A proposal for the new role of the health system CMO
TLDR: Health system marketers shouldn’t just prioritize ServingOverSelling by dramatically cutting promotional marketing. They should replace those wasteful and ineffective strategies with The Serving Model, our proposed outline for the new role of the CMO. The Serving Model, which leverages the insightful Living/Thinking/Solving Moments framework, reflects the philosophy that health system brands are built based on what organizations do, not on what they say, and calls for replacing promotional marketing activities with meaningful actions focused on consumers, communities and patients.
Since the launch of the ServingOverSelling movement in late September, we have spent the bulk of our time on the latter part of that equation, calling out why selling patients and communities through promotional marketing is ineffective, wasteful, and should be reduced dramatically by health systems. Given the level of spend on these strategies – likely $3-5 billion annually across the industry – and the growing healthcare affordability crisis in the U.S., this is not only a smart approach for health systems, but one that’s ethically imperative.
But to truly effect change, it’s not enough to point out what’s not working. There has to be a different path laid out, a vision for a new and better approach. For a transformation to take hold, we have to engage in what a conference speaker I recently saw called “painting the beautiful tomorrow.” From launch, we have provided broad brush strokes of what “serving” should look like and where marketing leaders could reallocate their promotional spending to such strategies as consumer engagement, access or internal engagement. So let’s try to create a clearer vision, that “beautiful tomorrow,” with what we call “The Serving Model.”
The Serving Model
The Serving Model is based on the key philosophy that brands in the health system space are not built on what organizations say, but rather on what they do. How they show up in market in terms of helping the patients and communities they support. In many ways, ServingOverSelling is about prioritizing the support nonprofit health systems owe those they serve. If “owe” sounds like a strong word, remember that as a nonprofit organization that receives local, state and federal tax exemptions, your organization is obligated by laws and regulations to provide a level of support to those you serve. But this shouldn’t be a legal/contractual obligation, and in truth, it isn’t. Just pull up your system’s mission. What does it say? I don’t even need to know the specific wording of your organization’s mission to know it makes some level of commitment to patients, communities and other key stakeholders.
So as a nonprofit health system, you are obligated by both charter and mission to serve your patients and communities. But now consider that obligation as not just a commitment you have to keep, but also the best way to build and support a powerful brand. We will be spending more time later on why this is true, but for now, let’s consider the viewpoint of renowned philosopher Onora O’Neill, who, in a 2013 TED talk, spoke on the difference between “building trust” and “being trustworthy,” an essential distinction given that at the end of the day, the foundation of brand value is trust:
“What matters in the first place is not trust, but trustworthiness. It’s judging how trustworthy people are in particular respects. That’s what we’re looking for: trustworthiness before trust. Trust is the response. Trustworthiness is what we have to judge. Calling things ‘rebuilding trust’ gets things backwards. Trust is given by other people. You can’t rebuild what other people give you – you have to give them the basis for giving you their trust. You have to be trustworthy.”
So if you want to build a powerful lasting brand reputation, you have to be trusted, and to be trusted, you don’t communicate to build trust, you show up in ways that are trustworthy. Once again, brand – and trust – are built not on what you say, but on what you do. So what can that look like in practice?
Meeting Consumers Where They Are By Serving Them
For The Serving Model, we’re going to reappropriate a marketing framework that was first shared with me by friend and colleague Bjorn Gunnerud, currently Chief Strategy Officer at North Memorial Health in Minneapolis. That framework, what we’ve called the Consumer Relevance framework, is a great way to demonstrate the implications of key truths in the health system space such as “Joe Public Doesn’t Care About Your Hospital,” and was used to show how systems could engage consumers in key moments through relevant marketing and messaging. What’s great about this framework is that it allows us to leverage a proven way of thinking about consumers from a marketing standpoint to illustrate how marketers can replace selling with serving.
The Consumer Relevance framework reflects the consumer mindset relative to health systems in three critical “moments”:
The Living Moments – This is where consumers are living their lives – working, watching the football game with their family, walking the dog, going to dinner, and so on. They are not thinking about their health, let alone their healthcare. The last thing on their minds – and the last thing they want to even think about – is doctors and hospitals. The vast majority of consumers spend the vast majority of their time in the Living Moments.
The Thinking Moments – This is when consumers spend time thinking about their health, though not their healthcare. Maybe they didn’t sleep well last night and are wondering why. Maybe their knee is sore after a run, and they’re not sure whether they should ice it or apply heat. Maybe their blood sugar testing is running a little high, and they’re thinking about cutting back in their diet. In these scenarios, while consumers are considering how to improve their health or deal with a health-related issue, they are still not thinking about healthcare – that is, doctors, hospitals or health systems – because they don’t believe they need that level of intervention.
The Solving Moments – These are situations where consumers are actually seeking care. They’ve just found out they’re pregnant and need an OB. They think they might have Covid and are looking for an urgent care. They’ve been in a car accident and need to see an orthopedist or spine specialist about neck pain. Here, finally, in the Solving Moments, consumers want information on their care options, though most will simply seek care where they have before. That means very, very few consumers are seeking care from a new provider at any given time.
As mentioned, this framework was used to help marketers understand the most effective messages to use in any given situation. For example, it’s a waste of time to spend money on mass advertising for US News rankings, given the vast majority of consumers are in the Living or Thinking Moments and will not find that information relevant. And if a message isn’t relevant, it’s most likely a consumer will ignore or dismiss it. Instead, we encouraged trying to engage consumers with brand messages that were relevant to them in the Living or Thinking Moments, much like Kaiser Permanente did with its Thrive campaign over the years, which focused on living a healthy life. With the ServingOverSelling philosophy, however, the Consumer Relevance framework opens the door to an entirely new mandate for health system marketers.
