It is just possible that marketing and brand are the most confusing words in the audiology vocabulary right now—our literature is becoming replete with discussions for different facets of marketing and brand. What do they mean? Are they real or hyped? Do they have value and purpose? Are the terms related, independent, or two words that mean the same thing? Who executes them? Do you get that uneasy feeling that they belong in the same realm as vaporware? Despite the confusion, neither marketing nor brand is a hot-air concept, and the meaning and merits of both terms are worth taking the time to investigate in depth. Just as we define psychoacoustic terms and their measurement, we can define marketing terms operationally and measure them quantitatively. And, in the same manner that theories of hearing relate to psychoacoustic definitions and measurements, so do marketing theories relate to a supporting structure of definitions, observations and measurements. The theory of Integrated Marketing Communications (IMC) elegantly explains the relationships of marketing and branding (Schultz et al., 1996). This article is the second in a series of four articles focusing on IMC and audiology practices. The previous article was written on the topic of Customer Relationship Management (CRM) and was published in July of 2006 on Audiology Online (Hosford-Dunn, 2006). The current article focuses on how audiologists can use IMC to give value and function to their own marketing and branding.
To begin, it is helpful to define some of the terms related to the quantitative evaluation of IMC:
Market: A group of people or organizations with needs and wants who are willing to spend their resources (time and money) to satisfy those needs and wants (Etzel et al., 2004).Accountants and the IRS refer to Brand Equity as "Good Will."
Marketing: It is a process. We use the marketing process whenever we create and make available what people with hearing and balance problems want in exchange for what they are willing to pay and do for it. We measure the results of the process by number of customers, sales, amount of profit generated, etc.
Marketing Communications (MC): This is an umbrella term for all communication avenues available for conveying marketing messages. These include advertising, public relations, sales promotions, direct response marketing, events, sponsorships, point-of-purchase materials, packaging, trade shows, customer service, and personal sales. MC is measured as the proportion of marketing dollars assigned to each avenue and the marketing return on investment (MROI) for each.
Marketing Mix: The MC elements used by a particular audiology practice, measured in marketing dollars and MROI.
Brand: It is the total collection of perceptions and associations (good, bad, and indifferent) that differentiate an audiology practice from its competitors. Brand is measured according to the equation:Brand Equity = Practice Value - physical net assets
Integrated Marketing Communications (IMC): Another process. IMC is the organization, planning, and monitoring of marketing components and data to control and influence brand information, associations, and experiences. The goal is to incubate profitable relationships and dialog with patients and other groups. This is typically measured by internal and external surveys, focus groups, managerial accounting, trend analyses, referral indices, etc. The IMC Model
"IMC builds the relationships that build brands." (Duncan, 2002).It is impossible to talk about IMC without talking about brand. That is because brand building relies on creation and nurturing of profitable relationships to meet objectives, which is the goal of all IMC processes. IMC devises strategies to use MCs to create and build brand for individual audiology practices. IMC has important characteristics (Figure 1), the discussion of which constitutes the body of this and other articles in the four-part IMC series.
- continuous and circular, with no beginning or end as long as the practice is alive.
- data-driven, using information collection and feedback from Customer Relationship Management (CRM) technology to develop messages and dialog with target markets.
- customer-centric, focusing on target market needs and wants rather than on specific products and technologies.
- strategic, creating a consistent meaning in all messages and dialog.
- nurturing, "growing" customers by finding new ways to increase their satisfaction.
- profitable, focusing on lucrative relationships to make them more worthwhile.
- integrated, ensuring that all messages and all personnel work together to speak with one voice.
- accountable, viewing marketing expenditures as short and long-term investments to meet objectives (MROI) rather than expenses to be minimized (Etzel et al., 2004).
- independent of any specific marketing mix, recognizing that each practice is unique.
Figure 1. IMC process is circular and data driven, using database information to link consistent and continuously refined messaging and dialog with target markets in an accountable manner. IMC can use any mix of MC components (center box), depending on the audiology practice.
