Health Care Communications
Untitled Document
Market Share Is Not
Sustained by Reputation Alone

by Barbara Long, APR

Academic medical centers are considered “scientific” places where students, staff, and physicians conduct research and clinical trials every day. However, an academic medical center also comes to mind as an example of Newton’s first law of motion, sometimes referred to as the law of inertia. That is exactly what happened at Rush University Medical Center in Chicago.

Rush has been part of the Chicago landscape longer than any other health care institution; the medical school received its charter even before Chicago was incorporated in 1837. It was comfortable in its role as the area’s top-of-mind health care provider with three hospital campuses, an 891-member medical staff, 620 residents and fellows, 8,536 employees, and 855 operating beds.

Inert in the 1980s
When competitors started marketing programs in the 1980s, Rush took a pass. Leadership felt that the organization’s reputation could stand on its own without advertising, promotion, or an “image” campaign.

Although Rush dabbled in some program advertising, no strategic planning and no serious marketing strategy existed. The marketing department functioned as an in-house service provider, fulfilling internal requests to communicate with staff, patients, donors, and medical school alumni through educational materials and newsletters. Outside of basic media relations, little effort was directed to communicate with the general public, primary care physicians, or the local medical community.

Furthermore, there were no basic hospital marketing tools in place. Rush didn’t even have an automated marketing message that played when callers were placed on hold or a current physician directory – much less any referring physician strategies or tracking systems.

Fast-forward to September 2002, when the external competitive forces at work for the past 20 years finally forced Rush out of its state of inertia. Patients weren’t coming through the doors the way they had in the past. Revenues were down – way down – and profitability was nonexistent. Even worse, Rush had slipped from No. 1 to No. 4 in consumer top-of-mind surveys. It was time to change … fast!

Enter Christine Malcolm, senior vice president of strategic planning, marketing, and program development, and Michele Flanagin, associate vice president of strategic and program development. The newly hired pair was charged with doing something never before done at Rush – planning, marketing, and strategic assessments, as well as providing strategic vision and management for new business initiatives and programs.

“It was basic blocking and tackling,” says Flanagin, who has since been promoted to vice president of strategic planning, marketing, and program development. “We didn’t do anything innovative. It was just new for Rush.”

Starting from zero, Flanagin and Malcolm built a strong business case, using tightly constructed financial models to convince the board and administration that Rush could not increase admissions without strategic planning and marketing. “Rush was not performing well financially, and the leadership had to fight its instinct to cut budgets. Marketing is riskier,” Flanagin says.

A ‘quick-start’ retreat
Convinced, the board took the leap of faith with Flanagin and Malcolm, and the pair launched a “quick-start” strategic planning retreat with 150 senior leaders and physicians. During the retreat, key services were identified and a basic strategic outline was developed. “It got everyone to agree to ‘do’ something,” Flanagin says. “The physicians in particular were so hungry for planning and marketing leadership, they wanted to do anything to help.”

Advertising agency Storandt Pann Margolis of La Grange, IL, was hired in December 2002 and spent six months on the marketing planning process, conducting interviews and focus groups, creating a positioning platform, and developing a budget for the fiscal year starting July 2003. An October deadline was set for rolling out a comprehensive advertising campaign, complete with television and radio commercials, billboards, transit signs, newspaper ads, a redesigned Web site, and a series of brochures.

A name change
During the planning process, it became obvious that something else needed to change – Rush’s name. The organization had been known as Rush-Presbyterian-St. Luke’s Medical Center since 1969. Driven by the marketing research, the board voted to change the institution’s name to Rush University Medical Center. The decision would be announced in September, just before the campaign was scheduled to begin in October 2003.

The old name was a mouthful, according to Sara Stern, associate vice president of marketing communications. “We’d been invisible for so long. We realized that we had a once-in-a-lifetime opportunity to change the name at the same time we launched our first mass-marketing campaign.”

All the pieces were in place: research conducted, plans made, budgets approved, advertising creative strategy developed, deadlines established. The communications staff now had four months before the campaign’s launch to shift from an internally focused model to an externally focused one, introduce the medical center’s new name, and build all the necessary marketing tools – including new recruitment materials, a new community newsletter, a redesigned Web site, and assessment tools – from the ground up.

“They had to stop on a dime and go in a direction they had never gone before,” Flanagin says. “It was done with a true team approach. The real story is how well all the teams worked together to share and integrate information.”