Using the mantra of building brands based on what you do, not on what you say, here is how marketers can apply The Serving Model using this framework:
In the Living Moments
The focus here is on serving the community. Consumers in the Living Moments aren’t patients or even prospective patients, so health systems will fail if they try to connect around care. Systems should instead build their brand by showing up in the community:
Engage in, support and/or drive community health initiatives
Partner with nonprofits, charities and NGOs who are supporting the community
Support community nonprofit health clinics and facilities
Support the idea of “food as medicine” through community gardens, mobile pantries and food banks in the area
Support or invest in affordable housing near medical campuses, and/or offer lodging programs for patients who are frequently admitted or need short-term proximity
Partner with local schools through nursing, athletic training, mental health counseling and more
Support or initiate violence intervention programs
Produce authentic community benefit literature that goes beyond meeting legal requirements or couching discounted costs as “charity care”
Create hiring and training programs for the neighborhoods surrounding your facilities
Engage residents in community benefit ideas, resource allocation and communication
Become a community leader in times of emergencies such as heat waves, floods or other disasters
Advocate for community and patient care policies and funding through the press and engaging policy makers (e.g. Medicaid coverage, public health funding)
Create coalitions with other systems in the market to support these efforts collectively, helping paint a picture of health system collaboration rather than competition
Again, this is not about doing good deeds to virtue signal or land a news story about your activities, though some of that will happen naturally. But the goal in the Living Moments is to be there in your community, on the ground, helping however you can. Not only does that answer the “what we owe” imperative, it will build your brand by engaging with consumers in ways that are relevant.
In the Thinking Moments
Hospitals, health systems, physicians, nurses – you remain the most trusted source for health information in America. Your job in the Thinking Moments is not to leverage that trust to try to sell your services – at this stage, while health is top of mind for a consumer, they do not need (or do not believe they need) your services. So don’t waste valuable resources on promotion – instead stand up and apply your medical expertise to the health issues your community faces. Examples of ways to show up in the Thinking Moments include:
Initiate or collaborate on important public health campaigns, such as:
Chronic disease awareness and education
Health safety awareness (e.g. gun safety, helmet laws, etc.)
Behavioral change (e.g. STDs, social media addiction, etc.)
Combating misinformation (e.g. vaccine adherence, dangers of raw milk)
Healthy living
Free community health screenings and health fairs
Free or low-cost health education and community classes
Offer community lunch and learns or other events on important health topics focused NOT on uncovering “leads,” but instead simply to provide assistance to those who need it
Establish a free nurse line for anyone to seek advice, whether they are your patient or not
Maintain a free online health library translated into relevant languages applicable to your community
Provide web-based/AI tools for managing a healthier lifestyle
As consumers move from Living Moments to the world of health that is the purview of hospitals and health systems in the Thinking Moments, there is no better time to leverage your medical expertise and offerings to help community members live healthier lives. And again, a critical reminder: all of this activity and public communications is about them, not about you.
In the Solving Moments
Now, finally, when consumers are seeking care, it must be ok to promote your services and differentiation, right? To a degree, yes. The ServingOverSelling approach still allows for some promotional marketing where it can make a difference to the health system but also provides a service to the prospective patient, and that marketing exists here in the Solving Moments. Here is where it’s ok to have SEM running so those seeking care through search can find you; where it’s ok to tout awards and rankings on your website because those seeking complex care do value your credentials; where you can help people who reach out through social media find a specialist.
While these promotional efforts are still allowable under the ServingOverSelling philosophy, there is so much more a health system can do to help those seeking care in the Solving Moments. Once again, the key is in serving rather than selling.
Work across functions to ensure access is as easy as possible, such as implementing true online scheduling and same-day appointments
Help lead efforts to improve the patient experience, covering everything from parking availability to the friendliness of staff
Ensure signage and wayfinding are clear and effective
Provide support for those having to navigate insurance and prior authorizations
Provide clear and accurate pricing
Provide proactive financial support and funding information
Provide clear and accurate billing
Provide care navigators for those facing chronic conditions or complex care encounters
Provide or partner for transportation for those in need
Consider offering childcare for patients in need
Partner with internal staff to improve the care experience
The New Role of the CMO
We propose that the new role of the CMO should follow The Serving Model as outlined here. After reading the specific actions outlined using the Living/Thinking/Solving Moments framework, you may be thinking that most of them would not be ownable by the CMO. Billing, for example, or running a free nurse hotline, or investing in affordable housing. And that’s true – many of the actions cited above would require those beyond marketing to implement and manage. But the marketing leader is the perfect person to drive and orchestrate all of it. If one of the primary goals of the CMO is building a powerful brand, and we know that what a system does is the best way to build a brand (not what it says), The Serving Model is the best approach to building brand. Imagine if the typical $2 billion health system reallocated the $3-5 million it spends each year on wasteful promotional marketing instead to some subset of the above activities. Imagine the impact on the community, on potential patients, and on actual patients. Imagine the impact on the brand reputation.
Moving forward, we’ll spend more time on The Serving Model, covering such topics as why the CMO is the perfect leader of The Serving Model, how the model would build a stronger brand than promotional marketing, how to transition from the status quo to this new marketing role, and more. In the meantime, we’d love to hear feedback on The Serving Model, so let us know your thoughts.