Author Archives: Angeline May

By Elizabeth Cohen

In our marketing research for healthcare providers, I continue to be stymied by the same contradiction:  Why is there such a disconnect between healthcare preferences (e.g., which hospital would you prefer for a certain service line if needed), and actual healthcare usage (which hospital did you use when you or a loved one needed care)?

In our work for healthcare providers, we spend a lot of time trying to determine how consumers make decisions about their care for specialty healthcare services, so that our clients can plan marketing strategy and messaging appropriately.  We ask questions such as, “if you needed a referral for healthcare services, how important are the following characteristics in your selection of a provider?”  Additionally, we explore the kinds of information and resources that consumers say they would turn to when making healthcare decisions.

We get a lot of sensible information from these lines of inquiry, both in qualitative and quantitative forums.  Most consumers say that if they needed additional care for a specific condition they would conduct research using the internet, consulting sites such as hospitalcompare.gov or healthgrades.com; and/or they’d ask their friends.  In  sum, they’d really take a considered approach to determine where to go.  They say that their doctor’s recommendation would be only one factor among many to consider.

However, when we change the question to “take me through your decision-making process the last time you needed specialty services,” the answers change dramatically.  Despite the ready availability of information online and from friends, the majority of consumers immediately say that they went where their doctor told them to go…even if they actually believed that someplace else provided better care for that need. 

What’s going on?  Why are intentions around healthcare decision-making so different from actual behavior?  I believe that part of the answer lies in behavioral science.

Healthcare, by its very nature, is a negative purchase.  Though it might help us to get and feel better, we wouldn’t need it if our health was fine in the first place.  (Contrast that, for example, with the purchase of a candy bar or a vacation, which are all about enhancing pleasure – icing on the cake.)

So…how do we feel in a doctor’s office?  Anxious.  We’re there because something is, or might be, wrong with us or a loved one.  A close doctor friend of mine always talks about “white coat syndrome,” which causes some patients to experience elevated respirations, blood pressure or heart rate simply because they are in a doctor’s office.

I believe that it is this very anxiety that can, to a certain extent, explain the contradiction between what consumers say they will do and what they actually do when faced with the need for specialty healthcare.  As demonstrated in a series of experiments by Francesca Gino of Harvard University, and Alison Wood Brooks and Maurice E. Schweitzer of the University of Pennsylvania, “…by eroding self-confidence, anxiety motivates individuals to reduce uncertainty and both to seek and to rely on advice from others” (click here for the full PDF article).  In other words, when a doctor gives a referral, most patients and families are not in the best frame of mind to be able to say, “thanks for your opinion, but I need to go home and do my research to determine where is the best place to go.”

What does this mean for our healthcare clients?  First and foremost, it necessitates acknowledgement that the consumer behavior model for healthcare is quite different from “positive” purchases.  And, with the shaky launch of the Affordable Healthcare Act – complete with political drama and technological disappointments – consumers have even more reasons to feel anxious today than in the past.

For those larger healthcare systems with the full range of service lines, this anxiety and resultant willingness to rely on a doctor’s advice may, in fact, have positive implications for keeping consumers within the system.  However, for smaller community or specialty hospitals with weak (or nonexistent) ties to a healthcare system, the marketing priority remains referring physicians, whose recommendations to anxious patients and families will often be greeted with acceptance.

Please join the discussion in the comments section below!  Acknowledging that healthcare is often a negative purchase that can be fraught with anxiety, what does this mean for consumer marketing of healthcare services?