The nature of the relationship-building process between audiologist and patient lends itself to the database-driven IMC process. This IMC step was covered in detail in a preceding paper (www.audiologyonline.com/articles/article_detail.asp?article_id=1630) that described the architecture and application of CRM software to audiology practices (Hosford-Dunn, 2006).
A good database management system serves as a practice's lifeblood. Without such modern technology that encompasses a comprehensive memory for detail, the practice cannot stay focused on customers and become "customer-centric" in the true meaning of the term. As audiologists come to know their patients, their lifestyles, family, and friends, they acquire much valuable information that can be stored in a CRM database for future use. Capturing and using this highly individualized data in a secure, structured framework is beneficial for both the patient and the practice. Measures of accountability and performance are readily available using CRM software. Such measures are part of the database-driven aspect of the IMC process.
"If I'd asked my customers what they wanted they would have said a faster horse." Henry FordIn the true nature of a circular process, new products are not created and then sold to waiting markets; ironically, the opposite is true. Markets create products, but often do not realize needs or recognize wants until products appear. This puts a completely different spin on the idea of targeting markets. Products do not find markets, markets find products. It is our job to make those products appealing in the first place.
"Talent hits a target no one else can hit; genius hits a target no one else can see."
Arthur Schopenhauer Quotes from The Week, August 26, 2006.
In audiology, we often consider our market to be everyone with hearing loss, roughly 34 million people in the United States (Ahlman, 2006). However, a market consists of people who not only exhibit a need, but also an active readiness to expend resources to satisfy that need. Thus, in the present audiology reality, we represent a "product" to a considerably smaller segment, consisting at present of some portion of the 20% of people with hearing loss who are interested in doing something about it. That is not so bad, considering that there are only about 12,000 audiologists in the United States and 6 million people with hearing loss who are seeking and obtaining evaluations and amplification. Hypothetically, if audiology captures just half of that market segment and fits them successfully with binaural amplification at an average retail price of $1,600/aid, every 4.6 years (Kochkin, 2005), that translates to about $350,000 in annual revenues plus diagnostic income per practitioner. Such estimates suggest that we can look forward to a better return on investment for time and dollars spent on audiology training and education than most audiologists presently realize (Smriga, 2006), especially if we can expand our penetration of existing and potential market segments.
Data-Driven Messages for Building Brand Awareness
Ironically, audiology's low profile enables excellent opportunities for defining its brand. "Hearing aids," "digital hearing aids," and even "hearing aid dealers" are generic terms denoting commodities rather than unique products in the public's perception. Trying to differentiate this terminology to consumers is extremely difficult and expensive. The same is not the case, however, with "Audiologist" and "Doctor of Audiology" as long as we target our markets with care (c.f., Foltner & Mansfield, 2006). Used properly, these words carve out a brand for our profession and go a long way toward building awareness in markets that value professional expertise, university training, reimbursable services, and ethical behavior. In addition, our tiny aggregate makes us a rarity, which offers up another branding opportunity; only about 12,000 people in the United States can present themselves in print or any other media as audiologists, and a smaller subset can present themselves as Doctors of Audiology. We now have the seeds of our professional message, but how do we differentiate ourselves from one another in the market's mind?
Crafting the Message
"If the differences do not exist in the patients, they do not exist in the marketplace." (Staab, 2000).So far, it seems as though it is great to be an audiologist, but individual audiologists and practices must create market awareness of their unique attributes by strategic messaging if they hope to build sustainable brands. Building brand awareness is not as easy as it sounds, and this is where IMC begins to prove its worth by stressing database analysis, message control, and careful monitoring of market feedback. To start messaging strategically, you must analyze your target market as well as yourself to hone a message that consistently and unambiguously says "you and no one else" to your market. What is your product? How does it differ from other practices' products? Can your target market see the difference? Can you?
