The easiest way to put ServingOverSelling is straightforward: reallocate money, time and energy from anything where the sole purpose is to sell your audience on your organization, your services, your doctors, whatever. If the only value to the audience is learning about your organization or why you’re better, that’s “promotional” and you can likely do without it. (See “The Case” to understand why). Another qualifier here is what we term “proactive” promotional activities – those marketing efforts where you spend money to reach out to your audience to sell your organization’s services. For most organizations, that’s the bulk of their advertising spend. Where it still makes sense to dedicate resources while adhering to ServingOverSelling principles is with what we term “reactive” marketing efforts. Those are efforts designed to engage audiences who are actively seeking you out. In those cases, there’s value in helping them understand what you offer and how to best seek care. See the “What stays” section below for more on this.

It’s probably fair to say that the majority of promotional marketing issued by health systems is not to support true business strategy but instead because of pressure coming from inside the organization. Take US News and World Report rankings. Most CMOs know there is little to no value in promoting these, yet across the country, when the new rankings hit in July, health systems have a temporary loss of sanity, spending huge sums to promote high rankings, or spending huge sums to promote their organizations to overcome poor rankings. But of course, it’s not just US News promotional campaigns that are frivolous from a business standpoint. Brand campaigns, service-line campaigns, advertising promoting new facilities, Super Bowl ads, sports sponsorships – these are all too often driven by internal pressures. Of course, everyone should take pride in the work they do, individually, as a team, or as an organization. But when that pride overrides effective business practices – especially in the face of a growing affordability crisis in healthcare – then it’s time to address this systemic issue. If the industry could convince itself to only support marketing efforts that make real business sense, we’d likely see a dramatic reduction in promotional marketing efforts on day one.

Another way to determine whether your promotional marketing effort should stay or go is whether you’d feel comfortable defending it to a room full of patients who demand to know why you’re spending money on such an effort. This goes back to the mantra “stop selling your audiences and start helping them instead.” The excuse that your brand campaign or service-line marketing is necessary “because consumers need to know what services we offer” no longer holds water and honestly hasn’t for years. If someone wants to figure out where to receive care, do we honestly believe they seek out, see or even value health system advertising? They will talk to friends and family, they will talk to a physician for advice or a referral, they will use tools provided by their insurance company, they will search online, they will review websites, they will ask AI. Promoting your organization or services is selling your audiences, not serving them, and that rationale will not stand up in the court of public opinion. As healthcare costs continue to climb in this country and more people face financial hardship just for receiving care, there will be more scrutiny of how health systems spend their money. Any potential positive brand lift from your pro sports team sponsorship will be overshadowed by one media story citing the $5 million cost of that sponsorship. If you can’t look a patient in the eye who is struggling to pay for their care and explain why your organization spends millions on promotional marketing instead of using those resources and energy to help patients instead, then that promotional marketing should probably go.

Just because we’re calling for reallocating promotional marketing spend – including brand campaigns – doesn’t mean brand doesn’t have value. In fact, your brand may be one of the most valuable line items on your balance sheet. The problem isn’t brands per se, it’s how health systems go about trying to build brands. For years, brand experts – including myself – have espoused the idea that brand reputations in the health system space are built on what you do as an organization, not what you say. The experience you deliver, the clinical excellence you offer, access to your services, etc. – all of that is what matters. Why? Because word of mouth and physician referrals are top influences on consumer choice and those are driven by experience you deliver (other influences, such as a patient’s connection to an existing provider, proximity and in-network coverage are next to impossible to control). So spending millions on a campaign to “build your brand” is a backwards approach at branding.  

 As is believing you can change your organization’s brand experience through a marketing-driven brand strategy, or worse yet, a promotional campaign. Early in my career in health system marketing, a hospital client was struggling from a poor reputation in their orthopedics department due to a difficult physician group and a poor patient experience. The CMO shared that the CEO had come to him and declared: “We need to fix our reputation – you need to run an ad campaign.” The experience your organization delivers is based on leadership, strategic decisions and investments, your organization’s mission, vision and values, your culture, how you treat your workers, etc. The idea that marketing will come up with a promotional campaign or brand strategy that impact the reality of the experience in some way is fruitless.

The stock approach for most health systems when it comes to marketing is to hire an agency of record to develop research, strategy, and creative for promotional campaigns, along with execution and production. Reallocating your promotional marketing spend likely eliminates the need for such a massive expense. Further, consider that even 5 years ago, the health system marketing vendor space was dominated by small to mid-size firms. Today, the two largest firms dedicated to health system marketing have or had private equity backing, with a third private-equity backed agency entering the space in 2025. I subscribe to the belief that private equity brings all kinds of negative impacts to the U.S.. Whether you agree with that sentiment or not, there’s no arguing that PE’s number one goal is making money, typically through driving “efficiencies” and raising prices. That means the largest health system marketing firms in the space are driven solely by profit and will continue to increase pricing to help achieve it. Given the advances in AI, which can reproduce much of what a full-service agency can do for a fraction of the cost, and adhering to ServingOverSelling, ending your agency relationships is key to reducing your promotional marketing spend.