Case study Radiance Reconstructive Surg

Please see the case study below for the paper.

I have also provided the chapters need to complete the case study.

Also please see instructions in syllabus. Syllabus: Organizational Behavior and Public Relations Management For this assignment, locate and read the case study titled \"Radiance Reconstructive Surgery\" at the end of section 5.3 of your course text.

Complete the interactive module associated with this study.

Then, conduct a strategic marketing analysis, similar to the one that Melissa would prepare, for Radiance.

Based on this information, thoroughly answer the following questions:

•What marketing strategies should Radiance pursue in the next five years? Explain why the strategies you select would best fit the organization.

•Should Radiance engage in lifestyle, sponsorship, or event marketing? Explain your answer.

•Which venues would best match with Radiance’s brand, should the organization choose to move forward with these types of marketing?

•What damage control techniques should Melissa employ? Or, would she be better off to just wait and let some time pass before responding?

Defend your answer. Your assignment must be one to two pages in length (excluding title and reference pages). Utilize your course textbook and at least one additional scholarly source. Your paper and all sources must be formatted according to APA style as outlined in the Ashford Writing Center. Carefully review the Grading Rubric for the criteria that will be used to evaluate your assignment. CASE Radiance Reconstructive Surgery Melissa Patterson serves as the director of marketing for Radiance, an organization that provides facial reconstructive surgery. Her activities include two primary functions. First, she is responsible for overseeing the organization\'s advertising and marketing efforts. Her duties consist of overseeing strategic marketing decision making, advertising, and promotions. Melissa employs one individual, who assists in these efforts. The second function involves supervision of public relations. Two publicists report to Melissa. One of the two oversees all image-building public relations activities. The other manages other public relations functions, including preparation of press releases, scheduling interviews or appearances by physicians in the organization, and responding to any unfavorable press or Internet chatter. The two publicists work together to publish a monthly newsletter that is sent to patients, other health providers, and the local media. The newsletter appears in both paper and an electronic version that can be attached to an email. Radiance opened in 2002, when a group of three plastic surgeons agreed they would have greater freedom by offering their services independently from any specific hospital. The three physicians maintain practicing privileges at the area\'s four major community hospitals. Radiance has its own examination equipment and surgical rooms. The organization employs five nurses, as well as four support staff members who take care of insurance forms, billing, scheduling, and other office duties. Three types of individuals seek reconstructive surgery. First, victims of accidents who have facial injuries often require immediate attention and follow-up care. After an initial visit to the emergency room of a hospital, an injured person may return to Radiance on numerous occasions to achieve the best results over time. Second, facelifts and other facial beauty improvements (Botox injections, nose realignment), which are elective surgeries, tend to be available to people who have larger amounts of disposable income. These procedures command a premium price, and quality remains the overwhelming criterion. Referrals and word-of-mouth often bring these types of patients to Radiance. Third, some individuals are born with facial defects, such as a cleft palate. Many times these individuals do not have health insurance coverage. The three surgeons have agreed that it is advisable to treat some of these patients on a pro bono (no charge) basis. Others with limited incomes receive drastic discounts for their treatments. Over the past five years, the number of facelifts and beauty-enhancement procedures had begun to dwindle. One explanation for this turn of events is the major recession, which has cut down on the number of individuals willing to pay for cosmetic procedures. It is believed that when the economy improves, that part of the practice will again prosper. A second explanation is that Radiance experienced negative publicity when one unhappy (and relatively famous) client went public with her frustration. The physicians believe that her complaints were totally without foundation, but they worry that public perceptions of the organization have diminished as a result. Melissa was asked to diagnose the cause of the negative publicity and to offer potential solutions. She knew it would take all of her professional skill to put Radiance back on the right path. In answering the following questions, it may be helpful to refer to Sections 5.2, 5.3, and 5.4. 1. Conduct a strategic marketing analysis that Melissa would prepare for Radiance. 2. What marketing strategies should Radiance pursue in the next five years? Explain why the strategies best fit the organization. 3. Should Radiance engage in lifestyle, sponsorship, or event marketing? Why or why not? Which venues would best match Radiance should the organization choose to move forward? 