The teaching hospitals are mainly engaged in offering medical education facilities. Research and training facilities are also made available in these hospitals where patients are used as inputs for teaching and research both by the teachers and by those who are taught. Medical institutes and medical colleges both offer education, training and research activities with one difference being that the institutes are specialised in a particular field and colleges are generalised.
P
RICINGThe second component of the marketing mix is the pricing strategy. The pricing decisions keeping in view the Indian condition help hospitals in subserving the interests of general masses. To be more specific in the developing countries like ours where the level of income of the general masses is found low, it is significant that pricing decisions are liberal to the economically weaker sections of the society. The pricing management of a social institution becomes complicated as the policy makers are expected to assign due weightage to social considerations. The people living in a welfare state have high hopes and aspirations from the government. They like cost-free services, albeit they belong to the affluent sections of the society. Naturally it jeopardizes the task of top management. It is rather impossible that the government more so in an over populated country makes available world-class services to all without charging any fee. Moreover, it is also not rational that we expect free services, though bear the capacity to pay. The application of marketing principles in the hospitals aims at pricing the services in tune with the paying capacity of our population. If we earn nothing, we are expected to pay nothing. If we earn something, we are expected to pay something. If we earn more, we are expected to pay more. The quality of services should not be allowed to deteriorate, albeit our development plans impose on the users some additional financial burden. It is paradoxical that the developing countries have been encouraging degeneration in quality simply to avoid a basic change in our policy decisions. The marketing principles advocate that the benefits of the latest developments should be made available to all. The services should be free or subsidized or cost based or cost plus subsidy compensating depending upon the paying capacity of our users. None of the socialistic doctrines never allow degeneration in quality.
The strategies help us in projecting our image. Not only this, if the strategies are welfare oriented, the task of satisfying the users is also simplified. But the satisfaction depends upon sophistication. And sophistication can’t be possible unless we change our pricing strategies. In the Indian setting, a good number of hospitals are managed and maintained by the government. Some of the hospitals are managed by the charitable trusts whereas some other hospitals are managed privately. The government hospitals generally adopt cost-free pricing strategies whereas the trusts and private hospitals adopt subsidized or cost based pricing strategies. In a few cases, some of the private hospitals also adopt cost plus subsidy based pricing strategies. The main thing in the pricing strategy is to link it with the paying capacity of the users so that all the classes get medical aids without any discrimination.
Free Services: All categories of hospitals should adopt cost-free services to the weaker sections of the society having no source of income for paying even the nominal charges. In this context, the trust hospitals and the private hospitals should be given special grants to avoid an imbalance in their financial management. To some extent, the private hospitals should also be allowed to continue with the cost plus subsidy strategy for the affluent sections of the society which would help them in compensating the losses on account of free services made available to the weaker section.
Subsidised services: The users belonging to the low-income group should be made available subsidized services. It is meant that the public or the private hospitals make nominal charges for the services made available to them. It is more or less clear that subsidized services are a bit lower than the cost involved on treatment. Both the central and state governments would give the subsidies. Another alternative is to allow hospitals to adjust the losses by charging more from the affluent sections.
Cost-based Services: this is based on the principle of no-profit, no-loss. Or say, the cost based strategy in which prices or fees are equal to the costs involved on treatment.
Cost plus Subsidy: this strategy allows charging more than the costs involved on services but only from the affluent sections and transferring the surpluses to the account of subsidy for compensating the losses on account of providing free or subsidized
services to the weaker sections and low income group users. No doubt the hospital is a service generating social institution where this practice may invite multi cornered comments but we find no alternatives, as degeneration in medical services can’t be allowed to move upward. If we welcome it, the avenues would be paved for expansion and modernization of hospitals.
Subsidised
Cost Plus Subsidy
Public Hospitals Private Hospitals
Segment
No – Income Low – Income Middle - Income High - Income
No doubt the standard of services would be uniform but the fee charged for the services would vary. This would help hospital organizations in charging more from high and middle income groups, charging equal to cost from the low income group and making available free services to the no-income group. The dependence on the exchequer would be minimized but the doors would not be closed for initiating qualitative or
quantitative improvements. Another important advantage of this segmentation is concerned with implementation of modernization and expansion plan for the hospitals. The hospitals in general fail in making available to the users the modern facilities due to inadequate funds. This obstacle would be removed when marketing strategies are based on this principle. Further this would also simplify the task of doctors, nurses and other staff specially relating to the study of their behavior. For satisfying the users, it is only not essential that they are made available the best possible medical aids. In addition to the medical aids, the behavioral aspect is also found impact generating, especially when we consider marketing a customer satisfaction-engineering tool. It is natural that the expectations of all groups can’t be uniform. On one hand, it is judicious that no discrimination is found in respect of making available the medical aids but on the other hand, we can’t adopt uniform policy while making available to the users and their attendants other facilities like standard of room, indoor facilities and other non medical amenities. This is justified on the ground that all groups are not paying equal fees for availing their services. Moreover when no income group has been availing the services without paying any fee, their expectations would not be more than the proper medical aids. The main purpose of segmenting the market in the hospital services is to study the uniqueness.
