Caroline Ratner of the IMTJ talks to Ilan Geva about what
branding means in medical tourism. Ilan runs Ilan Geva and Friends, a Chicago based
branding consultancy with experience of working with some of the world’s largest and best-known brands
including McDonald’s, Coca-Cola, Visa, and Ford Trucks. Ilan is now bringing his experience
in both healthcare and tourism to help countries brand their medical travel
products and present them to the American market.
How did you get in involved in medical tourism?
Throughout my career in advertising, I have worked with
multinational companies in both the healthcare and travel industries and have
worked within many different cultures. I’ve
been involved with some of the largest, healthcare, hospitality and travel
companies promoting to the US market and promoting destinations in the US.
Medical tourism obviously combines these disciplines and about four years ago I
was asked to do a viability test and research in the US for the Mexican medical
tourism market. As a result of doing
this work I started to network within the industry, going to conferences and
events and then started to speak at conferences. Since then I have created a speciality in the
branding side of medical tourism, promoting and building brands in the US
market, I am primarily involved in branding destinations and services, to
include places, cities, hospitals, and countries.
How important is branding in the Medical Tourism market?
Branding is very important in medical tourism but everyone
has a different definition of the term branding. I see what they do right and
what they do wrong. When you are branding and marketing there are many strands
of the marketing mix that need to be considered when trying to penetrate the
American market.
What do people need to consider when reaching out to the US market and
what are they doing wrong?
Many think branding is just putting together a nice brochure
and going to a conference and having a booth, but that is not enough. When I
talk about branding I talk about the whole brand touch points of medical
tourism. These touch points have many important elements including, online
presence, advertising, marketing, PR, reputation and more which all combine to effectively
and successfully reach the target market.
I’ve noticed that many of the people who come here to sell
their services to the US do not have a clue about what the brand touch points
are. For example, they are spending a
lot of money on building hospitals and buying expensive equipment for the
hospitals and they market these as big selling points but those are not
necessarily the factors that will make people go to that destination. They are
also very proud when they talk about having JCI accreditation and use this as
big selling point but they don’t understand what JCI accreditation means to the
patient and how relevant it is to them when making up their minds in the
pre-purchase process. Medical tourism companies need to do more research into
what is important and relevant to patients when they are choosing a
destination.
What should companies consider when branding their medical tourism
product?
It is important to remember that every purchase in the world
has three steps and this applies as much to Medical Tourism as anything else.
These three stages are the pre-purchase, the purchase and the post purchase.
The pre-purchase includes everything from how your website
looks, how easy it is to find information, how much information is available,
how relevant that information is to the potential patient and how transparent
it is. Then another extremely important
element of the pre-purchase process is word of mouth, what are friends and
family saying about a destination and their experiences as patient and as a regular
tourist.
The problem is that currently there are far too many countries,
doctors, hospitals and clinics that don’t incorporate these essential elements
in their pre-purchase branding. Oftentimes the business model is far too
simplistic and reliant on basic websites and facilitators to get patients. The
US market is very sophisticated and patients have certain expectations about
the availability of information and the extent of the information they need before
making a decision. As a result there are
many vital marketing tools that are not being utilised properly, or at all, in
trying to attract patients at the pre-purchase stage.
It’s the same again with the purchasing process, this process
can be a very long one because the minute you sign the patient agreement with
the facilitator or directly with the vendor you are in the purchasing process. Again,
doctors, hospitals, facilitators etc are not giving enough attention to the
detail in how they brand this part of the process or what is important to the
patient at this stage. There are so many
factors involved at this stage that are not being properly communicated to the
patient and often these vital touch points are overlooked yet they are often
significant factors in helping potential patients make purchasing decisions. These include; the type of treatment, how
long the patient needs to stay in the hospital and then how much recuperation
time they need before they return home, where are they going to stay when
they’ve been discharged, what kind of accommodation is available to their
travelling companions, do they speak English, what’s the food like? etc.
What is the most problematic part of the whole purchasing process?
