Core Exchange: Research. Data. Strategy.

Episode Transcript:

Stephanie: Hello, and welcome to The Core Exchange, a podcast for healthcare marketers. I'm Stephanie Burton, director of healthcare marketing for Core Creative. And I am joined by Al Chaney, who is the chief marketing strategist for Chaney Marketing Strategy. Welcome, Al.

Al: Thank you, Stephanie. I appreciate it.

Stephanie: Absolutely. So you are joining us from a land far, far away up in Marshfield, Wisconsin.

Al: Yeah. It does seem that way. Marshfield's up in the center of the state, but oddly enough, this small town of less than 20,000 people is home to a healthcare system that has about 700 physicians in its system. And I don't know what the numbers are now, but over 10,000 employees in their system and about half of everything is here in Marshfield for that healthcare system, so it's pretty amazing.

Stephanie: And that health system, I think our listeners might be able to figure out is Marshfield Clinic and one of the reasons that you're referencing it is you spent a good portion of your career in the marketing department there from 2006 to 2016.

Al: I did. I was recruited here as their first marketing director. I had been living in the Twin Cities where I began my marketing career and I spent 17 years at General Mills and in the Pillsbury company before I had a cup of coffee. I think I was at the American Red Cross for about three years. And then the opportunity with the clinic arose. And I remember reading the job description and I said, "I don't think they've ever had a marketing person in this position." And when I started the interview, they had not. And so it was the whole idea of bringing that marketing discipline into an organization. It had a great reputation, but didn't know how to manage it and how to manage its brand with the public.

Stephanie: Yeah. Yeah. So, this is an interesting question. I know that I'm the one asking it so I would say that. But how did Marshfield Clinic developed such an outstanding reputation that continues through to today after your legacy, but before there was even a marketing department?

Al: I like that question. And I've told people a lot that when I got there I was not working with a blank canvas. I was working with an organization that had a 90 year reputation and it began with six physicians way back in 1916 who, like the Mayo brothers, wanted to bring an interdisciplinary approach to providing healthcare. So these six physicians had different responsibilities within the practice and it grew slowly. It grew slowly through the decades. It didn't really start to grow quickly until like the late eighties and through the nineties. That's when the clinic went suddenly from like 100 physicians to 750 physicians.

Al: And I think there's some docs there who would tell you that perhaps they grew too quickly, that they didn't incorporate the culture with it. But it didn't matter. The reputation of the clinic had been solidified. In the decades before, it had meteoric growth. And when I was at the clinic, I could go almost anywhere in the state and I would hear people say, "Oh, I know Marshfield Clinic. My grandmother went there." "I know Marshfield Clinic. My uncle was there." And people had been there, it's a tertiary quaternary care center that people refer to as a "mini-Mayo".

Stephanie: Yeah, yeah, absolutely. In that land far, far away, much like Mayo. I think-

Al: [inaudible 00:04:33].

Stephanie: Yeah. So I'm looking at your career and you have the career, or have had the career and continue to, that people dream of when they get into marketing or PR.

Al: Oh, thank you.

Stephanie: Yeah, no, I'm just looking at some of the brands that you've helped with. Yoplait, Betty Crocker, Pop Secret at General Mills, at Pillsbury working with Toaster Strudel. It's amazing. And so you take this leap from working in Minneapolis-Saint Paul, go to the Red Cross, and then you are all of a sudden in healthcare. How did things change? What was the difference moving from these major consumer brands to a healthcare organization?

Al: I think that the biggest part was early in my career at General Mills, I was tapped on the shoulder and asked to be on the board of a local nonprofit. It happened to be the North Community YMCA. They needed some marketing help on their board. So I went, and it didn't take long before I was on, I don't know, four or five boards, while I was working at General Mills and then eventually at Pillsbury. And just when the opportunity arose, General Mills bought Pillsbury. That was a good time for me to say, "Okay, I can move on now." And also pursue some interests on the nonprofit side. I spent a lot of time they're helping nonprofits market their organizations and said, "why don't I do that?"

Al: And that was one of the reasons why I took the job with the American Red Cross and the clinic is it's a massive... It's technically a nonprofit, but it obviously makes a lot of money. Just the clinic part of it is over a billion dollars. But it's that nonprofit background, having been on those boards, that influenced me to do something more than just the work for for-profit companies.

Stephanie: Sure, sure. How were things different as you moved from those for-profit consumer-oriented brands to a nonprofit?

Al: The mission?

Stephanie: Yes.