4. What damage control techniques should Melissa employ? Would she be better off to let some time pass before responding? Defend your answer. Chapters needed to complete case study essay 5.2 Strategic Marketing Activities Strategic marketing and strategic management overlap in many areas. Effective healthcare administration requires that the two efforts mesh in order to achieve the organization\'s strategic and marketing communication objectives. In Chapter 4, strategic management was described in terms of: •Analysis and diagnosis—strengths, weaknesses, opportunities, threats (SWOT) analysis •Generating strategic alternatives •Strategy evaluation and choice •Strategy implementation To complement these activities, marketers begin by conducting a supporting program known as a strategic marketing analysis. Strategic Marketing Analysis A strategic marketing analysis program consists of an environmental analysis; a competitive and industry analysis; a segmentation, targeting, and positioning analysis; and a customer analysis (Clow & Baack, 2010). The program also combines elements of a SWOT analysis in that it assesses the external environment and various internal company operations. However, a strategic marketing analysis focuses less on strengths, weaknesses, opportunities, and threats, and more on the discovery of how the organization interacts with its environment, its markets, and specific customers. Executives seek to gauge how organizational leaders can create new relationships with patients and customers while also building on current relationships. Such an analysis can be extremely helpful to marketing managers in a healthcare system. Environmental Analysis An environmental analysis begins with careful monitoring of all external variables that have an impact on the healthcare industry. Assessments of all political, social, economic, technological, and semicontrollable forces should be made, much in the same format as a SWOT analysis. The information gathered should reflect specific issues that affect healthcare marketing programs, rather than overall strategic implications. For example, when examining political forces, marketers look to laws that directly apply to various activities, such as advertising. They must become familiar with what can, and what cannot, be said in a commercial for a hospital. The term puffery, for instance, means that an organization can make untestable claims, such as that a hospital is the \"friendliest\" or that it offers \"the most compassionate care,\" as no method can be used to verify or disprove such statements. Healthcare marketers also consider shifting demographics, cultural trends and changes, and rising educational levels to assess the impact of the marketing on their intended programs. Economic forces include economic conditions and how these might affect consumer choices, such as the decision to have an elective surgery to improve one\'s appearance. Healthcare marketers are consistently asked to get the word out regarding new services, service improvements, improvements in the delivery of those services, and technological advancements in medical care. Competitive and Industry Analysis A competitive or industry analysis first identifies the levels of competition, from the closest and most intense competitors to those that are the most distant but that are still viable organizations able to take away customers (patients). Marketers investigate each competitor in order to understand both the methods used by competitors and the individuals these competitors seek to reach. In healthcare, competition takes various forms. Marketers consult with other top managers to understand the impact on an overall organization, such as a hospital, or a specific form of care, such as an addiction treatment program. Competition arises from other hospitals, alternative care facilities, specific illness treatment centers, and, at times, individual physicians. Healthcare is unique in that patient \"customers\" may be anything from entire companies providing wellness programs to the government, through Medicare and Medicaid programs. Two elderly gentlemen playing a card game in a lounge © Jupiterimages/Comstock/Thinkstock In healthcare, one target market might be elderly people. Segmentation, Targeting, and Positioning Analysis The segmentation, targeting, and positioning analysis, or STP analysis (Kotler & Armstrong, 2007), helps the marketing team meet the goal of optimizing revenues by reaching the proper audience, both in terms of the services offered and the methods used to contact the individuals who might require such services. Segmentation involves identifying all potential customer groups that are viable for the purposes of marketing products and services. Most healthcare organizations cannot create enough services to reach every available type of patient. Thus, a market segment analysis categorizes customers into groups and identifies the characteristics of members of the groups (Myron & Truax, 1996). In traditional marketing programs, a segmentation analysis includes demographic characteristics, psychographic variables, behavioral actions, and geographic location. In healthcare, other categories, such as illness type and patient characteristics (some of which are demographic, such as seniors, children, and women), are more useful. The segments can be examined for potential to increase revenues based on the match of the service to the local community, the size of the segment, growth potential, reachability, consumer responsiveness, retention potential, and levels of competition. For example, a local hospital could decide to provide a mobile magnetic resonance imaging (MRI) unit to travel around a county or specified geographic region. A market segment analysis would reveal whether sufficient need exists to justify such a purchase and the employment of specialists to operate the equipment. After segmentation, the targeting component of the STP approach can proceed. Targeting includes selecting the market segments (e.g., diseases or groups of patients) that the organization intends to target or reach. For example, a mobile MRI unit would target various injuries, including those related to sports, accidents, and the aging process. Positioning involves creating perceptions in the minds of consumers about the nature of the organization, its brand, and its products and services. Positioning must match the characteristics of the selected target markets. Continuing the example, a mobile MRI operation would be positioned as a high-quality method of diagnosing injuries that would ensure the best possible care. Marketing programs would note that MRI imaging is superior to X-rays and computed tomography (CT) scans, thus