With some push from the other side, too: if in the 1990s advertising agencies were dazzled by companies making public issues, today their media and social network wings are focusing more than ever before on healthcare. Virtually all leading advertising agencies are said to have separate divisions that cater to pharmaceutical companies or hospitals. Small boutique agencies have also sprung up to do these special jobs.

And so you see hospitals announcing themselves right at the airport, on road medians, or on signage that carries a public-interest message.

According to Brand-comm's Padaki, in the last three-five years, cities across the board have seen a proliferation of hospitals. As hospitals are location-based, each chain prefers to announce itself by location and brand.

It is not that hospitals are waking up now, but surely they are spending a lot more now than before. That includes direct marketing tools such as leaflets, hand-outs, posters and direct mailers and CDs with patient-friendly publicity materials. They also have outfits to manage their Web sites and social media, from within the organisation or outside.

“Doctors,” says Padaki, “are talking-walking billboards and, probably, a hospital's best brand ambassadors. When they speak or write, it speaks for that brand.” There are other subtle ways to promote medical services. He says, “The Web is another visiting card these days and big spends are invested on sprucing up the Web and maintaining it from within the organisation or externally. Many players today exploit social media such as Facebook or YouTube. Websites, symposia, doctors' conclaves, and round tables are powerful media; then there are speaking opportunities for the doctor. They are also tapping community-related activities such as eye checks and blood donation camps. Ayurveda hospitals are also not immune to this trend.”

For Manipal, the 50-year-old hospital major, “The year 2005 was a turning point when we corporatised 11 hospitals. The consolidation and corporatisation that is taking place in the healthcare industry has an impact,” says Rajen Padukone, banker-turned-CEO of the Rs 500-crore healthcare chain.

“We have institutionalised healthcare and are building that brand, rather than individual doctors. Yes, all of us are focusing on building a brand for the network through events, facilities and services.”

Post-2005, Manipal raised its promotional spend to Rs 3-5 crore a year as against Rs 50 lakh earlier. The reason: it needs to talk about new services such as robotics. “By 2014-15, this will be a corporation with 4,000 beds (from 1,600 today) and will have moved into Orissa, Andhra Pradesh and Tamil Nadu.” Over the next three years, Manipal Healthcare will also unleash a new brand exercise called ‘Life's on'. Padukone flashes the new red-and-blue logo that will be the new credo. The commercials should follow early next year.

Advertising is mainly to build the Manipal brand, Padukone says. Many large specialised hospitals are expanding their networks, globalising, entering new places where they were unknown; there is a need to generate trust and build a name. “They are also moving towards higher levels of standardisation. The approach to hospitals also is changing. Earlier you went to a doctor; today you go to a hospital because it stands for something, it is a brand, like any other product or service.”

Simanta Sharma, who is spearheading Manipal's brand makeover, says there is stiff competition in the healthcare industry. Private equity funds which have invested a lot in the healthcare sector often drive the game today. “Word-of-mouth takes long; so you opt for means such as direct marketing or outdoor ads. You also build your ad around events related to awareness about cancer, heartcare or diabetes. In the end it boils down to quality of service.”

Sharma says the re-branding underlines the ethical practices and patient-centricity of the group. Borrowing a hospitality industry term, patients are called guests.

When you talk about advertising, don't forget to count articles and advertorials in newspapers and magazines; or the recent healthcare excellence awards that were given by a media major, said one of the people consulted for this report. “There are any number of surrogate advertising forms that hospitals use.”

Awareness campaign

Last week HCG (HealthCare Global Enterprises,) the Bangalore-based chain of cancer hospitals, wrapped up ‘Pink hope,' an awareness campaign on breast cancer.

Dr B.S. Ajaikumar, HCG's Founder and Chairman, believes hospitals such as theirs need to advertise or promote themselves to give out the right health message. HCG has a five-member marketing and creative team. “Yes, there is an increasing trend of advertising (by healthcare players). We at HCG spend around three per cent of our turnover on promotional and marketing activities and ‘soft' advertising. There are some who go up to 7-10 per cent of their top lines.”

Says Dr Ajaikumar, “Cancer is a special area that not all doctors or oncologists fully understand. I feel the need to talk about the Cyberknife facility (to treat tumours) because there is so much misinformation going around about cancer. In 80 per cent of breast cancer or other cases, the cancerous lump is removed. We believe in preserving the organ and want people to take a second opinion before taking out the organ.”

Asked if hospitals are pressurised by the ‘return on investment' demands of PE funds which have invested hundreds of crores in the booming Indian healthcare industry in recent years, “not in our case,” he quips. The patient has to know it all. So long as the advertisement is ethical, makes no untruthful claims, or the referring doctor is not part of a kickback scheme, it should, he reasons.

Preventive healthcare

According to PwC's Dr Mehta, often, hospital advertisements are not alarmist but mirror India's disease predispositions, such as diabetes, heart problems and cancer. If they are detected in time, lives can be saved. “We do not do so much of preventive healthcare here. Hospitals getting more footfalls is one thing as long as unnecessary procedures and tests are not done.”

Global Hospitals, the Hyderabad-based four-city group, as it spreads out to Mumbai, Kolkata, Delhi and Bhubaneswar, has a 70-strong marketing team of doctors and academicians; including a 10-member media and communications team in each facility. It's all because of the increasing demand for tertiary care, says Chandra Sekhar, its Executive Director - Marketing & Strategy.

“I agree the trend (of increasing promotions by hospitals) is visible in print, television and outdoor. People are demanding tertiary care today; they are seeking solutions for morbid obesity, or other lifestyle-related problems. That has been the trigger for healthcare players to ramp up their own mechanisms beyond traditional media in the last few years. Hospitals give out messages that raise public awareness about preventive health — which are all allowed.

“It is not that we are soliciting. Global started in 1998. Admittedly, advertising by hospitals has doubled in the last five years from almost negligible promotions earlier.”

Over the next five years, Chandra Sekhar says, Global will set aside 3-4 per cent of its revenue for promotional activities, up from the present two per cent. “We need to announce ourselves and our facilities in new places. This will be within the MCI code of conduct, which is necessary,” he explains.

If healthcare is taking a leaf out of FMCG or hotel industry strategy books, it is no wonder. As someone said, “Today, except for one or two days around surgery, it's mostly a five-star hotel stay that patients expect. They also want to be treated well.”

As hospital groups from the northern Fortis to the southern Narayana Hospitals invest to pan out and draw global patients, and as single-speciality or novel models such as Vasan Eye Care, Nova Medical or boutique child birth hospitals are explored, Dr Mehta and Padaki have no doubt the decibel levels will get higher.

Just how healthy an India will all that make?

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