‘Intangibility’ is only one of the particular difficulties that healthcare marketers need to conquer, and undoubtedly healthcare marketing is one of the most challenging of all the types of non profit marketing. Healthcare products are almost certainly the most intangible of the entire the services, and consumer has no actual way of being capable to measure the competence of a healthcare provider either before or after the services completed. Healthcare providers merely put their reliance in the skills of the healthcare profession and customers obtain the whole thing on faith, and customer can construct opinion about the quality of the healthcare products as well, which based on a complete series of surrogates, including their physical surrounding and besides manner of their healthcare providers.
France and Grover (1992) list a number of other factors which serve to complicate the healthcare marketing task:
Mismatch between customer expectations and actual delivery: the exacting risk for healthcare providers is, all service meets offer a huge number of opportunities to fall short of customers expectation, and all individual characteristics of customers; different demographic characteristics, different levels of physical characteristics and recuperative power, are quiet beyond the control of the healthcare provider that will make impact substantially on the outcomes, and correspondingly perception of the customers willpower depend up on the customers psychology.
The number of service providers; in healthcare setting; the diversity of opportunities exist for the encounter, for example, when a customer(patient)attending a hospital, patient have to deal with administrative staff, nurses, anaesthetists, catering staff, hospital porters, a variety of physicians, and their own surgeon.
Unpredictable demand: it is approximately not viable to predict with any measure of accuracy the demand for a healthcare service, because any new existing issues about healthcare like any new epidemic or endemic diseases make planning complex.
Derived demand: healthcare marketers face the major difficulties during the marketing of services such as when to market and whom to market.
Intrinsic intangibility is probably the most difficult for healthcare marketers, and increasingly competitive environment is constructing intangibility essential in healthcare market.
According to San Augustine et al (1992),
“organisations which learn to deal with this complexity will in the future lead the field positioning, the authors argue, is set to become like the key marketing strategy in achieving a sustainable competitive advantage in healthcare”.
Marketing constituent of the Healthcare Service
Two primary constituents of healthcare services that could be employed as the basis for a strong market positioning (San Augestine et al, 1992), first; Healthcare providers make objective or vision to position themselves as they are best in the globe among the competitors, certainly the portfolio of services could sustain the identified areas of expertise, and second; wider portfolio of existing provision is already in substantiation, because healthcare marketer can easily create a centre of attention of the customer.
Constituent of Healthcare Services
Adrian and Sargeant (2005) stated that,
“A consensus emerging from the available research to suggest that patients actually define the quality, of their healthcare provision as a function of three separate intangible factors
Since the competence of staff is particularly intangible.”
Lytle and Mokwa (1992) adapt the SERVQUAL model for use in conceptualizing the overall healthcare experience their view of the healthcare product is depicted in figure 1.
Measurement of Service Quality: Executives of services organizations have always confused regarding how to approach successful services marketing in an organized manner, because effective service marketing is a complex of many different skills and tasks. For viewing services in a structured, integrated way, there is a one approach ,a” gap model of service quality” which positions the key concepts, strategies, and decision in services marketing in a organized way that begins with customers need, and close the gap between customers expectations.(Zithaml and Bitner 2003).
Zithaml and Bitner(2003) stated that,
“There are four provider gaps, are the underlying causes behind the customer gap”:
Gap1: not knowing what customer expect
Gap2: not selecting the service design and standard.
Gap3: not delivering to service standard
Gap4: not matching performance to promises
Enhancing Service Quality: C bhattacharjee (2006) stated,
” quality in service is as perceived by the customer. There is no other way to either comprehend or administer. As service is intangible; the only way to measure the expectation of the customers before the receipt of service and measure customer perception after the experience, that is the service encounter. The gap between the two is a measure of the service quality. The larger the gap, the worse is the service quality; narrower the gap, better the service quality.”
Sargeant (2005) stated that,
” customer satisfaction can be modelled by looking at the five gaps proposed by Parasuramanet (1988).
Gap1: between consumer expectations and management perception.
Gap2: between management perception and service quality specification.
Gap3: between service quality specifications and service delivery.
Gap4: between service quality and external examinations.
Gap5: between perceived service and expected service.
Any attempt to improve customer satisfaction with healthcare hence commence with a through analysis of the nature of Gap 1″
More recently Sage (1991), identified five key aspects which may be employed to measure the quality of healthcare outcomes; access, choice, information, redress, and representation. These all factors have the capacity to influence the patient satisfaction: physicians manner, quality of information, professional and technical competence of physician, interpersonal and relational competence of physician, nature of the patients medical problems, demographic background of patient ( Sargeant, 2005).
