Truth #4: If you want to know what will work in healthcare marketing, don’t ask your customers
The Truths We Hold Self-Evident: Fourth in a Series
A few years back, we worked with a large dental practice that wanted to stand out in the market. In the initial meeting, we discovered management believed their best bet was to promote the expertise of their dentists, a decision based primarily on the results of an annual survey that showed respondents ranked “skill of my dentist” number one from a list of values they thought important when choosing dental care.
Think about that for a minute. Now imagine you’re buying a car, and someone asks you to rate the following values based on which are most important to your purchasing decision:
- style
- gas mileage
- reliability
- engine size
- that it won’t catch fire when driving in temperatures above 75 degrees
Given that list, which answer do you think would come out on top? Wouldn’t you select “e,” because after all, do the others really matter if your car threatens to spontaneously combust when driving in warmer climes?
Yet that same logic applies to the survey question on how customers choose a dentist. We don’t know anyone (normal) that thinks, “You know, I like it when my gums bleed, or my dentist wields a drill like a jackhammer.” So we think it’s pretty safe to say “skill of a dentist” is a given when looking for dental care. But that doesn’t mean a dental practice should base its market differentiation on that value. Imagine a car company centering its marketing on the tagline: “The Wren – the car that doesn’t catch fire, even in the summer.”
How Customers Think
On one level, this story illustrates a bad survey technique, but more to the point, it supports our contention that when it comes to healthcare marketing, organizations need to stop asking their customers what they think.
To many of you, this will sound sacrilegious. Experts implore: “Listen to your customer, the customer is always right, be customer-driven.” But listening to consumers and asking consumers what they think can deliver two very different insights. Turns out it’s how you listen that matters. The key is to not listen to what consumers say, because research shows what consumers say and what they do has little or no correlation.
Perhaps one of the best resources on this topic is “How Customers Think: Essential Insights into the Mind of the Market,” by Harvard Business School professor Gerald Zaltman. Zaltman uses research to show that 90% of what influences a consumer’s decisions and preferences lies in the unconscious mind. Because surveys and focus groups only tap the conscious mind, accurate insights into the true preferences of consumers are missed. In fact, consumers are not aware of the hundreds or thousands of factors that influence their decisions and preferences, so simply asking for that information will result in predictable answers (i.e., “I value the skill of my dentist”), but not necessarily the answers that reflect future, or even past, behavior. (Zaltman proposed a deeper “metaphor-based” interview approach to tap into that unconscious thinking.)
In essence, consumers don’t really understand why they make most decisions, so asking this question can be fruitless, or worse, misleading. Other books that support the contention that companies gain little from asking customers how they think or act include:
Buyology – Martin Lindstrom
Selling the Invisible – Harry Beckwith
Predictably Irrational – Dan Ariely
The same ol’ same ol’
Yet despite the evidence that asking consumers what they think or want is misguided, hospitals and health systems still do it, and they do it a lot. They ask what consumers think of their advertising, which heart center they would prefer, and how many beds a new hospital should have. And they use the answers to guide their marketing strategies.
Why does this still occur? For some, it’s an opportunity to show they “listen” to their community. (Surveys and focus groups can actually serve this purpose, but just not in gaining a better understanding of what works in the market). The lack of popular alternatives is another reason – “How else will we know?” (more on that later). But the two most popular reasons are a), because that’s what they’ve always done, and b) “CYA.” Many executives feel that if surveys or focus groups aren’t conducted, the sole responsibility for a marketing program’s failure will assuredly be laid at their feet.
Redefining how to “listen”
So how does an organization truly gain understanding of its customers, what they like or how they act? Again, you can listen to your customers, as long as you listen to their behavior, not their words. (One exception is the metaphor-based interview technique outlined by Zaltman). Some examples of how to gauge behavior include:
Observe
The practice of ethnography – the social science of observing people in their natural environments – is a powerful tool used by leading organizations like Proctor & Gamble to understand how consumers actually behave in given situations. Observations often provide far more insight into potential problems and possible opportunities than traditional research can.
Prototype
Whenever possible, create a prototype and let your customers actually test the experience, instead of simply asking them how they would respond to it. This could be done with a prototype patient room in a new facility, or a new web-based tool. Combined with observation, you’ll learn a lot about how customers might actually respond to your offering in the real world.
Test and Adjust
For some marketing activities – advertising or PR, for example – it’s nearly impossible to gauge how people will react from what they tell you. They don’t even know how advertising impacts them, so how can they help? Whenever possible, test marketing efforts to see how responses vary. Use different creative approaches in different, separated markets to see if one or more drives different behavior, such as attendance at a joint-pain seminar. Or, how changing the hours in a clinic might vary utilization in one community when compared with other office hours in a similar community.
All of the above techniques can work in certain circumstances, but the silver bullet of absolute certainty about what works and what doesn’t with your marketing efforts is elusive and may never be found. There are interesting explorations into the consumer mind using fMRI technology (see previous blog post), but even those just answer what a consumer may be thinking, not the more important question of why. In the end, you need to trust yourself, your team and your partners — those who have dedicated their careers to understanding marketing and consumer behavior — to provide the best guesses when the unknown prevails.
After all, some of this is straight common sense. Running a consumer survey that asks “which is more valuable when choosing your care, your doctor’s recommendation or a hospital’s advertising?” will provide results that should surprise – or enlighten – no one.
The Truths We Hold Self-Evident
As immutable as the laws that rule nature (the sky is blue, the earth is round), are a set of guiding principles we at Interval refer to as the “Truths We Hold Self-Evident.” These “truths” influence pretty much everything we do. Our thinking. Our approaches to marketing and client challenges. Our recommendations for and execution of marketing strategies and tactics for our clients. This belief system springs directly from our experience marketing and branding hospital and healthcare systems exclusively over the past six years. We accept and believe these truths passionately, as do our clients. But every once in a while we encounter those that, for whatever reason, do not. Some are marketers stuck in the traditional approaches of the past. Others, skeptics looking for proof. Throughout the year, we are presenting a series of articles articulating these Truths, their implications, and why we consider them self-evident. That said, there is plenty of room for debate and controversy. Consider this a standing invitation to join what we hope is a lively and illuminating conversation. At the very least, theses articles will clarify our biases while helping you better understand the issues and broaden your perspective on them.
Chris,
Great post. Keep them coming.
Reminds of a Silicon Valley corollary where youthful entrepreneurial start-up leaders are asked “why don’t you ask the customers what they want?” Same lesson – words usually matter less than customer behavior and data when evaluating or developing a new product or service. If start-ups only listened to the words of customers for existing products/services, they’d never actively consider launching new products or services.
Stated more directly: Does anyone think that customer surveys inspired the creation and launch of YouTube, Facebook or Twitter?
There are also ever increasing amounts of healthcare-related social media data available for review that don’t require a survey. E.g., there are hundreds of tweets posted each day by patients and families about hospital food, parking, television and wi-fi services. Some mention the provider by name. Some are positive. Some are negative. And it isn’t hard to figure out the geographic location of the party posting the tweet. (Sadly, I can count on one hand the number of times I’ve seen a hospital that was mentioned in a complimentary tweet respond.)
The social media stream provides an excellent opportunity for healthcare marketers to engage in real-time behavior, opinion and trend data gathering. So,”how else will we know?” Just listen and join the real-time social media conversations that are already underway.