The most problematic area is the post purchase practice
because this is really the Wild West of the medical tourism world, and is open
to a variety of different interpretations which mean different things to
different cultures and companies. As long as the post-purchase process is not
regulated it will hurt the perception Americans have of a country and its brands
because they don’t understand culturally what the American patient needs and expects
post-purchase.
Currently there seems to be a wide variation and understanding
about who is responsible for the patient when they have been discharged both
abroad and once they return to the US. As a result there are thus far no standardised
procedures, no norms, and it seems that no one in the industry can agree on
what the norm should be. A lot of this is down to cultural differences and while
some will follow a defined procedure of what happens to patients post-purchase others
won’t. Only one third of facilitators have some kind of a warranty in place
which means that the legal issue is wide open. This is an area that really
needs regulating because post-purchasing issues can be very damaging to a brand
even when there may be good pre-purchasing and purchasing tools in place.
So how do you work with clients?
I have a whole process which involves study, research,
evaluation, observation and training.
I start by doing a brand audit, and I start by spending 4 –
7 days in the hospital or the clinic so that I can observe everything from the
patients’ and the staffs’ perspective. The
most important thing to understand is that I am very adamant that when I am
observing a hospital that I start with the CEO and not the head of the
marketing department. I need to get to know the hospital from top to bottom.
When I first start working with a hospital I want to be
treated not as a visitor but as a patient from the US, I try and sleep in the
hospital or if they have a hotel for relatives I want to be stay there too and
also I need to get to know how the hospital is run as well as I possibly can. I
go through a process and get to know the staff and insist I have the freedom to
approach nurses and talk to everyone that works in the hospital and talk to
vendors and suppliers too, so that I can get a feeling of what’s working and
what’s not working. I then write a report about what I’ve seen and heard and how
I feel about everything I’ve experienced. Then I go back and spend time on
location, getting involved with patients from the pre-purchase stage through to
their post purchase experience, then we make recommendations and the training
starts in the hospital.
What are the biggest stumbling blocks and blind spots companies have
when branding to the US market?
I think lack of cultural understanding of what is important
to the US patient and also what the requirements there are of the different
cultural sub-groups within the US population. For example a patient with a
Polish background will likely understand what to expect culturally if they go
to Poland for treatment, whereas for example an African-American or a patient
from an area in the US where there are no visible ethnic communities and who
has no experience of Poland or Polish ex-pat community will have completely
different expectations of what it will be like to be a patient in Poland,
including everything from language, food, hospital procedures etc. This is a very important factor which needs
to be taken into consideration when targeting different markets and
communicating this to patients is a vital part of the branding process which is
often not considered. How would a guy from Texas feel if you throw him into a
hospital in Turkey and he feels isolated culturally and emotionally and there
isn’t anyone there who can connect with him and understand him? We’re not
talking about just fixing you as if you are a car in a garage, patients have
different needs that need to be heard and catered to because there is a lot of
emotional attachment to travelling abroad for medical treatment. Countries are
going to have work hard to make Americans from non-ethnic backgrounds feel
comfortable and welcome.
How’s India’s branding in the US?
India is perceived as a good place to go because of price. I’ve
sat in conferences and heard people from India talk with great pride about how
they almost have a production line of heart surgery, but what they don’t know
or understand is how the average American patient will feel if he knows he’s
going to be number 53 to go on the table for surgery that day. This just doesn’t
match the American psyche or the personality of the average US patient because Americans
want to feel special, that’s how Americans are sold to in America, and they
expect to be treated as special individuals - think of the L’Oreal “you’re worth
it” strap line. Obviously for Indian-Americans there is no problem because for
them it’s like going home and they understand where.
What other issues are there with selling medical travel to Americans?
There is the issue of distance, if you tell someone that the
best doctor in the world is in New Zealand but it will take you 20 hours to get
there but there’s a less famous but excellent doctor in Portugal and they are
only 6 hours from New York the patient is more likely to go to Portugal. That’s
why Mexico has great potential because it’s round the corner. Other places that
are close are serious contenders even if the medical reputation is not the
highest, like other Central and South American countries.
Another point is trust.
