Urgent message: Rapid growth of the urgent care industry has led to increased competition but little differentiation among urgent care providers, which consumers tend to view as “pretty much the same.” The opportunity for urgent care is thus to foster patient loyalty by creating differentiated brands, which starts by taking a process approach to the patient experience.
ALAN A. AYERS, MBA, MAcc
Urgent care is maturing into a big business. In 2015, the industry’s nearly 10,000 centers expect to see 160 million patients and generate $16 billion in gross revenue, according to the Urgent Care Association (UCA). Hospital systems, insurance companies, private equity, and venture capital firms have poured hundreds of millions of dollars into startups, mergers, and acquisitions in a market that has historically consisted of independent physician-entrepreneur practices. Yet despite boasting yearly revenue figures of the magnitude of the global coffee giant Starbucks—noteworthy for its enviable and powerful brand loyalty—the urgent care sector has yet to see any strong brands emerge, even among the larger regional operators.
To many Americans, however, “urgent care” is simply “urgent care,” and utilization is driven not by brand loyalty but by factors like convenience of the location, operating hours, network insurance participation, or experience with a specific physician. Without a differentiated brand, the risk is that a center’s patients will defect as soon as a more convenient/less expensive/more novel option becomes available. In markets where the growth of urgent care has resulted in more centers than the population can support, a lack of brand loyalty can prevent a center from ever reaching its volume potential.
This dearth of any firmly established brands within the urgent care space actually represents an enormous opportunity for the innovative urgent care operator. According to branding experts, building a brand that consumers will patronize repeatedly, even in the face of alternative choices, largely depends on that brand’s ability to meaningfully differentiate itself.
Consider the draw of such trendy “power brands” like Starbucks, Apple, Tesla, Virgin America, and Whole Foods. How these brands are experienced by their loyal patrons is what sets them apart from the competition. So for urgent care operators, the question is a simple one: How can the entirety of our brand experience be constructed to engender patient loyalty in the increasingly crowded immediate-care landscape?
From a consumer perspective, brands are experienced by way of what marketing gurus call touchpoints. A touchpoint is defined as “a single point of contact or interface through which a customer is exposed to a brand, in any way and at any time.” Touchpoints can include, for example, overhearing a colleague discuss a particular product, walking an aisle in a store that carries that product, and hearing an advertisement of that product on the radio.
Touchpoints, as illustrated in Table 1, consist of both tangible and intangible assets, and can overlap experiential time frames. Thus, a consumer can potentially be exposed to a brand’s marketing message before, during, and even after utilization. The sum total of a product and/or service’s touchpoints—potentially quite numerous—are what ultimately forms its brand experience.
In short, a brand is a promise. Established brands declare their promise explicitly, and they reinforce that promise at every possible touchpoint. Whether it is a promise of the highest quality, lowest prices, greatest convenience, or most novel experience, a touchpoint is the vehicle that brands employ to capture market share. For urgent care operators seeking to build the kind of regional or national brand loyalty that helps them stand out from the pack, there must be a definitive and forward-thinking process approach undertaken to shape their brand’s touchpoints.
|Table 1. Common Examples of Consumer Touchpoints|
|Prior to Utilization/Purchase||During Utilization/Purchase||After Utilization/Purchase|
The Patient Experience Pathway
In marketing, identifying the totality of a brand’s touchpoints is called creating a customer-journey map. In health care, it has been described as chronicling the patient experience pathway. Because health-care consumers do not actually become patients until they decide to utilize an urgent care center, both terms apply equally here. But regardless of which phase consumers find themselves in, they are nonetheless experiencing the brand’s touchpoints.
Starbucks, for example, goes out of its way to create a welcoming, community-like feel while serving up flavor rich coffee drinks. The comfy, oversized couches, the free Wi-Fi and power outlets, the hip background music, and the baristas who greet you by name—all while quickly whipping up your favorite concoctions from memory—are just a few of the many evocative touchpoints that make Starbucks the brand giant it is today. They have cultivated such fierce brand loyalty that even when they periodically nudge up prices, they suffer no backlash; their customers still show up in droves. But the bottom line is that Starbucks’ patrons come back—and keep coming back.