granting the physician greater precision in diagnosing and treating an injury. A positioning analysis discovers the place of an organization and its services in the minds of consumers and relative to the competition. Four components to be considered during this part of the STP analysis include the target audience, the organization itself or the service being offered, the frame of reference or category, and points of differentiation or uniqueness. Once completed, positioning strategies may be put in place. A perceptual map may assist in identifying the position of a healthcare organization in comparison to the competition. A perceptual map typically employs two axes representing the key variables that affect perceptions of a service. In traditional marketing, price and quality serve as the two axes. Figure 5.2 provides a perceptual map containing various providers of the same service—psychiatric care—using two common healthcare factors: affordability and accessibility. Affordability measures the degree to which a patient believes he or she can reasonably pay for healthcare services. Accessibility measures perceptions that a patient could obtain the needed service from a specific healthcare provider. These two concepts can be combined as surrogates for price and then be compared with perceptions of quality to provide a useful analysis. As shown, an individual psychiatrist is perceived as being the least affordable and accessible (the highest price), even though the psychiatrist might be perceived as providing the highest level of care. An individual psychologist costs less and would be more accessible; however, the quality of care might also be viewed as being somewhat lower. (Remember, however, that a patient would be able to examine insurance coverage to see if this changes the costs of each.) A support group in a hospital probably would be reasonably affordable and accessible (moderately priced) and would only hold an advantage over an unlicensed counselor if perceptions were that the quality of care was better. The unlicensed counselor would be perceived as being the most affordable and accessible (lowest price) but may be perceived as providing the least effective quality of care. More precise perceptual maps would incorporate the names of specific psychiatrists and psychologists. Figure 5.2 A perceptual map for psychiatric care Figure depicts the relationship between quality and price for psychiatric care. An unlicensed counselor is placed at low quality and low cost. Both the quality and cost of care increase for a hospital-guided support group and increase even more for an individual psychologist. An individual psychiatrist is identified as both the highest quality of care and the highest cost for care. A quality STP analysis allows an organization to avoid brand parity, or the perception that services provided by other institutions or physicians are basically the same. Healthcare organizations are best served when marketers are able to build brand equity, or the perception that a given provider is different and better (Schultz, 2009). Any dentist or physician holding such an advantage probably has a highly successful practice, as would any practice group or hospital. Customer Analysis A quality customer analysis provides marketers with an in-depth understanding of an organization\'s customers, or patients in the healthcare system. The \"W\'s\" and \"H\'s\" of a customer analysis include understanding the who, what, when, and where of patients seeking medical services, as well as how those services are obtained. In other words, marketers should ask, \"Who are our patients? What services do they seek? When do they seek them (e.g., emergency vs. routine visit)? Where are they located? How are the services obtained?\" The answers to these questions help a marketing manager in healthcare establish a target audience to reach. An effective marketing program necessitates careful study of the consumer buying decision-making process for purchasing a service (Clow & Baack, 2014, pp. 53–81). Each step offers the potential to reach and attract customers. Figure 5.3 details the steps of a purchasing process, as modified to fit healthcare circumstances. Figure 5.3 The consumer purchasing decision process: Applications to healthcare Figure depicts five steps of the consumer purchase decision process as it applies to healthcare. First, the consumer recognizes a health issue. Second, the consumer examines potential healthcare providers and options that could resolve the health issue. Third, the consumer considers the advantages and disadvantages of each type of healthcare provider. Fourth, the consumer seeks medical care. For the fifth and final step, the consumer considers recovery, degree of wellness, and satisfaction with the provider. Consider a person who experiences blurred vision. The individual recognizes that her eyesight has deteriorated. She considers the services of an individual optometrist, an individual ophthalmologist, or a company such as Pearle Vision Center, which offers both an eye exam and subsequent fulfillment of an eyeglass prescription. Next, she reviews her healthcare coverage to find out whether eye exams and glasses are included, which would affect her subsequent choice. If she is poor or unemployed or if her policy does not cover eye care, she may consider a public health facility that offers eye exams for free. Focus Groups and Questionnaires When the patient evaluates alternatives, she considers the cost of each option, along with the level of care. If she worries that a new problem has emerged, such as glaucoma, she may wish to see a more advanced medical professional, depending on the type of insurance she has. If she believes it is simply a matter of obtaining a new prescription, other options become viable. A person with no or low income will also think about the amount of time she would wait in a public health facility and whether she might have to take time off from work to take advantage of the free service. After she makes her choice and resolves the problem, she will review her experience. If she spent