It’s likely that the number one push back against the ServingOverSelling movement from health system marketers will be against the rationale that you can reallocate your promotional marketing spend because the vast majority of the time it is ineffective and expensive, and therefore is a waste of time, energy and resources. Some will claim positive ROI from their efforts. Others will point to consumer sentiment shifts from a brand campaign. And there’s no doubt that as the field has matured, health system marketing leaders have become better at showing an impact from their marketing. But the truth is, even with all the results a CMO may be able to show, can she honestly say marketing drives material revenue or margin to her organization? If you can honestly answer yes, then you’re one of a select few that’s able to demonstrate that. But if the answer is no, as is the reality in the vast majority of cases based on my 25 years spent in health system marketing, then it’s time to open your mind to a better way to allocate that money.

While arguing that marketing drives impact would be the number one public pushback against ServingOverSelling, the number one unspoken issue with the movement is likely that it could cost a marketing leader her job. Many marketing leaders will believe, rightly or wrongly, that if they were to bring the principles of ServingOverSelling to their leadership, they would be shown the door. While we believe there are far better ways for CMOs to deliver value than through promotional marketing, this fear is totally understandable. Even if a CMO knows pursuing ServingOverSelling is the right and smart thing to do, if she believes that will threaten her livelihood, then we understand people need to do what they need to do. As an industry veteran, I left a high-paying job in health system marketing in large part because I grew disillusioned with the industry, especially when juxtaposed with the overall ills of our country’s healthcare system. But I’m also in my late 50s and could afford to step away from a lucrative career to pursue making the world a better place for all. Many people are not in that position and can’t afford to leave their job just to take a stand. And we get it.  

As we’ve stated elsewhere in making the case for ServingOverSelling, perhaps the number one driver of promotional marketing is the pressures that systemically exists to, well, promote ourselves. Whether that promotion actually solves for a business need or adds value in some real way so often seems not to matter. In so many cases, CMOs know what they’re doing is a waste of money or resources, but they have no choice because the organization is demanding it in one way or the other. And we understand to a degree – everyone should take pride in the work they do, individually, as a team, or as an organization. And nearly everyone I’ve met throughout my career entered the healthcare space because they genuinely believed in the mission of helping others. But somewhere along the line, many organizations seem to deprioritize their mission to serve patients and communities to support the intrinsic need to feel good about themselves. Spending so much money on promotional marketing primarily as a point of pride is literally putting our needs in front of those we serve. And at a time of a growing healthcare affordability crisis in this country, we need to work hard to change this dynamic. The hope is that the ServingOverSelling movement will shine a light on how we’ve lost our way and will help convince health system leaders that promotional marketing does little or nothing to help organizations, and how reallocating the time, energy and resources could benefit both their organization and healthcare in this country.

Another logical counter to the ServingOverSelling movement – if I stop my promotional marketing, my competitors will gain the advantage. That argument is logical if you believe that promotional marketing makes a meaningful difference for health systems. Back when I used to speak at executive retreats or to organizational leaders about the principle behind Joe Public Doesn’t Care About Your Hospital (which implores health systems to stop wasting money on expensive promotional campaigns because no one cares), I often heard this argument: “But everyone else is doing it. How can we stop?” What comes to mind first of course is the old parental challenge to peer pressure: “If your friends jumped off a bridge, would you do it too?” But my response to these health system leaders was different: “Great! They are literally lighting piles of money on fire through these ineffective campaigns. Let them!” So logically, if you agree with the premise that promotional marketing in the health system space is so often ineffective and a waste of money, then who cares if your competitors do it? But in reality, this will be an effective cudgel against the ServingOverSelling movement, because it provides at least the semblance of a business argument for continuing your promotional marketing. Our belief is that if your organization reallocates its promotional marketing spend to actually helping patients and those in the community, you will trounce your competitors when it comes to brand reputation. The challenge is convincing your organization that’s the case.

Over the past decade, I and many others have touted the idea of looking outside the healthcare industry to other industries, such as retail or CPG, for the latest and greatest marketing strategies. In that same vein, the health system space has seen an influx of CMOs from outside healthcare, from industries as broad as entertainment, airlines, retail and consulting. On the positive side, this “outside in” trend has helped advance the health system marketing field, especially in how it has adapted digital marketing, content marketing, and a greater emphasis on experience. But along with those positives has come some negatives. While it’s natural to criticize the idea that “healthcare is different,” the truth is, healthcare is different. For hospitals and health systems, the vast majority of their services are not – and will never be – demand driven. You will not motivate someone to have gall bladder surgery no matter how creative your ad is or how big your media buy is. The pricing mechanism is different, how patients make decisions is different, how consumers perceive hospitals and health systems is different. So while we can learn from other industries to advance the health system space, we shouldn’t assume we can adopt their practices wholesale. Probably the greatest example of this is performance marketing – using data to target segments and microsegments hoping to drive utilization. If Pepsi uses performance marketing to target teenagers with personalized messaging that drives them to pick up a bottle of soda on their way to school, great. But a health system targeting a consumer who has a propensity for lung cancer? How well does that work? What about an ad to the same consumer promoting a lung cancer screening? While that can drive demand for that screening, that also drives over-utilization of healthcare, one of the leading causes for higher healthcare costs in the U.S.

As we’ve mentioned elsewhere, the health system marketing space is only roughly 40 years old. In that time, it has grown from a cottage industry with small marketing departments and few marketing agencies with experience in the space to a massive sector spending roughly $10 billion on health system marketing collectively. There are a dozen national conferences each year on health system marketing, and dozens of state level associations across the country dedicated to the practice. Thousands are employed in the healthcare marketing space, and those small marketing agencies are now dominated by huge agencies, most with private-equity backing. All of that growth and expansion shows the legitimacy of health system marketing, right? Or in other words, how can 10,000 health system marketers and vendors be wrong? Well, as we argued in “The Case,” times have changed, and the health system in the U.S. is broken. And despite 40 years of progress, very few health system marketers would be able to show that promotional marketing actually drives material revenue or profits to their organization. I can’t count the number of times I’ve heard health system marketers lament the inertia in their own organizations as they struggle to affect change, the old “but that’s how we’ve always done it” excuse. So let’s flip that around – just because health systems have pursued promotional marketing over the past 40 years doesn’t mean it should be pursued going forward. “But we’ve always done promotional marketing” is the first excuse to wipe off the board if you’re resisting ServingOverSelling.