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C ommercial manufacturers and retail chains aren't the only ones looking lor new business opportunities overseas, A number of savvy healthcare organizations are expanding their medical programs to draw more international patients. Healthcare providers that can do this successfully will find their investments can make good economic sense and the rewards can be significant.

Despite recent world events, which have caused many individuals to cut back on international travel and made it tougher for many foreigners—especially in certain parts of the world—to gain access to visas or wire money between countries, there are more people seeking healthcare abroad than ever before,

U,S, medicine has long been held up as a standard in other countries. Despite the problems in our own healthcare system, hundreds of foreign healthcare professionals come to the United States every year to train. In addition, foreign governments rou- tinely study U.S. models and approaches to medical care, and thousands of patients seek care v âthin our healthcare facilities. More recently foreign countries have been borrowing our ideas for managing health insurance, applying new information tech- nologies, and encouraging competition within healthcare. To many outside U.S. bor- ders, the United States maintains a sterling reputation for having highly trained physicians, state-of-the-art medical equipment and facilities, high customer service standards, and shorter wait times.

U.S. healthcare providers can benefit from serving international patients in a number of ways. For starters, national and international recognition can come from serving patients from across the globe, and certain countries, regions, and referral sources can encourage new loyalty The severity and complexity of medical cases can be rewarding, as can maximum reimbursement. All of these combined create a strong incentive for healthcare providers to court foreign consumers and their interest in U.S. medical care.

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Location is just one of several factors driving success in international patient marketing. Major U.S. cities and ports are key geographic draws for international patients who may find it easier to get in and out of the country at these locales. Tourist areas and major attractions will also draw foreign tourists who may need medical care while they're in the United States and who are marketing targets for future medical care. Likewise, large tertiar}' medical centers and teaching hospitals are always going to have a competitive advantage, as are healthcare sys- tems that have built national and international brands-

International Strategies What factors have been important in the success of those

organizations that have made inroads in the international market? First of all, having an international brand reputation can give global marketing efforts a boost. The Mayo Clinic, which boasts 10,000 patients annually from 120 countries, and Johns Hopkins, which boasts 7,000 patients annually from 90 countries, are two examples of internationally recog- nized brand names. These organizations work hard to build and maintain their brands internationally while they market to international patients.

Having internationally known physicians on staff also can help a health services organization break through to the inter- national market. Many organizations attract foreign husiness through the work of key physicians and surgeons. These prac- titioners—-who may come out of research, clinical care, or even teachmg settings—typically bring public awareness and referrals to key service lines.

Finally, internationally recognized clinical expertise is an important factor. Think M.D. Anderson or Memorial Sloan- Kettering for cancer care or HealthSouth for physical rehabili- tation. Through a combination of brand awareness, physician expertise, and coordinated clinical care, these organizations have built national and international reputations for tbeir expertise in particular areas of medicine.

While having an internationally recognized brand is a dis- tinct advantage, hundreds of lesser-known healthcare organiza- tions are attracting foreign patients to their facilities as well- So whether your organization already enjoys a large base of inter- national business or is currently building an mtemational pro- gram, having a detailed business strategy and a solid marketing plan are critical- In fact, unless you happen to be one of the top-tier medical centers with a highly recognized brand name tbat wil! automatically attract international interest, marketing is crucial. Those institutions can afford to spend less money on aggressive marketing and advertising programs because they can fall back on their well-known names to attract referrals and patients. Smaller, less well-known medical centers, which com- prise the bulk of U.S. institutions, must invest more to generate awareness and referrals to their programs.

Standing out in a Crowd Marketing lo international patients means more than just

offering a little information in Spanish on your Web site. It

requires a dedicated business effori with operational and clini- cal support throughout the organization. Assuming you can build a team that will focus on the special needs of these patients, a number of general marketing and communications strategies may help build your reputation, draw attention to your services, and attract new patients.

First of all, it's important to create a Web site that address- es international patients. While the Web isn't the answer to international marketing, it is a critical component of a good marketing program for ob\ious reasons. Organizations that have built successful international patient programs steer patients to dedicated Web sites, offer multiple languages, and provide support services and dedicated staff to assist prospec- tive patients. Mayo offers customized forms (e.g., need a Turkish International Appointment Request Form?) on its Web site, which also link back to information about the offices of their overseas representatives. That level of detail and customization ultimately sets Mayo apart from the hun- dreds of other medical centers that simply send a much broader and less targeted message abroad.

Having a well-trained call center and support staff also helps marketing efforts. Johns Hopkins maintains an International Patient Services group through its Johns Hopkins International (wvvu'.hopkinsmedicine.org/interna- tional) division, with staff that can coordinate all aspects of a patients care, including travel, cultural, and personal needs. The Cleveland Clinic Intt^rnational Center (www.cleveland- clinic.org/ic) coordinates much of The Cleveland Clinic's for- eign business and patient contacts. Other providers offer per- sonal interpreters, travel and scheduling services, and call center operators to answer toll-free numbers.