a long time in a waiting room and encountered a terse, distant eye care professional, she may tell others not to go to such a place. If her vision does not improve or is not corrected, postpurchase dissatisfaction will be high. She might decide to post her story on social media and websites that evaluate various eye care providers to tell friends and family about the episode. In recent times, many healthcare organizations take into consideration the steps of the buying process in some form, with particular attention paid to postpurchase evaluation. A variety of techniques may be used to ascertain levels of patient satisfaction with the services and service providers. Additional Factors When considering customers and patients, healthcare administrators can benefit from methods that help them understand market potential and market demand. Market potential consists of the total number of patients that might require a medical service. Market demand is the total current existing demand for the service. Company or brand demand expresses the demand for a particular company\'s brand and is often referred to as market share. For instance, an organization that provides CT scan services can determine how many patients from a geographic area would need scans in the coming year. Then the organization\'s marketers could identify the percentage of patients that use a specific facility as compared with all other facilities. In addition, the concepts of share of mind (awareness and recall) and share of heart (loyalty and affection) provide helpful ideas about how customers view a healthcare organization and its services. In a manner similar to a perceptual map, these two indicators can serve as axes used to evaluate an operation. Figure 5.4 provides an analysis of share of mind and share of heart (Goodall, 2011) for four hospitals in a large metropolitan area. Figure 5.4 A share of mind/share of heart analysis of healthcare facilities Figure depicts the share of mind and share of heart relationship for sample healthcare facilities. Both Mercy Regional and Elsevier are identified as low for share of heart. However, Mercy Regional is high for share of mind, while Elsevier is low for share of mind. Freeman is in the middle for both share of heart and share of mind. St. Mary\'s Community is identified as higher for both share of heart and share of mind. Source: Adapted from Goodall, 2011. In Figure 5.4, Mercy Regional is well known in the area but suffers from a poor reputation. People do not express warm feelings about the hospital. If the hospital marketing team wanted to instill more positive reactions, it would have to move to a much more favorable position. Freeman is less well-known, but those who do know if it have fairly favorable responses to its care. Therefore, Freeman\'s marketing team should work to raise awareness while maintaining positive reactions. Elsevier is the least well-known and is also not very well-liked. The marketing team will have the greatest challenge of trying to build both factors at the same time. St. Mary\'s enjoys the highest levels of both. Therefore, its marketing team should endeavor to maintain awareness and favorable responses over time in order to maintain this position. In summary, all of the assessments made assist a healthcare marketing team in understanding the nature of the environment, the competition, and how people view the organization relative to others. Marketing strategies can be developed to respond to the institution\'s unique circumstances. WEB FIELD TRIP Go to http://www(dot)pwc(dot)com to watch a video in which consumers discuss some of their experiences with various healthcare organizations. Under \"Research & Insights,\" select \"Health Research Institute.\" In the \"Watch Our Videos on Key Healthcare Issues\" box in the lower right corner, select video number four, \"PwC Man on the Street Video.\" •What do the consumers list as their most satisfying experiences with healthcare organizations? •What types of experiences leave them feeling most dissatisfied? •Are there any common threads in the consumers\' opinions? If so, what are they? •How might a marketing professional use these interviews in a customer analysis? Developing Marketing Strategies As is the case in any management or marketing activity, objectives or goals serve as targets to achieve. As a result, they guide the activities and choices of managers. Table 5.1 lists standard marketing communication objectives and their applications to healthcare. The market strategies that would arise from these goals include strategic efforts to build the image of a practice, create an effective positioning outcome, and increase the number of patients served or the market share held by a facility. The strategic marketing efforts designed to achieve these outcomes follow the variables discussed in the previous section. The strategic analysis should incorporate the selection of markets to be served. Specific target market characteristics need to match the other components of a strategic marketing program. The analysis would also note those markets that the healthcare organization cannot, or chooses not to, seek. One key choice in terms of markets is a concentration versus a multisegment strategic approach. A healthcare concentration strategy targets a single market and seeks to dominate or achieve a large share in that market. A hearing specialist or specialist group that focuses on delivering low-cost hearing aids to a variety of patients uses a concentration strategy. A multisegment strategy in healthcare takes the approach of serving several types of patients with differentiated needs. A hearing specialist or group that expands to provide treatment for ear infections, tinnitus, and other hearing maladies employs a multisegment strategy. Table 5.1 Marketing communication objectives: Applications to healthcare Objective Application to healthcare Brand awareness Increase awareness of a medical practice Change customer beliefs and attitudes Alter attitudes toward physicians and staff Enhance purchase actions Encourage decisions to seek medical