Stern was charged with coordinating the effort. She started by assessing the roles and responsibilities of the 15 in-house staff members, determining which activities needed to stop, and restructuring the department to focus on the immediate marketing needs for a redesigned Web site, a new referral and consultation guide for physicians, and the ad campaign. Storandt Pann Margolis handled the creative; Atlanta-based health care Internet consulting firm Greystone.Net was hired to work on the Web site; and the community newsletter was outsourced to Coffey Communications, Walla Walla, WA.

A consistent message
Stern says the team approach helped ensure that the campaign’s message was the same across all media. “Everything had the look and feel of the new branding effort, including ads for six different service lines, seven radio ads in Spanish and English, signage, HR recruitment … even the call center.”

A major component of the marketing program was to reconnect with neglected primary care physicians and referring physicians in the area. In addition to the development of the new referral and consultation guide, Rush developed a primary care directory for specialty physicians. New tool kits were designed to help physicians coordinate their marketing efforts with the medical center’s new look and feel. A new staff member also was hired to develop physician relationships and create more links with community hospitals.

Rush launched the campaign in October 2003, using television, radio, newspapers, billboards, and transit signs. The first wave of the broadcast-dominant campaign lasted six weeks and targeted women age 35 to 64. To grab attention, the first flight of TV ads featured 60-second spots while subsequent spots were 30 seconds. Ads ran on six stations, including network, public broadcasting, and cable, with a 99 percent reach and 10.5 frequency for all adults. Radio ads ran on the top 12 stations (English and Spanish) with strong female demographics. Moderate-size newspaper ads were alternated between the Chicago Tribune and the Chicago Sun-Times in the business, news, and lifestyle sections.

“The ad tag line, ‘It’s how medicine should be,’ communicates to the public Rush’s special approach to care and the level of expertise [clinicians] bring to patients,” Stern says. “The ads distinguish Rush from other hospitals and reflect what audience research had found: that Rush caregivers share a uniquely collaborative approach to patient care, that research and innovation benefit patients, and that the quality of the nursing care is superb.”

The ads do not use actors. Instead they feature Rush doctors, researchers, nurses, and other clinicians who deliver the message that Rush is where people work together to bring all the resources of an academic medical center to benefit patients. “They were not scripted. They are using their own words to talk about Rush and the innovations and insights they bring to solving patient problems,” Stern says.

A new Web site
The redesigned Web site had a strong visual tie-in with the advertising campaign. The new site debuted the same day the ads began and featured many improvements for the approximately 75,000 visitors who access the site each month.

Improvements included a greatly enhanced physician directory, comprehensive health information in both English and Spanish, better site navigation, a database of clinical research trials, and extensive information about Rush’s programs and services.

According to Marie Mahoney, director of Internet communications, it cost $53,000 to redesign the Web site to match the marketing and improve basic functionality. An additional $1,106,000 in 2004 and $900,000 in 2005 were allocated in the marketing and information technology support budgets to purchase software, increase staff and training, and continue improving online content management, marketing, and referral tools.

Flanagin declined to say how much money was spent on the total marketing effort. However, she notes that because the previous budget was so small, Rush’s budget is now comparable to what other medical centers in the area spend on marketing.

While the campaign was rolling out, Flanagin was hard at work on other efforts, such as the first phase of a comprehensive strategic plan and master plan to re-develop the Rush campus over the next 10 years. In tandem with that effort, work began on a five-year financial plan and an ambitious capital campaign.

The results
All the hard work seems to be paying off. In the weeks following the launch, Rush saw call volume to its physician referral line nearly double. There was a fivefold increase in queries to the “Find a Doctor” section of the Web site. Queries rose from a pre-launch level of less than 5,000 per month to almost 25,000 per month a year later. There also was a 20 percent increase in first-time visitors to the Web site.

The campaign also narrowed the consumer preference gap. Rush went from fourth to third place in top-of-mind awareness in the 16 weeks following the launch. This preference is translating to an overall upward trend in inpatient admissions and outpatient visits. Admissions rose 2.3 percent from the prior year and outpatient volume grew 10 percent. In addition, clinical program growth in top service lines is strong, with a better-than-average payer mix.

The 2003 campaign also marked a return to profitability for Rush after a period of losses. Rush reported a profit of $6.5 million, which is an improvement of almost $20 million from the previous year. In addition, hospital-operating revenues increased 9 percent.

Now that Rush has set a new course in motion, will it continue? Absolutely! A campaign featuring three additional service lines was launched in February

Barbara Long, APR, is president of E-savvy Communications in Jefferson City, MO. The firm specializes in strategic Web-based communications. You can reach Long at