Crisis 2022. New challenges in the healthcare industry - Irina Khomutova, Khomutova & Partners

Crisis 2022. New challenges in the healthcare industry.

What is the worst thing about a crisis? This is not only a fact of losing patients, but also a misunderstanding of what to do, where to start?

First of all, it is important to understand that any external crisis is only an indicator of internal problems. The success of the medical center in a changing market environment and increased competition for a limited consumer market is based on business adaptability to new conditions and effective management of five key components: Medicine, Atmosphere, Service, Team, Marketing. The MAST-M system needs to be implemented to see a significant increase in first-time patients, an increase in repeat patients, occupancy rates across all doctors and referrals.

A clinic with strong MAST-M scores is almost unaffected by external influences. People in a crisis do not stop getting sick, and there are no fewer patients. If the clinic has problems with sales, this is an indicator of poorly structured work with patients. They do not return and do not recommend this clinic to others. The task of the manager is to identify internal threats that reduce the level of trust and loyalty of patients, and eliminate these factors. If you are not satisfied with the deteriorating situation, it is necessary to audit the 5 components of MAST-M and develop improvements for each of them. The situation will improve in a month.

Only the combination of high-quality work of the medical center in all 5 areas gives an overall positive result in a crisis. It is impossible to significantly improve the situation only through marketing tools aimed at increasing calls from primary patients. Given the poor service and low quality of medical services, it is impossible to keep new patients, especially in the face of increased competition and a reduction in the overall level of the population's solvency. The clinic will deal with "disposable" patients who will come and go without recouping the funds invested in attracting them.


How is it recommended to start a program of improvements in a crisis? First of all, it is necessary to analyze the target audience, taking into account its changed consumer scenarios. The criteria for analyzing the psychographic characteristics of the audience can be: gender, age, social status, marital status, income level, psychotype, values, barriers, critical requirements, nationality, attitude to medicine in general and to the proposed service in particular, price barriers, scenarios for obtaining services, preferred sources of information, location perimeter, etc. If the clinic is already operating, it may already be focused on a certain category of patients. In this case, it is important to systematize the already existing audience, dividing it into subgroups and, after describing the key characteristics of the patient's avatars, separately record the key changes in their behavior scenarios in a crisis.

Why do it? It is important to accurately define each group of patients and develop individual offers and services, taking into account their behavioral characteristics in a changing market environment. Moreover, understanding the audience will give geographic boundaries, the so-called audience perimeter, which will allow, in conditions of limited clinic resources for promotion, to concentrate marketing efforts within the perimeters of limited locations, providing effective online and offline targeting. What is a perimeter? This is the area where the majority of patients are located. Coverage of the territory depends on the degree of uniqueness of the offered medical services and the level of their quality. So, for example, a well-equipped private maternity hospital may have a territorial coverage, including the nearest regions. The more expensive and better the services provided, the wider the geography. And if this is a dentistry with typical therapeutic services, located in a residential area in one of the houses, which has several offices, then, accordingly, the audience will be local residents and employees of nearby offices. As soon as the same dentistry has a special offer and conditions, the audience will become larger and the geography will expand. For example, specialization in pediatric dentistry with a specialized approach will attract an audience from remote areas of the city, subject to the provision of competitive services and quality of services.

If this is a dentistry specializing in smile SPA and whitening technologies, then its audience and geography can also be expanded beyond the residential area in the immediate vicinity. Moreover, the same dentistry can provide typical services, but with a specialization in foreign citizens. At the same time, the clinic can be staffed by employees who come from the same countries as the patients, so that patients can speak their native language. The main problem is the patient's fear, misunderstanding and incompetence in an extremely important issue for a person. The patient, even speaking the same language as the doctor, experiences difficulties in understanding due to the specific terminology used by the doctor and the stress in which he is. What can we say about a foreign citizen who is forced to understand a foreign language. Thus, if the center, understanding its audience, offers unique services and format, it expands its sales market and receives patients who will come specially.

The specialization and level of the medical center initially sets the target audience and territory. This rule works both ways. At any time, if necessary, to expand its geography and improve the audience, the medical center can introduce a service, referral, technology, or narrowly sought-after specialists, to which patients will go specifically. If the services are formed in the clinic with an eye to the demand for a certain audience, then there will be no problems with sales.

Problems begin when the clinic offers the market the next standard services, standard approaches, and dumping policy becomes its only advantage for patients in a crisis. Dumping as a tool to attract patients is certainly allowed as one of the short-term tools, but it reduces the stability of the clinic with significant fluctuations and an increase in the cost of purchasing consumables. A public offer declared today with a price for a service below the market may no longer be feasible tomorrow in the face of an unpredictable increase in purchase prices.