services Encourage repeat purchases Encourage decisions to return when new health issues arise Build customer traffic Increase the number of patients Enhance firm image Alter attitudes about the overall organization Increase market share Increase the percentage of patients that use a health facility Increase sales Increase revenues Reinforce purchase decisions Support positive postcare and treatment sentiments Source: Clow, Kenneth E. and Baack, Donald E. Integrated advertising, promotion, and marketing communications, 6th, © 2014. Printed and electronically reproduced by permission of Pearson Education, Inc., Upper Saddle River, NJ. The product component includes the services that the organization offers, such as the addition of new services, deletion of services no longer needed, and the improvement of current services. The product strategy reflects either a concentration or a multisegment approach. The price component only applies to certain types of organizations. For example, dental care facilities may advertise prices for various services, such as braces. Pharmacies may seek to compete against one another based in part on price. Some eyeglass companies compete based on price. Marketing managers must carefully consider whether price can be applied to create a strategic advantage for their organizations. Place, or distribution, includes the number of locations in which a practice operates. Hospitals and other practices may find it strategically advantageous to create smaller satellite operations, especially when such operations funnel patients to the main hospital. Again, these decisions reflect the choice of a concentration versus multisegment strategy. Promotions constitute a substantial part of a strategic marketing program. These efforts seek the strategic goals of reaching the right target markets, establishing an image, and achieving the desired positioning in the medical community. In the upcoming section, various forms of promotional tactics are described in greater detail. 5.3 Marketing Tactics: Markets, Products, Prices, and Promotions Marketing teams develop tactics designed to support the strategic marketing approach that the organization takes. Marketing efforts align with the overall strategies, mission, vision, and values established by the organization. Consequently, tactics are developed in the areas of markets, products (services), pricing, distribution (place), and promotion. Management then implements and oversees the tactics chosen. Markets As has been noted, medical practices and other medical services identify markets to target. At the tactical level, marketers investigate the additional characteristics of members of these target markets in order to better care for them. For example, elderly patients may prefer office visits earlier in the day. Women seeking specific healthcare may find it helpful to have access to day care or child care while undergoing diagnosis and treatment. Someone recovering from a heart attack would be best helped by matching medical care, such as follow-up visits to a specialist with heart rehabilitation services. Products (Services) The products, or services, provided by healthcare organizations should be tailored to target market characteristics. A Veterans Administration (VA) hospital will structure services to meet the needs of former service members. For example, a psychiatric care program would be designed to help those in need of special support. As another example, many Vietnam veterans were exposed to Agent Orange, and the VA responded with programs designed to assist those affected by the toxin. As another example, dentists often alter services to meet specific patient needs. One dentist might specialize in relaxation dentistry, relying on various techniques designed to reduce patient anxiety. An oral surgeon might conduct a different kind of practice to meet the needs of patients involved. A product-diversification strategy takes place when a medical care facility or physician offers a new service, such as an orthodontist who previously only administered braces to patients now expands his practice to provide reconstructive dental care for those injured in accidents in conjunction with a local hospital. Pricing Programs Pricing Goals For the most part, tactical efforts in the area of pricing are not practical or even advisable in healthcare. The complex nature of charging patients, offering write-offs, receiving insurance payments, and dealing with the uninsured makes pricing an unrealistic area for creating tactics in most marketing programs. There are, however, a few minor exceptions, such as eyeglass providers offering package deals on eye exams and prescriptions; denture providers; or for-profit companies that make and sell hearing aids. Promotional Tactics: Advertising Promotional tactics include advertising, personal selling, and sales promotions. These areas offer the greatest number of opportunities to develop tactics that support the overall marketing program for a healthcare facility. Consequently they receive the greatest amount of attention in this section. Some forms of medical advertising are relatively recent developments in the field of healthcare. Today, many forms of practices advertise their services. Developing effective advertising tactics represents the key to an effective marketing program in the area of promotions. Advertising management is the process of developing and overseeing an organization\'s advertising program (Clow & Baack, 2014, pp. 116–138). The tasks involved in advertising marketing include: •Setting advertising objectives •Generating an advertising budget •Choosing an advertising agency •Overseeing the advertising program •Assessing advertising effectiveness These activities take place in an environment that changes radically and dramatically each year. Setting Advertising Objectives Advertising objectives are based on the nature of the product, the target audience, and the activities of the competition, among other factors. The primary advertising objectives were noted in Table 5.1. In order to succeed, medical organizations