For urgent care, a great customer experience is even more crucial, because urgent care center utilization—except for select ancillary services—is episodic. That is, nobody actually plans to get sick. Therefore, it is of paramount importance that the successful urgent care experience consistently evoke feelings and emotions associated with the following core principles:
Effectively promoting such values throughout an urgent care model’s touchpoints—including, of course, the anticipated great clinical outcome—will help ensure that when the need arises, the brand is forefront in a prospective patient’s mind. Thus, urgent care operators desiring to seize the opportunity—establishing a buzz worthy brand within the still-evolving urgent care landscape—must fully renounce any lingering “build it and they will come” stance that they may still harbor, and seriously commit to designing their practice from the patient’s perspective, which is the only perspective that matters.
A Process Approach
Developing a differentiated brand takes planning, which entails designing processes, systems, and training that result in an exceptional patient experience. Back to touchpoints: As shown in Table 1, touchpoints can be many and varied. For most urgent care centers, pertinent touchpoints can be loosely grouped into the following categories:
- First impressions
- Registration and booking
- Waiting-room experience
- Front-desk interaction
- In-center service recovery
- After-utilization follow-up and communication
The role of the urgent care operator—thinking less like a clinician and more like a consumer or patient—is to view each separate aspect of the brand experience through the patient’s eyes, then tailor its touchpoints so that they (1) sufficiently and meaningfully differentiate the brand and (2) effectively reinforce principles that lead to brand loyalty.
What follows is an examination of each of the bulleted touchpoint categories, accompanied by design strategies and implementation tips to be considered. First Impressions: Prior to Arriving at the Center To shape first impressions, the provider steps into the role of the consumer and begins the customer-journey map with advertising and first impressions. Although some urgent care operators are hesitant to invest heavily in advertising without understanding the return on investment, this kind of outlay can be made confidently when marketing is viewed as a revenue center that, when done right, makes money, and is critical in creating favorable first impressions.
Advertising: What advertising modalities (e.g., newspaper, radio, billboard, television) does the center employ, and what brand personality does that advertising present to consumers? Does the message align with the center’s core principles? Repetition is key here, because a consumer must be exposed to a marketing message many times before the brand reaches top-of-mind status. So the ad campaigns must be regular, and spread across multiple channels. In addition, the adopted brand personality should shine through in all of the advertising.
Website: A professional, well-organized, and comprehensive website is an absolute must in this age of digital media. In addition, studies show that for the first time, people are now spending more time with digital media than they do watching television. Digital media is where consumers are, and your center must be there as well. To that end, an urgent care center should feature, at the minimum, a full-service website with patient login and registration functionality, a complete listing of services offered, and a detailed listing of hours of service. To take it a step further and really differentiate the center, examine the operating model of ZoomCare (www.zoomcare.com) centers in the Pacific Northwest. They enable patients to self-schedule from a smartphone, tablet, or computer with the provider of their choice, directly through the website. Self-scheduling is a novel concept in today’s urgent care scene, but early adopters have thus far received rave reviews from patients.
Center location: Consumer anecdotes and focus groups confirm that drive-by signage visibility is the number-one driver of urgent care awareness. In concert with the crafting the advertising, choosing center locations should be strategic and opportunistic whenever possible. Busy intersections and shopping centers are ideal because they offer good curb appeal. Signage should also be prominent and well lit, so that it is unmistakable that the building does indeed house an urgent care center. If there is any doubt as to where to locate an urgent care center, just follow the retailers that appeal to the center’s target patient base (e.g., Target, Kohl’s, PetSmart).
Community visibility and grassroots activities: Community engagement through grassroots activities provides a brand with the repetition necessary to reach top-of-mind, and it establishes the center as fully entrenched within the fabric of the community. Some great examples of effective grassroots activities:
- Interviews with local media (television, newspaper, Internet) when health-related topics are dominating the news: Having a “health expert” chime in lends credibility to both the report and the center. You would be surprised at how often the center is remembered due to local media engagement.
- Public appearances with booth setups or tents, freebies, and family-friendly mascots on hand, especially on holidays: Of course, have your literature, brochures, and decals ready to disseminate.