Where to start with perimeter and audience analysis? First of all, it is necessary to determine whether the offer is so unique that patients will travel from remote regions. If yes, then the next task is to determine the geography of Russia, the settlements with which to work.


Competitors require special attention in the perimeter. Having studied all the clinics on your territory, you can take into account the problems and advantages of those who also apply for your audience.

How to identify the closest competitors in order to keep a close eye on their slightest improvements and anti-crisis program of communications with patients? The first is the expert opinion of specialists based on an assessment of identical specialization, the level of technical equipment, the level of equipment of doctors, the target audience, pricing and services. The second is a study of the opinions of patients. Professionals and service users may have different points of view. Additionally, you can conduct a hall test in the clinic. Find out the list of the best medical centers in terms of patients. In order for the impact on the patient to be effective, it is necessary to reliably know where the patient is still applying and what are the advantages of competitors.

For example, mini-surveys, which are recommended to be carried out regularly, at the time of the conclusion of a contract with each new patient, can provide an understanding of competitors and their advantages. Knowing the reasons why patients go to other clinics in the same areas, you can strengthen your own offer. It is important to understand that every positive patient experience in another medical center is a threat of being lured away by loyalty programs, services, better service, friendly staff or attentive attitude.

IMPORTANT! It should be noted that it is possible to lure a patient at a price only if he does not see the value in the services themselves. The price in medical services plays the last role, unlike many other sectors of the national economy. A person pays for health, this is fundamentally different from buying paper for a printer, where it is easy to appreciate the difference in pricing between two manufacturers. If the clinic is faced with a situation where its prices are compared with the prices of competitors, this means that the patient does not understand what he is paying for. He was "not sold" the price. So, the patient is ready to pay, regardless of the cost of medical services, for a variety of reasons, motives and directions.

There is a state in which the patient always finds any amount of money, understanding the significance of medical services and realizing their value to himself. Being on the verge of life and death, when the world around is collapsing, the patient and his relatives sell everything that has been accumulated - apartments, cars, take loans, collect huge funds together with charitable foundations, ask everyone who has not been asked for anything before. The whole world is solving the big problem of one person. What used to be valuable no longer matters. And, on the contrary, what seemed to be taken for granted, namely the life and health of a loved one, becomes paramount and the only important thing. Values ​​change depending on circumstances. If one day young parents receive a terrible diagnosis that their baby was born with hearing impairments, then in order for him to once be able to hear his mother's lullaby, they put everything at stake without hesitation. This most powerful understanding of values ​​suggests that at critical moments a person changes his attitude to money, they cease to be valuable in themselves and become only a means. Parents will not choose a cheaper clinic. They will only choose the option that solves their problem in the safest and most guaranteed way. They will collect a lot of money, they will fly far and perform an operation on the baby. And he will hear and enjoy life.

What does the medical service mean in this context for the baby and his parents? It's hard to even call it a service. This is the right to another life. What does it mean for a person who will live his life hearing, the same medical center and a team of professionals who did their job professionally? A commercial organization that has done its job and the client is satisfied? No. This is the second mother who gave life in sounds and possibilities.

Medicine is a very special world, where different laws apply than elsewhere in the market. When buying shoes, a person consumes its properties, and when paying for a medical service, he expects dedication and help from the doctor. How much is a doctor's dedication and a saved life worth? She is worth any money.


In order to achieve high sales in a crisis, it will be necessary to build effective work with the patient not only during the stay in the medical center, but also after the visit. A patient who sees and feels care about his health will be betrayed himself and will bring with him, as an opinion leader, at least 12 people. His relatives, friends, colleagues will come with him, to whom he will recommend the clinic. Doctors and clinics are chosen according to recommendations, because the patient will not go to an unverified specialist if he has the opportunity to choose. Human health and life are basic values ​​that are determined by our instincts. Those who know how to work with patients, taking into account their fears, barriers and motives, do not experience any difficulties with sales even in the face of a crisis in the reduction of the general level of solvency of the population. Such medical centers have up to 90 of regular patients, have excellent occupancy with an appointment for months in advance and enough funds not only to maintain market share in a crisis, but also to develop business while competitors are experiencing significant difficulties and are not always able to maintain occupancy at pre-crisis levels.

The medical center is based on regular patients. If the clinic has less than 60% of repeat patients, it is necessary to conduct an express audit and debug internal mechanisms. The stability of the medical business in a crisis directly depends on the quality of communications with a permanent audience. It is impossible to endlessly attract a new audience, which, in conditions of limited resources, includes additional psychological barriers, which become more difficult for marketing to overcome, the more tense the situation on the market and the more pessimistic forecasts for its development.

