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We may not need politicians to dictate healthcare reform; MDs, consumers and other healthcare practitioners can handle it on their own.
March 1, 2012
By: Erik Goldman
Editor in Chief, Holistic Primary Care
It’s axiomatic in any business: to succeed, you must know your customers, understand their needs, and be able to communicate—clearly and truthfully—the ways in which your products or services can meet those needs. For companies that market nutraceuticals, healthful foods and other natural products through healthcare practitioners, that axiom gets a little more complicated. Firstly, practitioner channel companies must satisfy two customers: the practitioners, who represent the points of sale or recommendation, and their patients—the end users of the products. Success depends on understanding how to sell to both, and how to leverage the influence of one (the practitioner) in an ethical way to help the other (the patient). Presumably, you and your team have thought about how your products can help end users. Have you considered how to help practitioners? Executives with strong practitioner brands understand they need to help practitioners build relationships with patients and create a context that’s not only free of hard-sell tactics, coercion or misleading language, but also provides practitioners with tools and services that meet patients’ needs. Essentially, business in the practitioner channel is about balancing and satisfying two sets of desires: the practitioner’s desire to help patients optimize their health, provide convenience and in most cases generate revenue for their practices; and the patient’s desire to improve health and well-being, reduce risk of serious diseases and in some cases ameliorate existing conditions. In your job as a marketer, do you facilitate the ability of both parties to meet these needs? That should be your primary marketing objective. To convince practitioners to sell or recommend your products, you need to earn their trust and confidence to such a degree that they in turn can convey that confidence to their patients. Multiple Playing Fields In one sense, the situation is similar to that of consumer-focused companies who must first convince retailers that their products are effective and likely to be popular with customers. The retailers, in turn, must sell to their store customers. But there are many challenges and dynamics unique to the practitioner channel that make it quite distinct from health food and mass market retail. For example, the “channel” is actually many different channels. The term “practitioner” or “healthcare professional” is a convenient catchall for an astonishingly wide range of people with disparate training, skill sets, scopes of practice, income potential and incentives. Most companies tend to stratify their practitioner business according to the degrees held by various practitioners (e.g., MDs, DCs (chiropractors), ND/NMDs (naturopaths), etc.). That’s helpful, but it is incomplete because it does not account for important factors like practice setting or specialty orientation. For example, within the “MD” category are dozens of different specialties, each with its own culture and standards of practice. Some may be more open to incorporating supplements than others. The practitioner channel is not one playing field; it’s many distinct though overlapping fields. Practice Settings: A Key Variable These days, specialty is almost secondary to practice setting in defining practitioner incentive. A doctor in independent private practice who wishes to remain so is under a very different set of incentives than a doctor who—for economic reasons—sold his practice to a hospital system. This is true across specialties. Over the last decade, as the economy has deteriorated and insurers have cut physician reimbursement, there has been a strong trend toward the latter. Many solo and small group practices find themselves behind an economic 8-ball of rising overhead but dwindling revenue. Some are solving that problem by selling their practices and becoming salaried employees of hospital systems. According to the American Hospital Association, hospitals now “own” 20% of all physicians in the U.S. This is a major 32% increase in the number of hospital-employed doctors since the year 2000. At the other end of the spectrum, a growing number of doctors who want to stay independent are leaving insurance-based medicine and stepping into direct pay, membership or “concierge” practice models. This sector has grown despite—or perhaps because of—the down economy, as people realize the actual value and long-term savings that comes from eliminating healthcare’s middle men and engaging directly with doctors who can devote time and attention to actual care rather than administrative nonsense. Practitioners in direct pay/concierge settings obviously have greater practice freedom and stronger economic incentive to dispense supplements, so they’re an attractive market segment. But many insurance-based doctors are developing mixed or hybrid models, and are also looking for new revenue streams to offset reimbursement