Patients as Customers: Medical Practice Management (Part 1)

How did you start your career in healthcare? What drove you to support the private healthcare sector in the way you do?

I came originally out of the pharmaceutical industry, working on ethical drugs with Beecham, one of the big pharma companies. I spent quite a while there in the marketing and management of ethical drugs, and then I moved into the UK private healthcare sector in the boom time of the late ‘80s to early ‘90s. I worked for AMI Healthcare (which became BMI Healthcare, the biggest private hospital company in the sector). When I got involved in the web business, I saw an opportunity; there just wasn’t enough information online regarding private healthcare and how to access and use it.

Having looked at all the material you’ve produced over the years, there’s a vast wealth of information for patients who are looking to access private GPs and other healthcare practitioners in the private sector. In your experience, what are the most common problems these patients face when they are actually trying to understand private medicine and access a doctor in the first place?

The problem that patients face is: “How do I actually go about it?” The issue with healthcare is that you don’t often buy healthcare. It’s not like today’s consumer where we’re familiar with buying stuff online. When you’re buying private healthcare, no one really knows quite how it works. Whether it’s people who have health insurance or those who are self-paying, do people know whether they can go directly to their consultant? They wonder whether they have to go to their NHS GP first and where they should start. For most people, and even if, like me, they’ve been through the private healthcare system a few times, it’s a real challenge… what you need to know to really understand how it works.

When people access private healthcare, they’ve got a healthcare issue. You want it to go as smoothly as possible, but it’s not so straightforward. The private healthcare sector doesn’t make it very easy in my honest opinion.

Is there specific you think private GPs, practice managers and all the other people involved can change about medical practice management to increase awareness and engagement with potentially new patients and keep hold of these patients?

They’re not very sophisticated in terms of marketing, and it’s true, across the board, even when you take it up to the level of a private hospital. They’re not great at marketing. It’s very much a process-driven industry rather than a customer-driven one. It’s focused on getting stuff done: “You’ve got a problem, we’ll treat it and fix you”. For me, this is where they miss out.

So, if they do manage to get a patient, their medical practice management approach doesn’t include anything effective to retain the patient?

No, they don’t. Something we’re always banging on to our customers about is that the private healthcare experience just comes to an abrupt end, in many cases. It usually stops at the end of your treatment or when you’re discharged from the hospital. You’ll very rarely get any further contact from the practice, hospital or consultant who treated you. If you have a major operation, you will get a follow-up appointment, but in terms of a so-called “marketing” follow-up, you’re unlikely to get anything.

If you make a major investment in a car, I can guarantee you’ll be part of the car retailer’s database for the next 5 years. At some stage in the next 3 years, you’re going to replace your car. Likewise, if someone has a hip replacement, they’re going to need a second at some stage. No one really sees this as repeat custom.

Perhaps it’s because the majority of UK physicians are trained by the NHS, which is very process-driven. Do you think this has a bearing on why people in private medical practice management aren’t very good at marketing?

Most consultants are just not business people; it’s true of most private practices. There are some exceptions, but most see it as the business comes in through the door and goes back out through the door. They don’t put much thought into future business and the development of a customer relationship.

It seems like there’s a lot private doctors could be doing about their medical practice management but are not. At Medesk, we say “This is what you can do if you want, and this is how to do it”. This is our goal.

In general, private healthcare caters to all kinds of patients, but would you say there is an average patient? Is there a typical patient who tends to actively seek information on private practices?

However, it’s a mixed bag and it depends on what they want.

There’s more and more self-payers and the web plays a massive part in their pre-purchase research. In terms of seeking information, I think you’ve also got a bit of a challenge in that there’s been this big drive to create the “informed patient”. There’s a drive to expose a lot of the information in the private sector on activity, outcomes, and so on. The question you have to ask is:

If someone’s got one outcome statistic and another consultant has another, what does it mean? There’s a classic issue regarding outcome data. When I used to run a private heart hospital in London years ago, the best cardiac surgeon had the worst outcome data because he was willing to take the most difficult cases.

You clearly promote medical tourism in the UK and you’ve done a huge amount of work to promote the benefits of our healthcare system in the private sector. Is medical tourism important to the average clinic and if so, how do they incorporate this into their medical practice management?

I think it’s significant in London, but it depends on the consultant and the specialty. Around 25% of private hospital income in London comes from international patients. These are the private hospitals like the big HCA and NHS private units. The difficulty at the moment is the severe pressure the international business is under.

The markets which have always delivered international revenue into London are from the Gulf and other Arabic-speaking markets. The situation there has changed over the last 2-3 years, and there’s a lot of competition from other markets. London has lost a great deal of business. The numbers coming from the Gulf have declined significantly, and HCA’s international business has suffered as a result. This will be reflected across private practice.

London has been very good in the past at marketing doctors and specialists, in particular at marketing individuals by getting them out into other countries and getting them working with surgeons and physicians in these places.

Read the second part.