Who do you trust most in medical tourism? “60 Minutes” broadcast a programme
about a year ago that had a report on some clinics in Mexico that were
blatantly fraudulent. This programme did
a lot of damage to the whole medical tourism business and I think it was aired
it at least twice. When potential
patients see this they think “I’m not going anywhere, I trust my doctor here”. So
there’s a challenge for medical tourism companies because the current medical
tourism business model is based on directly recruiting patients through the web
and facilitators, but in the US we’ve learned again and again that people trust
the opinion of their family doctors more than anything else when it comes to
making medical decisions. So, for example, if someone is diagnosed with cancer
they will go to their family doctor for a referral and recommendation to a
specialist because people trust them.
The issue here then, vis a vis medical tourism is that currently our
doctors do not recommend their patients go overseas for treatment but this also
means that there is great potential for doctors to develop referral system for
sending patients overseas and this would involve a different type of branding
strategy from the one being used to attract patients directly.
Are countries beginning to market directly to US doctors?
Not yet. It’s being discussed among doctors, some
discussions on LinkedIn, but I have not yet seen a very determined and committed
process, it’s up to those in the business to push this branding angle.
Will US medical insurers start sending people overseas?
Insurance companies are realising medical tourism is cost
effective but there are currently the post-purchase problems and potential
legal issues that need to be sorted out.
There are some insurance companies specialising in this and I think they
realise what the potential is, and their business model is very smart.
Do countries need to do to promote their brand as a country or should
they continue to promote themselves as separate entities in the US?
I’m seeing this issue with how Israel, for example, promotes
itself in the US. Their problem is that they are divided as a country in terms
of marketing themselves to audiences in the US and therefore they are not very
well known in the US. This works very
well for them in the former Soviet Union nations where they are very successful
and this is where most of their overseas patients come from but doesn’t work in
the US marketplace. Israel as a whole
receives about 30,000 international patients a year, Jordan which borders
Israel receives 250,000. In the US, Israel has no branding as medical tourism
destination whatsoever yet they come to conferences and compete with each other
instead of working together, no one
pushes Israel as a destination and this is not working for them in the US. Similarly with Turkey, which has the largest
number of JCI accredited hospitals in the world, yet Turkish influence is
minimal and Americans just don’t know about them because they are not being
branded properly. I think we will see
more and more investments in infrastructure, hospitals, equipment etc but if
they are not being branded and positioned properly then no one will know about
them and the businesses will fail.
So, what would you main message be?
Do your homework. When people put business plans together
they have everything down to the last detail when it comes to mass forecasts
etc but they don’t pay attention to the most important thing and that is “what is your vision, what is your position in
the market, what brand are you building”. Those are the most neglected areas
yet without this the business cannot succeed. It’s not a big a deal to build a
fantastic building with amazing facilities and get the best doctors in the
world to work there, but so what, if you don’t do your homework and if you
don’t make the commitment to positioning your business or have a real vision
and be different from the others then all you’ve got is a building with no
patients.
What countries do you think will succeed in the US market?
Mexico has great potential because of geographic proximity
to the US but they have to sort out their issues in terms of reputation and
safety, because this is so extremely important to Americans. Other Latin
American countries have great potential, also because of proximity and of
course because the biggest ethnic group in the US is Hispanic and it’s easy for
them to go “home” for treatment. European countries are second because the
European standards are considered to be closest to American standards and in
some cases they exceed it. In Eastern
Europe some countries are providing good serves but their strengths may emerge
in the wellness sector and not necessarily in very advanced medical
procedures.
Ilan Geva runs, Ilan
Geva and Friends, a Chicago based branding consultancy. Geva has many years experience in advertising
and branding working with some of the world’s largest and best-known brands including McDonald’s, Coca-Cola,
Visa, Ford Trucks, The Chicago Tribune, SA Breweries, Panasonic, Nestle,
American Express, Unilever, V. He has
worked in healthcare, travel and hospitality brands in the US and abroad
including many US hospitals and healthcare companies, the Mexico Tourism Board, Lisbon Convention Bureau, Turismo de Lisboa, British Tourism Authority, Israel Ministry of
Tourism, Illinois Department of Tourism, State of Iowa Tourism
Division, Satour, South African Tourism, Turkish Tourism.