Audiologists often answer these questions by falling back on professionalism, "highest quality," and "caring" as their primary, customer-centric message. In a competitive marketplace, these intangibles are too generic to constitute a message that unambiguously represents "you." It is doubtful that there are any audiologists that want to send a message of "medium quality". Therefore, how can consumers compare across professionals if they all claim to be of the "highest quality" and who "care"? At best, it is a zero-sum game. Such superficial messages may even backfire. You and your staff in white lab coats may prompt consumer associations with laser hair removal technicians in the mall, portable labs, and nail technicians; a "We Care" slogan can link you to the car dealer down the street who also "Cares" if you are not careful and purposeful in the delivery of your message.
In general, consumers use tangible attributes to decide whether products differ and intangible attributes to decide how they differ (Duncan, 2002). For example, Pepsi and Coca-Cola expend vast advertising dollars annually to capture the top spot in consumers' minds. Their tangible product similarities far exceed differences, yet consumers express strong preferences for one brand or the other. This is largely due to consistent, repetitive, and targeted advertising messages linking Pepsi and Coke to intangibles, such as lifestyle choices and other emotion-evoking images which appeal to consumers.
The Relevance Factor: What is in it for me?
"...keep the consumers' joy and pleasure front and center when it comes to positioning [your] brands, developing marketing messages and designing [your] products."Think about the lifestyle choices of your target market and how you can become part of those choices. The following questions may help you determine the integrity of your marketing strategy as you consider your target market: Does your message appeal to consumers' self interests? Does your target market consist of older people whose schedules may already be overwhelmed by doctors' appointments? Are there ways you can make their visit with you different and enjoyable, compared to what they experience in other offices? Are you targeting working baby boomers? Are there ways you can make them feel "with it?"* Are there ways you can streamline the process for these busy folks? Are you targeting luxury consumers who insist on "experiencing" quality? Are there ways you can give them such experiences? Within that segment, do you want to capture the younger, affluent market, 52% of whom rank spending money to increase their personal enjoyment and pleasure as a top priority? (Table 1). Bottom line: the higher the relevance of your message, the more likely your target market will be to think about facts presented by your brand (Petty et al., 1983). Although hearing aids are not included in luxury item categories at present, there are good arguments for considering them as such: they are expensive, they are selected by only a small percentage of those for whom they are intended, and they are melding into designer-packaged personal communication devices that work seamlessly with other wireless communication devices. A quick look at Table 1 suggests that our tangible products, combined with our expertise and relative rarity, make for good packages to attract luxury consumers.
(Pam Danziger, Unitymarkingonline.com, 2006).
Table 1. Ranking of a range of motivators that drive luxury consumers in making luxury purchases. (Unitymarketingonline.com, 2006)
You must do market research and formulate meaningful answers to questions of this type to develop your own message. In my case, my target group is narrow and my message is simple: "Celebrating Life with Better Hearing." I seek out patients of all ages who are passionate about living enthusiastically. The message they get from my office is that we will do everything in our abilities and training to help them continue to realize their passions. As part of that message, we want to ensure that every minute they spend in the office is fun, productive, educational, memorable, and unique. What is your message? How do we get our messages out there to build awareness?
Advertising is a common means of building brand awareness. Often referred to as TOMA (top of mind awareness), this component of the marketing mix sends a "one-way" message to a mass audience. It is especially important for new practices or locations, which must first make target markets aware of their existence, to continue reminding the market of their existence so that they remain fresh in the paying consumer's mind.