PLACE
Place refers to the contact point between the service provider and the customer. Two main issues considered regarding the decision of the place are accessibility and availability of the service to the customer.
PROMOTION
Recently, the administration and management of hospitals has gained prominence allover the world. Albeit the developing countries have shown their interests in managing the service generating organizations in general and the hospitals in particular. The management of a social service organization like a hospital is a difficult task. It is, ofcourse, thorny especially in the developing over-populated countries like ours where degree of illiteracy has complicated the task of generating health consciousness. The multi-prolonged health hazards are found instrumental I contracting the resistance capacity of general masses but unfortunately they are not in a position to get the required medical aids. The exchequer finds it difficult to offer free or subsidized services to the masses. On the other hand, the technological sophistication has raised the cost of services as the inputs used in making available the medical services are found costly due to rising inflationary pressure. All these things necessitate application of marketing principles in hospital management. The main purpose of applying the marketing principles is to satisfy the users and to raise the service generating capacity of hospitals. It is found that marketing principles have been successful in making an assault on multi-faceted problems and this most neglected service generating social institution has failed in making available to its
users world-class services. The marketing experts advocate that application of marketing principles in the hospital services would raise the efficacy of hospitals vis- à-vis would act as a customer-satisfaction-engineering-tool.
P
EOPLEIt is necessary that the staff in the hospital is trained to provide quality patient care with the help of state – of - the - art technology.
The objective of providing quality service to patients can be achieved by:
1. Motivating employees to be efficient, dedicated and loyal to the organization. 2. Providing regular on – the – job training of employees to ensure continuous
improvement in health care
3. Utilising services of professionally competent medical consultants. 4. Use of the latest technology.
Motivation is not necessarily by giving high salaries. There are many other ways to motivate employees – concessions should be given to the employee’s near ones and there should be active participation of the employees in the activities of the hospital.
PROCESS
Process is a set of activities that take an input, convert it and add value to the input and finally, create an output. Processes are designed by blueprints, which sets a standard for action to take place and to implement the service.
A process is divided into the following phases in a hospital: 1. The joining phase – which includes
The arrival of the patient
Registration – where a patient has to make an initial deposit at the inpatient billing counter after which a file is opened in the patient’s name to know the patient’s medical history
2. Intensive consumption phase – which includes
Diagnosis – where the consultant diagnoses the illness by making the patient undergo various tests
Treatment – where the illness is treated with proper medication or surgery
Information about further actions – the consultant will instruct the patient regarding the diet to be followed, the medication to be taken etc.
3. Detachment phase – which includes
Discharge of the patient
Payment – after the patient is discharged, the bill will bee paid at the billing counter.
4. Feedback – at this stage, the patient is requested to fill an evaluation form, which helps the hospital authorities to know the level of satisfaction derived by the
patient. Patient’s suggestions are always considered for improving the hospital services.
PHYSICAL EVIDENCE
Physical evidence makes a huge impact on the customer. Physical evidence provides customers means of evaluating the service. Corporate image plays an important role in terms of physical evidence. This can be developed with corporate relation programs. Modern hospitals need to create a good ambience. This ambience plays an important role because when a patient walks into a hospital, he immediately forms an opinion about the hospital. The staff should follow a dress code to show professionalism and maintain discipline. The staff also needs to be trained to be understanding, warm and comforting because the clientele that goes to the hospital is usually disturbed or unhappy. It is necessary for a hospital to be well organized and segregated into different departments. All the doctors should be provided with a well – equipped cabin. If possible, the hospital should be centrally air – conditioned. However, good lighting and ventilation is a must. Special care should be taken to maintain hygiene; cleanliness and the whole hospital must be well – lit. This is generally taken care of by the housekeeping department. A hospital has to keep in mind both the aspects of physical evidence that is essential and peripheral evidence. Physical evidence plays an important role in a hospital where the patients are already depressed or traumatized and a good atmosphere could make all the difference.
PRODUCTIVITYAND QUALITY
Productivity in services is how we transform the inputs into outputs, which are valued by the customer. Quality is the degree to which the service satisfies a customer by meeting their wants and expectations.
Breach Candy Hospital, a multispeciality hospital, is situated on the coastline of South Mumbai and has an atmosphere of quietude and unpolluted air. It is a Private Charitable Trust hospital. The hospital is renowned for its excellent medical expertise, nursing care and quality of diagnostic reports. The hospital has earned national recognition as a leader in interventional cardiology. Many techniques in routine use including Coronary Angioplasty, Magnetic Resonance Imaging and Hysteroscopy were first performed here. One of the first ICU's in the country was established here. The hospital is continuously in tune with the latest technology that promotes the health care and well being of the patient.