- Free, relatively inexpensive services offered at ribbon-cutting events that announce the urgent care center’s inclusion in the community: MedExpress (http://medexpress.com), for example, recently opened a clinic in Battle Creek, Michigan, and in an effort to generate foot traffic offered free flu shots to all visitors who stopped in during the first week.
- School-related team or club sponsorships: When your center’s logo adorns the T-shirts and sweat shirts of schoolchildren all around town, your brand reaps the benefits of not only constant exposure but also of deep affiliation with the town or city.
These and many other grassroots activities are important touchpoints that will help shape and define the brand, often before a patient even sets foot in the center. Indeed, an implementation of this scale may result in a considerable upfront financial outlay, but recall that marketing is a proven revenue center when fully understood. Over time, the brand’s growth will generate the foot traffic necessary to pay for these outlays, and then some.
Minimizing Patient Wait Times: Registration and Booking
When consumers decide to visit an urgent care center, that is the perfect time to show that your center will reward their patronage with uncommon efficiency, convenience, and satisfaction. This is a grand opportunity to differentiate the brand further, and to dramatically reduce the negative emotional impact of any wait, no matter how brief.
- Online preregistration: Ensure that your website allows patients to preregister from their computer or tablet. Then, after ascertaining their driving distance from the center, call them when their time in the patient queue is approaching.
- Allow patients to leave the center while waiting: If patients are not too sick or injured, the urgent care center can promise a phone call when it is their time to be seen while they shop or run errands nearby.
- Schedule appointment times online: Again, examine the aforementioned ZoomCare model for insight into how to go about patient self-scheduling, or discuss it with your information technology staff members. As ZoomCare centers have demonstrated, patients absolutely love this feature, and it gives them a sense of control over their own health-care choices.
The center with the most modern and extensive waiting-room perks is the one that will leave an indelible mark on a patient’s positive impression of the brand. Quality amenities include the following:
- Digital entertainment: Almost everybody, including kids, has a smartphone these days, so by providing complimentary Wi-Fi, you will spare many grateful patients from having to burn through their own data plan while waiting. Also, a couple of flat-screen televisions for viewing should be mounted in customer waiting areas.
- Reading and activity materials: Parents who have brought in a sick and cranky youngster will especially appreciate the momentary distraction that magazines and activity books or coloring books provide. These items can be purchased inexpensively at a discount store.
- Beverages and snacks: An urgent care lobby striving to help patients feel like welcomed guests should include items such as chips, pretzels, granola, bottled water, coffee, and cocoa. Gestures like these go a long way toward pleasing patients.
- Blankets: For sniffling, sneezing, and shivering patients, a warm blanket will provide a huge psychological boost and help them feel that staff members really care.
- Waiting-room concierge: Hire urgent care staffers dedicated to enhancing the waiting-room experience. They can apprise patients of how long it will be before they see a clinician, comfort and reassure little ones, refill and restock beverages and snacks, and hand out blankets. One urgent care center, for example, has its waiting-room concierge go to a store next door and return with fresh doughnuts if wait times began to creep up.
Recall the earlier Starbucks examples that outlined how the company’s staff members go out of their way to make their customers feel welcomed and at home, much like an invited guest. For an urgent care center that offers these types of amenities, the effect would be similar. Remember that brands capture loyalists through the experience, and rolling out the proverbial red carpet in this way helps provide that coveted differentiation that stellar brands exhibit.
Front-desk staff members have an opportunity to set clear expectations for the visit immediately, putting patients at ease with the knowledge that their visit will contain no unpleasant surprises. Staffers can accomplish this by outlining the entire patient experience in
advance, which will include the following information:
- The total amount of time patients will be in the center, including how long before they see a clinician
- Exactly who patients will see, and what the clinician’s medical experience and credentials (PA, MA, RN, NP, etc.) are
- All tests and procedures that will be done
- Financial obligation of the patient. Lack of price transparency has long been an annoyance to health-care consumers, so this level of full disclosure will be very welcomed.
- Answers to questions, in the form of bulleted handouts, that patients frequently ask, such as “Why am I waiting?” or “I have to pay how much?”
Showing this level of respect and transparency can serve to make patients loyal to the center because it eliminates much of the intimidation factor that people often face when trying to navigate the health-care system.