Managing service environment: services make a distinction from the other products; goods, is in intangibility because goods have tangible description and in other words service cannot held and examine before acquiring, and customers is also the part of the production process that’s why consumer create complications to retain the stability and effectiveness. These difficulties may be overcome by managing in the service environment (Reid & Bojanic, 2010).
Healthcare Service System
Marketing can also assist in developing the quality of interactions among a variety of healthcare communities and in encouraging individuals to adopt healthier life styles, thus diminishing the use of resources. Importantly however; marketing can also assist improve the nature of healthcare relationships, and the medical profession have always been effective in attempting to cure disease; regrettably, however; many physicians and healthcare organizations left impression on patients.
UK Model of Healthcare Service
Healthcare market in the united kingdom, which can be divided generally into public healthcare; the NSH(National Health Service)which consists of hospital and community health service(HCHS)and family health service (FHS),and private healthcare; which consists of on private medical insurance(PMI),and other healthcare services; that covering complementary and Alternative medicine(CAM)and palliative and healthcare.
In the United Kingdom the Healthcare services are under increasing demands from a demographically ageing population. In addition, medicine is a technology driven market, and with new treatments and procedure that continuously expanding and stable the scope and facilities of care.
The private sector has responded to funding or budgeting or cost pressures and the drive for cost efficiency by adding value to services, which expands the extent of these services.
The most of the problem in some countries has been the manner in which the healthcare framework has developed. In the United Kingdom, for example, the National health service (NHS) has pride itself on its ability to provide high quality of healthcare service, this healthcare service is free of charge to any one who might require it, the United Kingdom healthcare service system, NHS (National Health Service) proved successfully achieving the goal of providing high quality health care service; its success has come at a price.
Interestingly, this apparent itself not only in deteriorating levels of customer service, but also in extensive variations in clinical care from one region of the country to another, and the idea that one should both serve customer requirements and monitor the performance of competitors.
Key Changes in UK Healthcare Service
For the improvement of the performance standard of healthcare service in United Kingdom, the United Kingdom government in the late 1990s and early 2000s have introduced changes for the delivery and management of healthcare services. According to Saegeant (2005) the key changes introduced are as follows:
Money now follows the patients; essentially National Health Service funds now allocated to peoples according to the size of population to one particular healthcare provider, and adjustment made according to demographic patterns and patterns of need. national healthcare service also provide the facility to GPS for referring patients for treatment to their chosen hospital, and then funding of national health service follow the patient for the hospital
Regulation of the market has been achieved through written contracts; the contract gives the detail about the nature of service, when be provided, and how many patient will be benefit, and what will be the cost; and this contract drawn between purchasers and providers.
Healthcare providers now have greater management of autonomy; healthcare providers have free access about the structure of contract; healthcare providers have freedom to structure the contract for better facilitation through an appropriate manner.
Healthcare providers are now also monitor the quality of healthcare provider; and due to this healthcare providers, thus have greater accountability; because the audit commission has given the responsibility about financial frame work and give the term value for money
United Kingdom makes a new modification in healthcare service; that is emphasis from cure to prevention. Characteristically these modifications might be involve researching demand, endorsing a range of health/wellness clinics and also catch the attention of the new patients, and also increase the general facilitation of healthier lifestyles.
Although United Kingdom facing problems about healthcare are very complex, inflexible and substantially, and there are huge participation of public and political about perfection of healthcare delivery in the United Kingdom.
Healthcare Model of USA
USA has traditionally different requirements for marketing, and different applications for marketing. In USA professional citizen are be grateful for their own healthcare insurance provided by their employers, so insurance company pay their treatment charges. Conventionally Americans had enormous alternatives regarding treatments place or healthcare providers, and in addition individuals’ doctors catch the attention of the patients by fees and quality of their reputation. Majority of Americans pay for healthcare service through healthcare insurance company, and only few Americans or poorest members of American society are looked after by the state through the Medicare and Medicaid system, and In the USA, in all branches of healthcare, the promotion campaign, and GPs freely advertise for patient attractions; because in the USA GPs relay only on service on fees (Saegeant, 2005).
Although Americans GPs openly advertise to attract the patients, but; it is interesting to note, that BRITISH GPs are have to learn new marketing communications skill for their practice and patient encouragement for healthy life styles, and also attend the health and wellness clinics.