must make persuasive advertising arguments. Generating an Advertising Budget An advertising budget should be created to help achieve the various marketing communication objectives. The four primary methods for creating advertising budgets are: •Percentage of revenues •Meet the competition •Arbitrary allocation •Objective and task The percentage of revenues method allocates funds to advertising and promotion based on either a percentage of the previous year\'s revenues or a projection of the amount for the next year. A larger healthcare facility might choose such an approach. The meet the competition method, in which a company matches the advertising expenditures of competing organizations, is unlikely in healthcare. A major organization, such as a hospital, might select this approach if it dealt with one or a few key competitive rivals. In that unusual circumstance, hospital marketing managers would need to identify how much rivals spend and then match that amount. Arbitrary allocation occurs when company leaders set the budget at a level they think should be spent or that they believe the organization can afford. This method is sometimes called \"what we can afford\" and is common in many organizations, including healthcare facility marketing programs. The objective and task approach uses the organization\'s marketing objectives as the basis of the budget estimate of dollars needed to achieve the organization\'s objectives. In healthcare, the objective and task approach would be effective when launching a new service or treatment program. Choosing an Advertising Agency When choosing an advertising agency, the first decision in many for-profit companies is choosing between an in-house advertising program and an outside advertising agency. It would be extremely rare for a healthcare organization to create its own advertising program. Instead, the organization may choose to work with local television stations, which often provide advertising design services, as do local newspapers, radio stations, and magazines. When a healthcare organization retains an outside agency, selection criteria play a key role. The criteria of agency size, relevant experience, creative ability, and services offered are reviewed, along with any existing or potential conflicts of interest. The advertising company\'s creative reputation and capabilities merit careful consideration. When agencies are asked to make formal presentations (known as the creative pitch or shootout stage), the marketing team gains face-to-face insights about each firm and its proposed approach. Finally the agency that is chosen begins work, and others are notified that they did not win the contract. Overseeing the Advertising Program Overseeing the advertising program is another key role of the marketing manager in advertising healthcare. This step includes selecting the final advertisement(s) and approving the selection of media. An advertising agency or local media outlet prepares potential commercials or advertisements. The marketing manager, in conjunction with others in the department, normally makes the final choice. Media selection combines the choice of a primary medium with all secondary media to be used. The traditional list of advertising media comprises television, radio, magazines, newspapers, outdoor/billboards, direct mail, and the telephone books. In most instances, these would be local choices, such as the city\'s newspaper or local billboards. A few larger health organizations advertise regionally or nationally, often in places such as magazines offered by various airlines and in national newspapers, such as USA Today. Traditional media is often combined with nontraditional or alternative media to complete a fully integrated advertising and marketing program. Nontraditional media includes websites, social media forums, and placements on Internet search engines. Assessing Advertising Effectiveness To fully assess advertising success requires deployment of several tools, not the least of which is reasoned judgment by the marketing team. Assessments of all of the campaigns center on attitudinal effects and behavioral effects on consumers or patients. Attitudinal effects are measured using surveys and interviews via various media. Focus groups assist in evaluating messages before and after being released. Attitudes to be evaluated include recall of the ad, recognition of the brand, attitudes or feelings, brand positioning, perceptions of loyalty, and brand equity or parity. These variables are aligned with strategic goals, such as improved share of mind or share of heart. Behavioral effects provide identifiable and immediate results from a marketing effort. Some of the standard behavioral measures include increases or decreases in store traffic; telephone, mail, and Internet inquiries; website visits; direct marketing responses; redemption rates of consumer and sales promotions; and sales by units or total volume. In healthcare, behavioral measures include inquiries about health services, increases in patients for specific treatments, and website visits. Healthcare marketers should be aware that a direct relationship between an advertising campaign and subsequent patient visits probably will not take place, as a person does not utilize a healthcare service until the need arises. For that reason, share of mind (consumer recall of the organization) becomes an important marketing goal for healthcare providers (Hall, 2004). A typical advertising campaign lasts between four weeks and three months. Those campaigns with continuous formats run advertising uniformly throughout the year. Campaigns with pulsating formats feature advertisements throughout the year, with a spurt of additional advertising during major seasons, such as Christmas. A discontinuous format includes periods in which there are no advertisements and other periods when advertising is heavily used. For example, diet and exercise programs tend to focus on the New Year and the start of summer. Most hospital and healthcare services use continuous formats, which best matches the objective of creating and maintaining share of mind and building levels of share of heart. 