"Too much of today's "marketing," ... is based on...hearing aid technology.... Without a program to make oneself unique in the patients' minds, technological superiority alone no longer guarantees success or even a position in the race...If what you are offering is not perceived by the patient as having added value, it is considered a commodity." (Staab, 2000).Start-up audiology practices face a major advertising quandary when developing a brand message and building brand awareness. They can follow the colas' lead by investing precious advertising dollars into raising brand awareness of their unique, but intangible, message. Or, they can advertise a tangible product (hearing aids) to achieve a quicker ROI and try to introduce customers to their brand message once they are in the door. The former sacrifices cash flow; the latter sacrifices professional integrity. Not surprisingly, IMC process argues against the latter because it diminishes brand by sending a conflicting and inconsistent message ("Come get a hearing aid from somebody in a white coat."). IMC argues for the slower, long-term brand-building approach, as part of an affordable marketing mix that sends a consistent message of how the practice is different from its competitors; namely, how it addresses its target market needs and wants better than competitors.
An excellent example of building brand awareness by way of advertising is demonstrated by the Holiday Inn Express (HIE) hotel chain advertising campaign (Fallon & Senn, 2006). HIE entered the limited-service hotel market as an unknown entity with a small advertising budget, overshadowed by Marriott and Hampton Inn. Deciding to "outsmart instead of outspend," HIE narrowed its market to road warriors, or "drive ups", capitalizing on the belief that experienced travelers do not make reservations, priding themselves on their savvy ability to find the best lodging deals. HIE advertising created a "Stay Smart" brand, linking staying at its hotels to an intangible feeling of superiority ("Staying at a Holiday Inn Express will not make you smarter, but you will feel smarter"), which quickly differentiated HIE from its competitors, creating a strong brand and a loyal following. In our profession, we can only hope that we raise our brand awareness to the point that a future HIE ad runs along the lines of "Wow, are you an audiologist?? No, but I did stay at a Holiday Inn Express last night." Better yet, you or I can hope to craft our own messages so effectively that a future HIE ad finishes with, "Wow, are you [your name goes here] the audiologist?!" If Martha Stewart can do it, why not one of us?
Controlling Consumer Brand Knowledge
Regarding Martha Stewart, only the most determined hermit can remain unaware of her brand's fluctuations in goodwill and credibility in recent years. It is a good illustration of the difference in Public Relations (PR) and Marketing Public Relations (MPR). The former monitors public opinion and manages relations between the company and its stakeholders, and the latter seeks publicity to communicate and increase brand credibility. Both build awareness, but not always with the same effect. In the Martha Stewart example, PR worked to gain control over negative public opinion by minimizing publicity, while MPR was (and remains) busy controlling the message through positive, on-message news releases, featured stories, links in mass media, and media kits. The relative success of MPR depends on the practice's relation with the media, which can be positive or negative, resulting in being in the news or being ignored
PR for audiology practices often takes the form of good deeds (associating with local charities, volunteer boards, service club memberships), professional endeavors (state and national agencies and organizations, educational writings, teaching, awards), or expertise (medicolegal, OSHA programs, industry advisors). A practice's success in publicizing its positive PR efforts constitutes its MPR. Thus, working at the local food bank and chairing the Lions program for hearing and vision screening generates multi-linked PR when your captioned picture makes it into the local paper (Local Audiologist Works for Food, Lions, and Children), and can be an even larger MPR triumph in building brand awareness and credibility when the publicized message is strategically controlled ([your name here] Selflessly Leads Health Professionals in Fight to Conquer Hunger and Hearing Loss... article on page 1). The example is tongue-in-cheek, but effectively illustrates the importance of using IMC to craft and control all out-going messages to the practice's public by turning PR into MPR whenever possible.
Customers: Acquiring Brand Knowledge
In addition to media publicity, MPR works to involve other stakeholders (yet other target markets) as well:
- Being tapped as an expert adds value to your brand. Media look to the practice not only for advertising revenue and features, but also for explanations and expert opinions when preparing investigations and stories.
- The local community relies on local businesses for tax revenue, jobs, and boosterism. Participation in local service clubs, volunteer boards, Better Business Bureau chapters, Chamber of Commerce, etc., are means of spreading your positive brand message.
- A positive brand position in the community influences the financial community's perception of the practice, thus giving it a financial competitive advantage.