Another strategy is to have internationally based sales rep- resentatives and field offices- Some organizations, such as The Cleveland Clinic, maintain overseas offices as a way to deliver quick, customized information and services to specific mar- kets. Mayo maintains intemational representative offices in Turkey Mexico City, and the Middle East- While maintaining representatives abroad may seem like a significant expense, the continuity of marketing contacts and referral channel management may be well worth the investment.

Hosting tours for international business, consumer and civic groups is another way to showcase your facilities and services to potential healthcare audiences. Often these tours can be arranged through your local chamber of commerce or other business and higher education groups and univer- sity contacts-

U.S. physicians and other healthcare providers who travel abroad often help establish local contacts, referral sources, and future business for their organizations. These efforts can be built around exchange programs, mission trips, or educa- tional conferences. In addition, medical schools and residency programs that train foreign physicians can serve as important links to international referrals. Maintaining active alumni and graduate programs is an important strategy for opening the door to foreign patients.

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Likewise, many foreign physicians come to the United States on short trips for the purpose of continuing medical education programs. These doctors represent possible referral sources for new patients and complex cases as well. Referral development should be a key strategy for any provider look- ing to attract international business.

U.S. companies with international operations and foreign companies with U.S. operations may also be sources for mar- keting to international patients. Many healthcare providers have relationships v^th companies in their local markets but never explore the prospect of leveraging those relationships to reach foreign patients.

It's also a good idea to coordinate with foreign government offices. The U,S Embassy in Madrid (www,embusa.es/medical/ indexen,html) features a link on its homepage to U,S. medi- cine. The site lists several hospitals from U.5 News & World Report's America's Best Hospitals rankings as well as advice on how lo contact U.S. healthcare providers. (According to the site; cancer and ophthalmology are the two most requested service lines.) U.S. providers might work with foreign offices to place their names on referral lists as well as meet important diplomats and other government and social contacts.

Another strategy is to establish pannerships with chambers of commerce, economic development groups, and other healthcare providers. A growing number of communities are building sister-

public relations and media relations can also help draw inter- national attention to your organization. But this should be more than the occasional press release. !t requires a dedicated public relations program that will work with foreign and domestic journalists to develop and place story ideas, conduct media tours, and position the institution and its caregivers as key information sources.

Another advantage of the Internet is the number of inter- national medical directories that have sprung u p to help fun- nel referrals to healthcare organizations that pay to be listed on these services. Medical Resources USA (www.medicalre- sourcesusa.com) is one example. But marketers should be careful to research the sites, ask for details on how they pro- mote themselves and check with current advertisers to see how worthwhile their listings have been.

The Future Given the growth of the global economy and the United

States' reputation for healthcare excellence, it's only natural that more U,S. healthcare businesses will explore ways to market to international patients. While the United States' Canadian and Mexican neighbors already provide a steady flow of patients to U.S, healthcare facilities, many providers are finding a rich source of patients in Europe, Asia, the Middle Fast, and other parts of the world as well.

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Marketing to international patients means more than just offering a little

information in Spanish on your Web site.

city programs, marketing overseas, and targeting foreign investors. Healthcare providers should look for ways to paitner with these organizations to expand their reach and exposure. One innovative approach, called Philadelphia International Medicine (PIM) (www,philadelphiamedicine.com), began in 1998 when 10 healthcare organizations in the greater Philadelphia area formed an initiative to focus on attracting and serving international patients. PIM, which serves as a central point of access for intemational physicians and patients seeking care in the United States, combines the marketing resources of a number of providers in a way no single facility could do as effec- tively According to Leonard Karp, executive vice president and COO for the organization, its success stems from several factors, including senior management huy-in and support, one-on-one relationship building, and excellent customer ser\ice, which results in strong word-of-mouth referrals from previous patients.

In some cases, running ads in foreign publications and media outlets may make sense and help generate inquiries and leads to intemational patient programs. While healthcare providers don't need to throw money at just any intemational publication, paid advertising and direct marketing as pan of a coordinated mar- keting and communications effort may be a good investment.

Highlighting recent successes, medical breakthroughs, new technology, and exceptional physicians through coordinated

And other healthcare organizations—not just hospitals and physicians—are discovering investment opportunities abroad. U.S. health insurers, home health companies, medical manu- facturers, and healthcare technology companies are all experi- menting with exporting their expertise and products while importing new sources of revenue and growth.

Competing in a global healthcare environment takes more than simply a desire to serve foreign consumers. Those institu- tions and companies that are successful today have been work- ing at it for decades and have learned what works and what doesn't. And with a growing number of U.S. organizations (as well as other international healthcare groups) competing for the same business, U.S. companies will have to work harder to differentiate themselves. Promoting quality or advanced tech- nology doesn't mean much when 10 other organizations are doing the same. Identifying and marketing attributes that truly make an institution or medical program unique will be the key to future success in a crowded healthcare marketplace. MHS

About the Author Daniel Fell spearheads client service and marketing com-

munications efforts for Daniel+Douglas+Norcross, a Chattanooga-based marketing firm. He may be reached at [email protected].

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