Al: Nonprofit organizations tend to be much more mission-oriented. General Mills is driven by a culture. They had an unwritten culture. You just knew and you learned how to behave there, how things were done. At Pillsbury, when I was there, they were owned by Diageo, which was a British company and they had clearly articulated their mission, vision and values with everybody. Everybody has the mission, vision and values on their desks, they were on coffee mugs, they were in every single conference room. And probably that was part of the decision with executive leadership that they'd look at the mission and vision and values statement on the wall and say "this is how we need to do this". And it's going like, "okay, that's walking the walk".

Al: But going to the American Red Cross was just at a different level. The mission was in front of you with everything that you did. You didn't hear talk about money except from a budget standpoint. We had to meet the budget, but there wasn't this profit motivation in there. It was really about "how do we help people that are in need" and getting to the clinic. It may not have been to the level of the American Red Cross, but clearly leadership had some real strong views on how they should behave and conduct their business.

Al: One of them was that from a marketing standpoint that was very... How would you put it? Very clear on where the physicians stand that "we will take all comers". And I would look at the mission statement, and it not there. It's not in the mission statement. It's not there, but it was unwritten and there were physicians that would sit there and argue that "we can't do that, we can't treat people differently. We take all comers." And it was like, wow, even though it was not written down, it was part of their unwritten mission that they're going to take everybody who walks through the door.

Stephanie: Yeah. Yeah. Really important. What were some of the surprises that you had as you transitioned to a health system?

Al: I would say that's interesting because I did see some real differences. The business wasn't as disciplined as in a General Mills or Pillsbury. So they've got financial controls and systems that are tracking everything. They know how much they're making because either it's going up to a larger organization like Pillsbury to Diageo or General Mills. It's like, "well, we promised Wall Street we're going to do this, so we got to we got to deliver on that." And everything was oriented to getting it. So they had the controls, financial, operational, people in place to make sure they did that. One of the first thing that I noticed when I was at the clinic is that I couldn't get data on unique patients, which is similar to the measure, it's patients coming through your door.

Al: It's like cases of product going out of your warehouse to your customers. And I couldn't get that data. And I couldn't get it for years. Or a history, I couldn't get my hands on. And so that made it difficult trying to understand how the clinic was doing, was it growing, was it in decline or whatever. But something as simple as that I wasn't able to put my hands on. And I don't know if that's common for all of healthcare, but just having those controls and that data available to access in the mind, to figure out what's going on, wasn't there. So in my first year we spent about $600,000 to do market research, all kinds of market research-

Stephanie: Good for you.

Al: ... to try to understand what was going on in our marketplace. We talked to our patients, our competitors' patients, we used political psychologists to talk to our patients and their patients. We did quantitatives, and qualitatives. We did everything that we could to try to understand what was going on in our marketplace. And I really do believe what we learned is evergreen. And even though it is, what, 13 years old now, I think much of what we learned, at least the conclusions, are still evergreen and still work today.

Stephanie: What are some of the things that you learned?

Al: One of the big things is that... And this is one thing that healthcare doesn't do well. If you watch advertising, and I know that you're in the Milwaukee market, but whether you're in Milwaukee or Madison, these bigger markets, you see a lot of healthcare advertisements. And generally speaking you can take, you know, you could substitute any one for each other. There isn't a lot of differentiation, there isn't a lot of effective branding. It's getting better and probably I think one of the reasons why it's getting better is that a lot of folks have copied what we did at the clinic. But the consumer doesn't differentiate between systems very well. If you have clinic or hospital on your building, they believe you're competent to do the job.

Al: It doesn't matter that a physician has their credentials, their diplomas on the wall. If you walk in and you introduce yourself as Dr. So and So, they're going to believe you, and they're going to believe that you could take care of them. They're not going to assume that you were trained at Mayo or you went to Harvard. They don't know and they don't care. They just care that you can take care of them. And there are degrees of separation between facilities, between physicians, health systems. Some are better than others. They're not all the same, but they're not necessarily so different that it means that you got to walk out and go someplace else. You just need to be aware that are you getting the right care, particularly specialized care, where you're going.

Stephanie: So one of the questions that I have is you had mentioned it was hard when you got there to get your hands on data. I know a number of people, number of healthcare marketers, have this problem. It's an age-old problem. How were you able to break through and get your hands on that data so you could hold yourself accountable?

Al: Right. Well, it helps to do the research and every bit of the research said we... Look, the organization, my boss who was the president of the clinic knew what we were spending and what we were doing and kept him in the loop on everything. And so when the research was done, we presented it to leadership, we presented it to the... And at that time the board of the clinic was all, if you will, the tenured physicians. So the board was 600 physicians and they would meet periodically. And I had the opportunity to present my work to the leadership team and then to the board of 600 physicians. And that was good. It was good to build credibility. It was good to handhold the organization through what we were doing. And what is neat about working with physicians in this regard is that physicians don't do anything without data. They won't touch a patient, they won't take care of it unless they had clinical research, reams of clinical research, that tells them that this is the protocol, this is how they're going to do it.