Promotion Health Care Services
Health care promotion is the forms of social marketing, that cannot concerned with product because health care services have concern with ideas, causes or practice. Health care services are promoted by the principles of marketing that make encouragement about adaptation or rejection of particular services (Hayden, 1997).
Conquer the complications of Intangibility
Health care marketers need to conquer the difficulties of Health care marketing; major difficulty in HCS is intangibility that may be overcome by promoting their intangible products such as physicians, quality, satisfaction, service, environment, public relations.
Marketing to physicians: in today’ typical market place consumer is characteristically excellence conscious, well educated and better informed as a result of health care advertising and media also to educate the public, therefore health care marketer should emphasis on patient perceptions among the competing health care providers b using consequential quality of service (Brown, 1992).
Marketing to quality: in health care services the quality is also a major marketing issue; this because of rising numbers of complicated customers, employees and other buyers of health care services. Health care marketers have challenge to make intuition on buyers of health care services about good quality and create a centre of attention for the buyers through perception of good quality (Brown, 1992).
Marketing to satisfaction; Reid & Bojanic 2010 stated that,
“Most firms understand the consequence of customer’s satisfaction and will provide basic training to their employees. The more complicated firms actually have instruments that they use to measure customer’s satisfaction and institute bench marks for future assessment. Unfortunately many firms still pay only lip service to customer’s satisfaction and the complaints received from the customers. The following information was through the efforts of the “technical assistance Research Program” several years ago but it remaining accurate today.
The average business does not hear from 96 percent of its unhappy customers.
For every complaints received, 26 other customers have the same problem.
The average person with a problem tells 9 or 10 people and 13 percent will tell more than 20.
Customers who have their complaints resolved to their satisfaction tell an average of 5 people about the experience.
Complainers are more likely to do business with you again than non-complainers who have a problem: 54 to 70 percent if resolved and 95 percent if resolved quickly.
Thus statistics support the contention that a dissatisfied customer tells people about a bad experience more often than a satisfied customer tells people about a good experience (Reid & Bojanic, 2010) . In health care services, customer’s satisfaction is the top priority of all HC marketers and customer satisfactions occurs when organization’s services meet customer’s perception and expectations that makes good reputation and also good quality images among the competing organizations (Reid & Bojanic, 2010).
Marketing to primary healthcare: Primary healthcare practitioner; such as GPs are need to address the marketing issues, identification of market needs, promotion of healthcare clinics, information/education, enhancement of customer satisfaction, motivation of practice staff, and attraction of patients (Sargeant, 2005).
Marketing to hospital services: Marketing of hospital service quality varies from country to country, In United State of America; marketing of hospital service has been documented that marketing play a major role in patients magnetism, while conflict among hospital administrator also exists (McDevitt & Shield, 1985), however in United Kingdom the framework of hospital work quite different, because hospital earnings in United Kingdom is assured, and there is no need to view healthcare purchasers as customers (Sargeant, 2005).
Sargeant (2005) stated that,
“Hospitals now begin to face competitive pressures, particularly, the NHS (National health service) hospitals’ trust require marketing skills to do these: redefine there catchments area, define the competition, improvement of network, get close to customers, involve customers in new service development, develop employees, conduct internal promotions, incorporate these areas into institutional development, and not underestimate the impact of change”
Managing Public Relations: The term; Public relation is extensively and frequently distorted in different business sectors, and also in healthcare services. As public relations interrelates with the variety of publics; such as general public, organizational employees, consumers, suppliers, and many others and public relations go on by associations with publics, valuable public relations do not transpires by chance, they must be the basic needs of public relations; particularly in healthcare services, make obtainable precise information to publics (Reid & Bojanic, 2010).
Understanding the benefits of ‘intangibility’ in healthcare services
Considerate about the benefits of ‘intangibility’ in healthcare services can help the organizations, and also the healthcare service provider, that; how to conquer the difficulties about intangibility, and challenges about the marketing in healthcare services, that will maintain and ensuring effectiveness of services. Some healthcare organizations augment the demand of their products; continually or infrequently, perhaps within a competitive environment (Hayden, 1997).
Kotler and Clark (1987) suggest that in non-profit markets, the benefits which peoples are looking for can be classified under three headings: economics, psychological, social. However, for healthcare it would be necessary to add another category: physical benefits, which is constructive for the healthcare service provider to consider the benefits of intangibility (Hayden, 1997) when offering intangible services as opposed to the tangible products, then it is more important to communicate the benefits of ‘intangibility’ which the service delivers (Hayden, 1997).
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