What do patients pay for? For life and health, for reliability and safety, effectiveness, comfort and painlessness, ethics and confidentiality, friendliness and, most importantly, the involvement of specialists in the patient's "situation".

IMPORTANT! If a medical center is experiencing difficulties with sales in a changing market environment, we read between the lines "with the trust of patients", then there are obvious or hidden problems. There is no doubt that the reason for low sales is in the medical center itself, and not in a difficult market situation and strong competition. In order to improve financial results, it is necessary to find and eliminate the reasons for the loss of trust and loyalty of patients. Most importantly, you need to understand that this problem cannot be solved by lowering prices. Having become cheaper for patients, but without giving them what is valuable to them, the medical center will still lose a client. You can't keep it low. You can attract, but you can't keep.

What is a medical service for a patient is a set of actions that a doctor or a team of specialists performs. If the team's actions corresponded to the patient's expectations and his ideas about how it is right, then the medical center receives a loyal patient who is satisfied with the service and understands what he paid for. All medical services can be divided into two large groups. The first is those services in the course of which any manipulations are performed with the patient, equipment is used. And the second subgroup is an exclusively consulting expert area, where the patient pays only for the doctor's recommendations. So, if we talk about the first group, then the understanding of its value for the patient is often higher, because equipment and consumables are involved.

If a patient compares the prices of a clinic with competitors, he compares all the constituent elements - the novelty of equipment, technological completeness, as well as information received from specialists. The patient loves such concepts as proven technologies, the latest components, advanced equipment, etc. What does this tell him? About the guarantee of the quality and reliability of the result obtained by him. If it is a consultation, then the patient pays for the decision and for the effective advice of the expert. In this area, there are a large number of questions from patients, such as “why is the consultation so expensive”, “what did I pay for”, “they didn’t tell me anything new”, “I could buy these medicines at the pharmacy myself”. If questions arise, it means that the question is the quality of the consultation and the format of its implementation, and not that the clinic has uncompetitive prices or the patient has no money. He thinks the price is unfair because the service didn't live up to his expectations.


Understanding the real situation, based on internal audit, receiving feedback from staff and patients, makes it possible to identify and eliminate weaknesses where there is a weakening of patient confidence. All problems are solved if you know about their existence. The main trouble of clinics that lose patients every day is that they do not see causal relationships and any deterioration in the situation is associated only with a decrease in the level of solvency of the population.

The fall in the level of solvency of the population can only affect expensive services that are not directly related to health. And this is only on the condition that in the pre-crisis period the clinic was positioned for an audience with an average income level. External crisis phenomena in the market may be manifested by a reduction in the flow of patients with an average income level in such expensive areas as aesthetic surgery and aesthetic dentistry, implantology. These are the cases when the patient invests in his appearance, fulfilling his dream. The criterion for choosing a patient in this matter will not be the cost, but recommendations, the accumulated image of the doctor and the clinic. A client will not go for mammoplasty or liposuction to an unverified surgeon in order to get a big discount.

If there are no funds for the chosen surgeon due to a decrease in her own income level or an unstable economic situation, she will simply postpone the operation until better times. For a patient in this category, it will not be the price that matters, but the value of the specialist she will be waiting for. If the clinic specializes in services that relate to aesthetic medicine, it is recommended that first of all work on the image and status of surgeons.

IMPORTANT! It makes no sense to influence patients with low prices, discounts. It is important not to reduce the price, but to increase the value and security guarantees. If now there is not enough money to buy a “dream”, the client will not buy a cheaper service instead of the desired result. He will wait for the right moment. At the same time, the clinic faces the task of diversifying the audience and focusing its positioning on that group of potential consumers who, in the conditions of the crisis, retained the pre-crisis level of solvency.

It is very important to understand how patients rate the medical center and what its rating is relative to competitors. When conducting surveys, it is important to take into account a number of features of the survey, formats and pitfalls. Incorrect questions can lead to distorted data and send the company on the wrong track. Any survey should be aimed at finding specific answers. It is not necessary to find out the obvious, for example, whether there is a need to raise the level of service in the clinic. The answer to this question will in most cases be positive. You can not conduct surveys for your own comfort, especially in times of crisis and the threat of losing disloyal patients. Any question costs money and time. So, thanks to research, you can deal with problems and find the reasons for weak sales for a particular service.

For example, if a multidisciplinary clinic does not sell pediatric dentistry, the reasons for low occupancy can be identified through a survey and addressed. So, based on internal statistics, it is possible to identify the category of children who are observed in general pediatrics, but not in the dental department. The parents of these children consciously or unconsciously receive this service from competitors. It is important to identify reliable reasons for the service in other dentistry, eliminate them, and then the referral will begin to generate income for the clinic, even if this service was not in demand before the crisis.