Al: So by and large they got, you know, they said, "Oh he's doing research and it's quantitative research to support what he's doing." It takes that bias out of it. I hear too much from my colleagues in other systems and in agencies that it's basically what the docs want. They promote, they advertise, the marketing is really centered around what physicians want and they don't know. They're smart people, but they don't know as conclusively as you can get when you do that quantitative research, when you use the consumer research to really understand what the consumer is thinking and believing. And so by presenting that research, I think to the physicians at the clinic really gave me a lot of credibility with them that we had some insights and the direction that we were going was a good one.

Stephanie: Did you have any naysayers, physicians who may have questioned the validity of the research or the methodology of the research? So I'll start with that question and may have a follow-up.

Al: Oh, goodness, yes. Oh, goodness, yes. And between my boss and I, the protocol was if somebody complained... And know this, and this could be a little bit concerning. I remember the first time it happened because my boss called me over to his office, and I didn't know why it was being called. But I'm being called to his office and I'm going like, "Okay, what did I do wrong?" And he said, "I want to show you something," and it was an email that one of the naysayer physicians had sent to all of his colleagues. Not just to my boss, to all of his colleagues at the Y. And he said, "Welcome to the clinic." And I'm like, "Oh wow."

Al: And really it wasn't, you know, I don't remember the question, but I do remember that one of the first campaigns that we did, we didn't talk about the doctors, we didn't talk about our facilities, we didn't talk about our buildings. We showed patients in real world situations, living life. And by extension it was that, "If you want to live a good life, come to Marshfield Clinic and get our care. That'll give you the best opportunity to live a rich, full, active, healthy life." Most of the physicians really liked the campaign. But there were a couple that were saying, "Why are we selling fumes?" And so our protocol was if somebody complained, go sit down with them, go talk to them. And I remember getting in my car and driving two and a half hours up to Rice Lake to talk to a physician. I remember driving two hours up to Minocqua to talk to another physician, driving an hour over to Weston to talk to another physician.

Al: And I probably had sit down with about a half dozen physicians out of 600. And I can honestly say that at the end of the day I was on good terms with every physician that misinterpreted or had issues with our initial work. Whether it's with how we did research or with our initial advertising or whatever, I left them better informed, and they understood and they appreciated the fact that I would get up and leave the ivory tower and go visit them at Rice Lake or Minocqua or Weston. And it was very helpful.

Al: But yeah, there were people that didn't believe. "Oh, an N of 300 is not enough. An N of 1200 is not enough. You need 10,000, you need 25..." Like, no. That's clinical research, you do not need that in consumer research, but hard to convince these people who are so scientific-minded that you need that huge in. But fortunately those folks, I think too many of them understood and said, "I think you're taking it to an extreme place with needing an in that large and no one has the budget or clearly we didn't have the budget to do that depth of research.

Stephanie: Right, right. Absolutely. You don't have an unlimited budget. And I think that there's a huge victory though here in this story. And that's that you were able to talk physicians off the ledge with your research and actually walk out of the room and still have a good relationship. You were able to explain things, help guide them to the solution that you reached and explain the reasoning behind that. And I think that as we launch or as we introduce physicians or internal audiences to research and to new campaigns, that sort of thing, it doesn't just stop at that meeting. It actually starts at that meeting and then it's the relationship work, the followup conversations that you have to have afterwards to make sure that you've got the continued support of your internal audiences. So yeah.

Al: You're absolutely right, Stephanie. You're absolutely right. Yes. And as you said, that phrase too, "talking them off the ledge". But yeah, it's the relationship building. You want to have support. You don't want to build enemies and the physicians had so much clout. I mean, they're board members. Come on, you got to keep your board happy. And yeah, it was just simply sitting down and taking them through. And I felt it was rewarding for me because if they understood my logic, these are people with terminal degrees, if they understood my logic and reasoning, then I knew that I was doing something right, that I was on the right on the right track. And like I said, I had doctors, every one of them apologize, and would say that, like, "Sorry that I did that, I overreacted," or whatever. And that wasn't what I was looking for. I really was just looking for, you know, help them understand what we were doing because I wanted to have allies and not enemies in getting it done.

Stephanie: Right, right. That's fantastic. And I think that's a perfect note to end on. Al Chaney, you are the chief marketing strategist for Chaney Marketing Strategy and former director and head of marketing and communications and branding at the Marshfield Clinic. It was a pleasure to have you on The Core Exchange.

Al: I enjoyed it.

Stephanie: Yes, thank you.

Al: Thank you for having me.

Stephanie: Indeed.

Al: I appreciate it.

Stephanie: Thank you. Absolutely.

Al: All right. Have a wonderful afternoon.