5.4 Marketing Tactics: Alternative Methods, Image Building, and Public Relations To fully support the marketing strategies that a healthcare organization intends to pursue, programs beyond traditional approaches have become available. These programs are compatible with the shifting nature of the social environment, as well as the goals of healthcare marketing programs. This section examines alternative marketing methods, image-building programs, and public relations activities that assist in achieving key strategic outcomes. Alternative Marketing Programs Healthcare officials should be aware that advertising programs cannot accomplish all strategic marketing goals. However, advertising can be accompanied by alternative marketing programs that reach customers in new ways. The most common alternative approaches include lifestyle marketing, buzz or word-of-mouth marketing, and guerrilla marketing. Lifestyle Marketing Lifestyle marketing involves tapping into a target audience\'s core lifestyle, music, culture, or fashion venues. The approach features engaging with customers at places where they relax and enjoy leisure activities. Farmer\'s markets, bluegrass festivals, citywide garage sales, flea markets, craft shows, stock car races, fashion shows, and 4H events present potential lifestyle marketing opportunities. In healthcare, an example of lifestyle marketing occurs when a set of medical providers offers a health fair in a given venue. Lifestyle marketing can target employees of a single company or organization or be oriented to a more general audience in an auditorium or meeting center. Such events allow prospective patients to interact with members of the healthcare organization in more comfortable settings. Healthcare marketers can employ lifestyle marketing at a variety of events. For example, a booth can be set up as part of a county or state fair promoting an organization, such as a hospital or specialized form of practice. Marketers from a hospital or health organization might decide to attend an event related to a race or culture, such as a Hispanic heritage festival. Medical problems that are common for that group can then be targeted at a display or booth. Chamber of commerce and other community events often feature various types of organizations at larger gatherings, and hospitals and other health organizations can take advantage of these opportunities to create positive, image-building events. Word-of-Mouth Marketing Buzz marketing, or word-of-mouth marketing, involves consumers passing along information about a product. In healthcare, word-of-mouth marketing can make or break an individual physician\'s practice. Marketers in larger organizations look for ways to monitor what has been said, in both medical and nonmedical terms, about how the healthcare provider treated patients. For example, anyone who has experienced a nightmare relationship with a hospital\'s billing department gladly relays this information to a wide audience. Many healthcare facilities now follow up patient visits with surveys designed to discover how the person felt after the treatment was over. Guerrilla Marketing Guerrilla marketing seeks to obtain instant results with limited resources using tactics that rely on creativity, quality relationships with customers, and the willingness to try unusual approaches. Guerrilla marketing emphasizes quality rather than quantity. Reaching a carefully selected target audience becomes the goal of the planning process, and effective timing is a key factor in the success of a program. The message must reach the target market at the right time to gain maximum impact. Guerilla marketing tactics are not useful for the majority of physician offices, joint practices, or hospitals. However, such tactics can be used in conjunction with more specialized practices, such as by a hearing aid company showing people the advantages of a quality hearing aid in some unique way. To attract people to the demonstration, the company\'s marketers might build a gigantic ear, which would capture the attention of people passing by a display in a public venue, such as a state fair or a sports event. Image-Building Programs In traditional marketing, managers often take advantage of programs that combine the efforts of the sales force, public relations personnel, advertising specialists, and others from the company. Four such programs are sponsorships, event marketing, cause-related marketing, and green marketing. Healthcare marketers can take advantage of many aspects of these programs. Sponsorship marketing involves the company paying money to sponsor someone, some group, or something that is part of an activity. Sponsorships range from Little League Baseball and soccer teams to national music tours. Some healthcare organizations, such as hospitals or specialized practices, can become involved in sponsorship programs by sponsoring items such as closed-captioning of local news programs on television. Event marketing is similar to sponsorship marketing, but instead the company supports a specific event, such as an arts festival, a local rodeo, or a concert in the park. Although sporting events attract the largest sponsorship and event marketing dollars, hospital marketers might be more inclined to establish a presence at a cultural event, such as a classical music program, a theater production, or a special Christmas gathering. Both sponsorships and event marketing programs require similar steps and activities. The marketing team first determines the objectives of the program. The audience profile for both programs must match the target market. The event is then promoted. The sponsoring healthcare provider or brand will appear prominently in promotions for the event, and the sponsor tracks results to make certain the program achieves its goals. Cause-related marketing programs link a charity with another organization in order to generate goodwill. Many hospitals and healthcare services benefit from cause-related events, such as a golf tournament sponsored by a local company