to their hospitals. It works like, if you are from rural area, and knows nothing about the hospitals in Bareilly, you stop to one hospital gate to visit doctors in the same time outsider person not from hospital come to you and tell bad things about hospital and take you away to their hospitals. Outsider used to visit in the OPD of other hospitals only to convince patient and take away patient to other hospitals. 

How this non ethical commission based referral system tarnish the name of hospitals? 

Not only in rural area, but also in city doctor do not think about the patent care but they want patient to come again and again to them. By this approach if patient is internally ill and it is not recognized by general physician and patient condition become more critical and when doctor thinks patient is out of their control they refer this patient to those hospitals where they get higher commission.  No this critically ill patient reached to hospitals and hospitals verifies that patient condition is very ill and even they can cure the patient. At the end patient die and patient think that is hospital responsibility. 

The most important things here is to think about due to above unethical referral system hospital some time get very critical patient or if patient die then Hospital mortality rate increases and hospital record get affected.

Evidence based Hospital design

In near future you will not see curtains in between two patients, patient will not get affected by noise. Evidence based hospital design is on rise. Many researches proved that patient in single room get cure faster that in semiprivate rooms or share room facility. No patient wants to see other patient crying in pain. So, now single rooms for all patients going to be fashion in hospital design. Just imagine the situation, you are taking your patient to bathroom and you find that other patient is crying sue to pain. How do you feel? When you feel very bad about this then how a patient going to feel about it, patient self motivation will decrease due to watching this situation. Also, in sharing type of hospital bed facility patient is not getting proper sleep but to cure fast patient needs good sleep. Single room prevents many noises from neighbor patient like noise of TV and patient visitors. Other benefit of single room bed is like patient need not to more for bathroom, a separate bathroom also prevents infection.   A research shows that Natural light is very necessary for patient, which is generally not possible in shared room facility.

At the time of emergency situation get more whores when one patient get serious and doctor give treatment and nurse running around, other patient scared of watching this.

Single room facility also improve hygienic in patient area, if wash basin will be provided outside the patient room then family member or relative will only enter inside the patient room by washing hand so infection can also be controlled by this.

It will take time but soon or later it will be on demand as patient are now conscious about personal health.