The Doctor Is Out--Shooting A Commercial

By ADAM COHEN

There's a scary moment during tonight's WCW Thunder wrestling program: a referee collapses and is rushed to the hospital. He's not part of the show. He's a football ref, and he's in a commercial touting University of North Carolina Health Care. Channel surf in Raleigh-Durham and you can see an artsy black-and-white ad featuring a country singer who doesn't have the usual complaints of "heartbreak"--brought to you by the WakeMed hospital's new Heart Center in Raleigh. Or a Duke ad--the sort of tasteful, care-focused spot you'd expect from a prestigious academic hospital--in which the real-life doctors featured just happen to be a hunky, ready-for-ER specialist and a looker of a female general practitioner.

Even if you don't watch much TV, the hospital marketers will find you. You may open your mailbox and find one of Duke's slick, multicolored brochures. Or you may visit your kid's school and have to shoo away Twinkle, WakeMed's man-in-a-plush-yellow-star mascot, who brings joy to the hearts of youngsters--and (not incidentally) stirs up business for WakeMed's Children's Center.

Has it really come to this? An institution of Duke's caliber forced to sell itself like toothpaste? Indeed it has. Long gone is the day when Marcus Welby hung up his shingle and started calling "Next" into a waiting room full of patients. People no longer just go to the closest hospital or the one their parents went to. They're reading articles and surfing the Web, and looking at quality rankings. And smart hospitals are out there hustling to win over these skeptical consumers. In the trade, that means having a marketing strategy.

Two years ago, Duke brought in a sales-minded Texan to yank it into the new era. Alvis Swinney, vice chancellor of business development and marketing, works on everything from pricing strategies to focus-group studies of how people choose a hospital. But he's also known for wandering the medical center and advising doctors to upgrade their waiting rooms.

Swinney's focus groups have shown that consumers already believe that Duke has the highest-quality medical care. But many people regard it as off-putting--a place you'd go only if you were very sick. Duke responded by adopting the slogan BRILLIANT MEDICINE THOUGHTFUL CARE to reassure patients that Duke doctors really do care about their patients. And they put real doctors front and center in their ads--not just on television but in print and on billboards at the airport.

For patients, this focus on the customer can be refreshing. Duke and its competitors are listening to patients and giving them what they want. WakeMed's new Heart Center includes an attractive built-in hotel that allows families to stay in the hospital while the patient undergoes surgery. Duke has shifted its primary-care physicians out of the main building to satellite locations, since focus groups show that patients want street-level parking when they visit doctors they see regularly.

These days one of the highest priorities for Duke's marketers is making the medical center's recent acquisition of Raleigh Community Hospital work. Raleigh is the most populous city in the area--more than 60% larger than Durham. Even though Raleigh is a mere half-hour drive to the east, Duke had only about 3% of that market. Since luring Raleigh residents to Durham would be hard--marketing studies showed people like to get routine medical care locally--Duke decided simply to commandeer a Raleigh hospital and use it as a base of operations. Today, only half in jest, Duke administrators refer to Raleigh as the "Eastern Front." The war for market share between Duke, WakeMed and a third, the private institution, Rex Hospital in Raleigh, is heating up.

High on the list of things keeping Swinney up at night are "carve-outs." These are private medical clinics--like Cancer Treatment Centers of America--that compete for a specialized piece of the business and threaten to steal the most lucrative medical work, leaving Duke with money losers like the emergency room. Swinney's answer is to adopt more of a "service-line strategy"--trying to get Duke to think less like a large department store and more like a collection of boutiques in a mall. One idea is to spin off individual practice areas from the monolithic medical center, giving them separate buildings or entrances. That's how marketers think.

Not everyone at Duke buys into Swinney's strategy. Rheumatologist Rex McCallum numbers himself among those who are worried that marketing is turning medicine from a profession into a business. But the grumbling noises are fading. When some of the young doctors McCallum helped recruit weren't as busy as he wanted, he picked up the phone and called Swinney's department--to ask about running some ads.

--By Adam Cohen