Health Care Marketing Matters, Summer 1999

Mind over Matter

Barbara Bix

An ever-growing body of evidence demonstrates that "alternative" medicine—such as mind/body programs, acupuncture, massage and chiropractic services—produce desirable health outcomes for a host of medical conditions. Yet, as we approach the year 2000, most physicians still don't offer patients alternative medicine as an option.

Today, resistance to its acceptance comes from the unaware, the unconvinced and the unmotivated. It's no longer a question of "does it work," but how do we reach the right people with the right message—a classical marketing dilemma.

This spring, Health Care Marketing Plus turned to area providers to find out what they're doing, what works, and what they've learned about marketing these services. We conducted in-depth interviews with representatives from 9 of the 15 Boston-based health care institutions with sizable alternative or mind/body health care practices.

Our goal: to get a snapshot of how Boston-based health care organizations are marketing mind/body and alternative medicine.

In this issue of Health Care Marketing Matters, we present insights from our recent study, "Marketing Mind/Body and Complementary Medicine in the Greater-Boston Area."

Below, you'll find two of our findings.

The Road to Reimbursement
As the study progressed, an interesting paradox emerged. While most of the respondents talked more about provider-administered physical therapies—such as massage, acupuncture, and chiropractic techniques—the programs that had the most success with reimbursement were those that focused on mind/body self-care. Largely influenced by eastern religion and culture, mind/body self-care trains the mind—through yoga, meditation, tai chi and other techniques—to overcome bodily symptoms of diseases such as skin disorders, urinary incontinence, heart disease and other stress-related conditions.

Four of the organizations that offer mind/body self-care, (three participated in the study, one sent literature), receive reimbursement for their therapies. What did they share in common?

• Physician referrals: Typically, a patient is referred to one of these programs by a licensed physician or mental health practitioner for treatment of a specific medical disorder.
• Training over treatment: These programs emphasize training in self-care instead of physical treatments administered by providers.
• Reporting on health outcomes: To measure care, programs document patient progress by means of comprehensive questionnaires that patients complete at enrollment and at the end of their training.
• Minimal technology investment: These are relatively low-tech enterprises that require simple tools such as cushions, exercise mats and audiovisual materials.
• Outpatient billing: Services are typically billed to insurers as outpatient visits.
• Group options: Most programs offer training in group settings, an option that increases overall cost-effectiveness.

Many health care organizations have expressed interest in launching some form of alternative medicine program. Given the relatively low start-up costs, documented outcomes, and the willingness of insurers to provide reimbursement, mind/body programs that incorporate these characteristics seem to be an excellent way to begin.

Bringing Doctors In
Conventional wisdom suggests that physician resistance is an impediment to the progress of alternative medicine. We found, however, that successful organizations have placed physicians at the center of their programs—and have been rewarded with growth and credibility.

Risa Shames, Project Manager at Harvard Vanguard Medical Associates, credits physicians for the expansion of their complementary program, Alternative Paths to Health. "In November 1997," Shames says, "we began piloting Alternative Paths to Health at our Cambridge site to respond to patient demand and ensure coordination of care between traditional and alternative practitioners. Since then, interest and demand for alternative medicine has continued to grow throughout our multi-specialty office. Physicians at other practices have been instrumental in bringing Alternative Paths to Health to seven other sites."

Here's what our respondents say works for them:

• Seeing is Believing

Progress is often driven by converts, and converts are won through first-hand experience. Joan Strauss, Program Coordinator for the Healing Connection at AtlantiCare Health System in Lynn, says, "One of the most important things we've learned since we started our program in 1990 is that you have to experience it to understand it. Consequently, we place a lot of emphasis on reaching out to staff and offering them self-care programs." This outreach is consistent with AtlantiCare's goals -- and its philosophy. "We believe," says Strauss, "that it's important to return people and human relationships to the center of the healing process for the benefit of both patients and caregivers."

Repeated exposure is also important. Kathleen Beyerman, Director of the Community Health Institute at Winchester Hospital, notes that, "It takes more than one or two exposures to treatment for physicians to think about referring their patients. Real awareness strikes when the first patient comes back looking and feeling good."

• Administrative Support

Respondents repeatedly stressed administration's vital role as the connection between conventional and alternative providers. One administrator credits her one-on-one networking between conventional and alternative therapists for the 50% recognition rate of her alternative medicine programs among her hospital's affiliated physicians. Another said that were she were to start all over, she would add more administrative personnel at each site to help raise awareness.

• Physicians on Staff

Make no mistake: when it comes to credibility, physicians trust physicians. Janet Tewhill of American Home Health says, "We've found that having physicians on staff is important. Referring physicians communicate best with other physicians because they speak the same language."

Placing physicians on staff may be the answer. The Marino Health Center started life as a facility that only offered alternative therapies and had trouble gaining credibility with physicians and the public. But when they added board-certified physicians affiliated with local hospitals, referrals soared. Marino Health Center Administrator Carmen Pascarella says, "The biggest surprise is that adding physicians to our staff has really helped improve our credibility. In a period of two years, we've gone from 2 referrals per week to 15 referrals a week from conventional physicians."

• Value of Planning

Some programs are beginning to formalize their physician marketing efforts with cohesive marketing plans. Their objective? Building awareness with consistent marketing messages.

Planning can make a significant difference. After implementing a plan, Devorah Steinberg, Outreach Coordinator for the Wellness Community, a non-profit cancer support organization in Newton, witnessed a leap in recognition from almost nothing to 25% in general medical audiences and over 50% in oncology audiences.

"The implementation of the plan," Steinberg says, "caused us to focus on marketing rather than just responding to other opportunities. We visit major hospitals once a month and others every other month. We attribute our success to a systematic process and just the sheer amount of time that we've been in the business."

• Marketing, Inside and Out

If there is a consistent lesson across the above examples, it's that the internal audience is as vital to success as the external market. From establishing credibility to generating referrals, alternative programs have learned the importance of actively soliciting provider support with self-care programs, one-to-one networking and ongoing communications. As programs mature, we can expect to see the informal means of communications, such as networking, reinforced with more formal marketing plans that actively promote consistent messages.

Acknowledgments
We'd like to thank all of the participants for contributing to our study. The following organizations have allowed us to acknowledge them by name. Please return the favor by considering their centers when you require care:

American WholeHealth Centers

AtlantiCare Medical Center, The Healing Connection

Harvard Vanguard Medical Associates

Marino Health Center

Northeast Health Systems, Health Connection

The Wellness Community

Winchester Hospital, The Community Health Institute