cuts, so don’t rule out insurance-based docs. Little is known about how physicians in hospital networks view or interact with nutraceuticals. In general, their practices are more constrained by administrative oversight, and historically, mainstream hospitals have not been friendly to supplements or nutrition-based medicine. After all, hospitals traditionally made their money by moving patients through their beds and operating suites, not by keeping people healthy and happy. But incentives could change radically under healthcare reform; insurers will no longer be able to pass along their cost increases, which will put serious pressure on hospitals to curtail expensive procedures and cut costs. Prevention could suddenly become a magic word for hospital-managed physicians. The ‘Language Barrier’ Marketing to practitioners, especially to conventionally trained MDs, DOs and nurses, is also challenging due to a language barrier. Put simply, these clinicians think in terms of diseases and treatments for diseases. The Dietary Supplement Health and Education Act (DSHEA) requires you, as a marketer, to describe your products in “structure/function” terms and explicitly forbids you from speaking in the language doctors and nurses understand. As a result, messaging that keeps you on the good side of the law can sound like new age blather to practitioners. This is why it is important to solicit pre-market feedback from the types of practitioners you want to reach. You need to craft your product messages in words that resonate with them. It’s also essential to support good, independent science as much as possible, and to promote its dissemination via continuing medical education activities. Two of the most widely accepted supplement categories among doctors—omega 3 fatty acids and probiotics—have reached that status because there’s a wealth of good published science to support their use. Clinical researchers are not bound by DSHEA; they can speak, and write, in language that doctors understand. Despite many hurdles, practitioner sales and recommendations are growing, and now represent an aggregate volume approaching $3 billion per year. It’s a growth market and one of the few segments with significant room for expansion. Why? Because people often want guidance in their use of nutraceuticals and they turn to practitioners. Practitioners are seeking new practice models, and new revenue streams. Holistic Primary Care’s (HPC) survey of 2000 primary care doctors last year found that 41% are actively seeking new revenue streams, and office-based supplement dispensing was the top option they’re considering. (The survey can be purchased at www.holisticprimarycare.net). New Practitioner Channel Forums The unique challenges of the practitioner channel were the subject of a lively vendor education session at HPC’s Heal Thy Practice conference in November 2011. Participants included representatives from many of the major practitioner brands, who had an opportunity to share experiences and gain new perspectives on marketing to clinicians. James Maskell and Steve Wickham, two independent marketing consultants who both have extensive experience in developing practitioner-focused brands and services, spoke about the importance of relationship building. They emphasized a need to move out of the mindset that views your job as an effort to move product from your warehouse to practitioners’ offices, and into a mindset from which you see your job as helping practitioners create therapeutic relationships with their patients. Success ultimately depends on helping clinicians move bottles from their offices into their patients’ lives. It’s about empowering them to do a better job of helping patients to heal. This needs to be done in a way that is truthful, sincere and scientifically sound. This exhibitor education session—a first at medical conferences—was extremely well received and will be continued at Heal Thy Practice 2012 (November 9-11, in Long Beach, CA). HPC is also partnering with our friend (and fellow Nutraceuticals World columnist) Greg Stephens, principal of Windrose Partners, to develop an intensive executive-level educational forum focused exclusively on identifying and addressing the challenges of marketing nutraceuticals, healthy foods and natural products to practitioners. The first Health Practitioner Marketing Forum will be held on the West Coast in early fall. Over the 2.5 days, we will explore: Trends in practitioner engagement with supplements; Strategies for “Influencing the Influencers;” Creating effective (and legal) claims language; Dynamics between various practitioner subsets; Identifying future opportunities; Lessons from pharmaceutical marketing; Optimizing return on medical conferences; and many other issues. The forum will also provide opportunities to learn directly from practitioners, and to flex some problem-solving “muscle” through fun test-case workshops. We welcome your questions and input, so send an e-mail and let us know your top practitioner marketing challenges! For more information, e-mail [email protected] or [email protected].
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