or university with part of the proceeds being donated to the hospital. This type of marketing would be more likely to take place when the hospital is a not-for-profit organization (Chiagouris & Ray, 2007). Close-up of a violinist playing in an orchestra © iStockphoto/Thinkstock Hospital marketers might be inclined to establish a presence at a cultural event, such as a classical music program. In the current environment, companies carefully choose charities, making sure the beneficiary matches the company\'s image and theme. If a charity seems unrelated to the company, the program may experience consumer backlash based on the perception that no true altruistic intentions are present; instead, the public may believe that the firm seeks to capitalize on the charity\'s activities. A hospital provides a wide variety of services, which makes it a logical candidate for many cause-related programs. Green marketing is the development and promotion of products that are environmentally safe. A green marketing strategy should align with the wishes of the firm\'s target audience. Rarely would such a program fit with a healthcare organization. Public Relations Many times, public relations are at the top of the agenda for a healthcare organization. Public relations include all nonadvertising-based communications with organizational publics and stakeholders. To maintain quality relationships with patients, providers, and the larger public, quality public relations departments and programs are essential. Note that although advertising programs often involve purchasing services from outside organizations, most healthcare providers would conduct public relations activities in-house. The three primary areas covered by public relations departments are publicizing image-enhancing events, monitoring messages, and performing damage-control activities. Publicizing Image-Enhancing Events The public relations (PR) department is responsible for informing the public about all of the organization\'s positive activities. For example, PR releases are developed to highlight any lifestyle marketing, sponsorship, event marketing, or cause-related marketing programs. The PR department notifies patients, nonpatients, and other members of the local community about these events. Press releases, press conferences, letters to constituents, and postings on the company\'s website all assist PR officials in sending out positive stories. An entitling takes place when the organization makes sure it has been given credit for a favorable event, such as a note in the program for a local music event that says the healthcare provider served as a sponsor. An enhancement involves increasing the value of a favorable outcome, such as when a health provider notes that its free screening program assisted a number of people in discovering and resolving medical problems (Clow & Baack, 2014, pp. 354–377). Monitoring Messages The PR department also monitors contacts between the company and noncustomer publics, such as interest groups with specific agendas, including the American Heart Association, the American Cancer Society, and Alcoholics Anonymous. The PR department can become the key listening post for all communications that take place. Gathering this type of information, including reactions to new treatment programs, provides the organization\'s management team with valuable insights regarding public perceptions of the firm and helps the organization take proactive steps to build or maintain a positive image. Damage Control Negative publicity occurs when a health provider faces a story either based in fact or due to some unusual circumstance. At times, the provider creates these problems, such as through medical malpractice, discrimination, or unfair pricing or bill-collection techniques. At other times, the negative publicity is beyond the provider\'s control, such as any false charges regarding the quality of care delivered by a physician or the overall organization. Dealing with negative publicity can include an apology, defending the organization\'s innocence, or providing justifications through Internet interventions or other explanations (Baack, Harris, & Baack, 2013). An apology begins with the acknowledgment that the provider did something wrong, whether by choice or by accident. It continues with a statement of regret and the promise not to engage in the inappropriate behavior again. Then the organization offers to compensate the injured party. However, rarely do medical providers make open apologies, due to the preponderance of lawsuits these organizations encounter. In addition, the negative publicity associated with a public settlement of a lawsuit by an admission of guilt would create additional public relations damage. Defending the organization\'s innocence relies on evidence and proof that the company was not at fault. Many healthcare organizations vigorously defend against charges of malpractice or poor-quality care. Hospital leaders make public statements, prepare op-ed pieces for local newspapers, and respond in other media when the organization or one of its members has been falsely accused of a misdeed. Providing justifications includes creating reasons for the inappropriate behavior that lessen the negative impact. For example, a provider affected by a strike may note that it is less able to provide the quality of care that patients normally receive. Internet interventions involve monitoring information that circulates online, including discussions in chat rooms or on social media sites such as Twitter. The organization then works to set the record straight when false information is being passed through such outlets. However, most healthcare organizations do not have enough employees on staff to heavily engage in such activities (Needleman, 2009). Other explanations are those that suggest that a negative event was a single-time occurrence, such as one due to the actions of a disgruntled employee or an act of God, and that they will not happen again. In some rare instances, healthcare managers offer such explanations when an unusual image-damaging event occurs.