In-Center Service Recovery
A patient who leaves dissatisfied with the overall service delivery is said to have experienced a service failure, such as these:
- Rude and aloof frontline staff members
- Excessively long waits
- Payer issues (i.e., insurance not being accepted)
- Higher-than-anticipated co-payments
- Substandard clinical outcome
- Incorrect prescription medication
- Lack of comfort and convenience
- Domination of the consultation by a clinician who ignores or trivializes a patient’s questions and concerns
Studies show that once patients who have experienced a service failure leave the center without remediation, the negative word-of-mouth that they will spread can be very financially damaging to a practice. In addition to telling their friends and family about the awful service, they may take to an online review site like Yelp to bad-mouth the center to an audience of thousands, or contact their payor or other third party, leading to unwelcome scrutiny of the provider.
For a brand to flourish, there must be an in-center service recovery strategy designed to catch service failures as soon as possible. Waiting to attempt service recovery until after a patient has left the center is not ideal, as it may be too late by then. In-center service recovery strategies can include the following:
- Actively engaging patients for feedback as they are leaving the center. A simple query such as “How could we have improved your experience today?” is usually enough to get the ball rolling for a disgruntled patient. Surveys work as well, but many patients will not want to hang around to complete a lengthy survey—save for those who are aggrieved and welcome the opportunity to vent.
- Giving frontline staff members the power to remediate and rectify issues on the spot. Study after study has shown that empowering frontline workers to handle service failures is the single best predictor of a successful remediation. Examples include giving out gift cards and writing off the cost of the entire visit.
In sum, urgent care operators must embrace a simple truth when it comes to dissatisfied patients: No effort toward service recovery is too extreme. When service recovery is done correctly and enthusiastically, a service recovery paradox will often result. This paradox describes a situation in which patients are so happy that the center went out of its way to satisfy them in response to an initial service failure that their brand loyalty actually grows stronger than it was before. Hence, urgent care staffers should go out of their way to seek out and remediate service failures at every opportunity.
After-Utilization Follow-Up and Communication
Post-visit follow-ups and communication represent a valuable opportunity for the provider to reinforce its brand values many additional times. In fact, the touchpoints at this stage are just as important as the ones at prior stages, because they communicate the center’s appreciation for the patient’s business while making clear the center’s intentions to court future business.
- Follow-up calls within 24 to 48 hours: Contacting patients a day or so after their visit helps to ensure that a great clinical outcome has occurred, and it also sends the message that your service delivery extends well beyond the in-center visit.
- Solicit sign-ups for the center’s opt-in e-newsletter: An e-newsletter is a great way to keep patients abreast of the center’s activities. The content should include trending health topics of interest to providers and patients, a calendar of events for both the center and the community as a whole, and photos of community and grassroots events that the center is involved in.
- Social media engagement: Social media studies show that Facebook users who “like” an organization’s page are 60% more likely to recommend the organization’s brand to others. Twitter, Google+, LinkedIn, YouTube, and Pinterest are other great tools to engage your patients online and help turn them into fans. Through these venues you can push out additional center-related advertising and announcements of seasonal offerings (e.g., flu shots, sports physicals, allergy evaluations). You can also post photos of grassroots events and community engagement.
Although urgent care has grown into a multi-billion-dollar industry, consumers still generally view all urgent care centers as the same because few operators have built brands differentiated enough to engender fierce patient loyalty. There is the opportunity, however, to use branding tools to gain a very large and loyal customer base. Chief among those are identifying and shaping touchpoints solely from the customer’s perspective, and creating a differentiated brand experience that triggers a multitude of positive feelings and emotions. By focusing on the entirety of the experience, an urgent care center can create similar differentiation and begin to build a loyal patient base.
Forward-thinking providers must first identify and understand their service delivery through the eyes of patients, and then develop processes that ensure efficiency, convenience, professionalism, and satisfaction at every touchpoint. Hidden and neglected touchpoints are also shaping your brand, so aggressively finding and fixing them is critical.
It all comes down to how many resources—financial or otherwise—that an urgent care brand is willing to commit to the goal of true, meaningful differentiation. That is what all strong brands do, and the urgent care center that is successful in using its touchpoints to create that differentiation is the one that will rise to the head of the class.