- Special interest groups such as the Hearing Loss Association of America (HLAA, formerly SHHH) can become valuable source of positive word of mouth brand messaging;
- Competitors can become valuable allies in support of state or local legislation favorable to audiologists.
IMC is a strategic marketing model for using some or all aspects of Marketing Communications to build a strong brand through consistent, interactive communication between audiology practices and their target markets. IMC is neutral insofar as MC functions are employed, but this article has used advertising, PR and MPR examples to illustrate use of different MC functions to in meeting IMC strategic goals for targeted markets.
IMC focuses on building brand by creating databases that continuously monitor and respond to market needs as relationships are fostered between practices and their patients. As with all marketing, the goal of IMC is to maximize profitable transactions; furthermore, IMC is strategic in searching and selecting premium long-term relationships to simultaneously build premium brands while maximizing profitability. Identifying profitable relationships and building on them is the topic of the next article in the IMC series.
* As a member of that market segment, I can say absolutely if an optometrist had a message I perceived as "read fine print and pluck my eyebrows like I did when I was 20," I would be lined up in front of their office at dawn. Think of the hearing messages audiologists could send out to this group, now that hearing level devices, cell phones, iPods, and PDAs are converging!
This article, focusing on strategic messaging to build brand, is the second in a series of four papers examining Integrated Marketing Communications (IMC). The series was written by Dr. Holly Hosford-Dunn, an Audiology Online Contributing Editor in the area of Practice Management. The first article in this series, focused on Customer Relationship Management (CRM), was published in July, 2006 on Audiology Online and can be accessed via the Articles Archive or directly by the following URL: www.audiologyonline.com/articles/article_detail.asp?article_id=1630
Ahlman, M. (2006). Road to Audiology Oz. Advance for Audiologists, 8(5), 68.
Duncan, T. (2002). IMC: Using advertising and promotion to build brand. New York: McGraw-
Etzel, M.J., Walker, B.J., & Stanton, W.J. (2004). Marketing (4th Ed). New York: McGraw-
Fallon, P. & Senn, F. (2006). Juicing the Orange: How to turn creativity into a powerful business advantage. Boston: Harvard Business School Publishing.
Foltner, K., & Mansfield, B. (2006). Branding audiology: It's a budding opportunity. The Hearing Journal, 59(5), 41-44.
Hosford-Dunn, H., Dunn, D., & Harford, E. (1995). Audiology business and practice management. San Diego: Singular Publishing Group.
Hosford-Dunn, H. (2006, July 10). Integrated Marketing Communications (IMC), Part I - CRM: The Ginsu Knife for Marketing. Audiology Online, Article 1630. Retrieved October 18, 2006 from the Articles Archive on www.audiologyonline.com. Direct access URL located at: www.audiologyonline.com/articles/article_detail.asp?article_id=1630
Kochkin, S. (2005). MarkeTrak VII: Hearing Loss Population Tops 31 Million. The Hearing Review, 12(7), 16-29.
Petty, R.E., Cacioppo, J.R., & Schumann, D. (1983). Central and peripheral routes to advertising effectiveness: The moderating role of involvement. Journal of Consumer Research, 10(2), 46-153.
Schultz, D.E., Tannenbaum, S.I., & Lauterborn, R.F. (1996). Integrated Marketing Communications: Putting It Together & Making It Work. New York: McGraw-Hill.
Smriga, D.J. (2006). For audiology, dentistry offers a good model for preserving independent private practice. The Hearing Journal, 59(9), 36-44.
Staab, W. (2000). Audiology: Practice Management. In Hosford-Dunn, Roeser, & Valente (eds). NY: Thieme.
Traynor, R.M. & Holmes, A. (2002). Personal Style and Hearing Aid Fitting. Trends in Amplification, 6, 1-31.
Unity Marketing. (n.d.) Tracking What the Affluent Consumers Buy and Spend Every Quarter, Plus How They Feel. Retrieved August 29, 2006, from www.unitymarketingonline.com/reports2/luxury/luxury3.html