First of all, the task arises to find out where else the patient goes, whom he trusts more and why. So, you can ask a number of typical questions to the parent of a small patient: “Do you know that we have pediatric dentistry?”, “Have you contacted our dentists?”, “In which clinic, which dentist is your child currently seeing?”, “ What does he like best there?”, “And what is convenient for you in that clinic?” etc. What will such a set of questions and answers reveal? Firstly, it will help to determine how effectively internal marketing is built. The basic problem of multidisciplinary clinics is that there are a lot of services and patients may not know about some of them. This problem is especially true for new directions.

IMPORTANT! A regular patient may never learn about a new service if the clinic's corporate website is the only source of information. The site of the clinic is used by new patients who are determined with the choice. They build all further communications internally, without referring to external sources. If the survey reveals this problem, then it will be obvious to carry out an internal active work to inform all regular and new patients about the services of pediatric dentistry. Moreover, from the solution of one problem, conclusions can be drawn in other areas that are in decline. It is immediately recommended to take action on them, without waiting for the results of the next study. The problem may have a systemic error in the lack of patient awareness.

The second thing that such a survey will reveal is a group of patients who are aware of the availability of pediatric dentistry and consciously do not choose it. Obviously, there are specific reasons why patients do this. Identification of the reasons will give accurate solutions to improve the service, communication of doctors, the atmosphere of specialized pediatric dentistry with a set of relevant paraphernalia. So, it may turn out that other medical centers have playrooms, tell stories to children, show cartoons during treatment, give gifts, etc. If such research results show clear advantages of competitors, then the task of implementing the same tools.  

It is very important, after the answers are received, to make a rating of competitors, as well as a rating of selection criteria. Next, you need to conduct your own peer review of the designated competitors and determine the list of their advantages, based on the opinions of patients. It is important to double-check the information, since patients can only give part of the answers, moreover, they may unconsciously distort reality. None of the respondents specially prepares for surveys, does not analyze their motives and is not obliged to give a reliable assessment of their actions. Therefore, a multilateral analysis will help to avoid misinformation and an incomplete picture.

What features should be taken into account when surveying? It is important to avoid programming patients for certain responses. Nobody likes answering questions because it's work. People try to get rid of this task as quickly as possible by choosing the first one that comes across from what they are offered. You can encounter another phenomenon of perception - people deceive themselves quite often, substituting concepts. Thus, if you ask the patient why he does not go to the dentist and give him options for answers (expensive, no time, inconvenient to get to, uncomfortable, etc.), he will choose the first one that comes across and at the same time the most decent of the answers. It will be unpleasant for the patient to admit that he is insolvent or that he is afraid. The most convenient answer would be - no time. You can not direct patients, give them convenient tips. Respondents will deceive themselves and the researchers. Only open questions can give a reliable picture, which must be further subjected to peer review.


An important rule of a successful medical center resistant to external challenges is to make each service a hit. The clinic should not have average doctors that patients do not want to go to. Nobody is calling for a multidisciplinary center. Moreover, it is recommended to optimize directions as much as possible, to concentrate only on those that are in demand. Equipment, doctor, conditions, services - everything should be with a XNUMX hit. Each service should be conceived not in itself abstractly, but for a specific audience, according to its needs and capabilities.

The financial health of a business is often compared to the health of an individual. Undermining the immune system can be gradual and not noticeable to the body. Little by little, day by day, a clinic can lose patients for a variety of reasons. Obviously, if health is seriously undermined, the cost of restoring it can be significant. If this does happen, the doctor usually starts with a diagnosis. Only after analyzing the causes of the current condition of the patient, the doctor can give an appointment. The speed of recovery depends on how high-quality the diagnosis will be.

The same principles apply in marketing and sales. The causes of the "disease" can be external and internal. If a clinic has strong immunity, it will be difficult to undermine its business stability from the outside. Therefore, a crisis is always an indicator of internal problems. A strong company, especially in the healthcare sector, does not understand what kind of crisis everyone is talking about in the country. Only those who could barely keep afloat will immediately feel all the hardships of the crisis as soon as it arises. What definitely should not be done in the face of loss of patients is to wait for external positive changes and a decrease in the critical influence of market crisis factors in order to improve the financial performance of the clinic. A multilateral audit, audience analysis, identification of patient motivation and competitive advantages are designed to provide transparent answers to complex questions and help to successfully reach the planned level of financial performance in the context of the general crisis faced by the industry.

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