So, you have attended a couple of great skills courses and you are excited about offering new services that will add revenue to your business. Your tools will enable you fill a need expressed by your customers and keep business you previously lost. You and your staff are skilled providers and there is no reason why your practice shouldn’t now be the leader in your market area. You may even hire some additional staff and invest in additional equipment or facilities.

Those are thoughts commonly expressed by providers during the business development process. But, adding skills is no guarantee that the new services will automatically result in additional revenue. Your competition that has been offering services that utilize your new-found skills are likely tough and skilled providers themselves and they will not give up their territory easily. It may surprise you, but your competition is paying attention to what you are doing as well and they are likely aware that you are now offering new services. This will result in an increased emphasis on their part to maintain their market share. Worse yet, nothing would please them more than your practice failing miserably in its attempt to provide services for which they have already demonstrated competence.

Providers are typically not good businessmen. Healthcare providers “provide” services to help people and usually are not skilled in selling. Traditionally, providers are touchy-feely people-persons who expect business to come in the door because they provide services that customers need. The fact is – it’s just not that easy. Today, providers need to know how to compete and need to understand the Marketing process.

Marketing is defined as “an organizational function and a set of processes for creating, communicating, and delivering value to customers and for managing customer relationships in ways that benefit the organization and its stakeholders,” (Kotler et al, 2008). As a practical matter, providers need to identify and position themselves in the market area as the preferred practice from which to seek a service or product. This requires the provider to possess three key characteristics: a vast network of potential customers or at least the potential to develop such a network; a high level of clinical skill to deliver the desired service; and the ability to sell and maintain a customer base. If the provider lacks one or more of these characteristics, then he or she will need to surround themselves with people that do – either within their organization or through the assistance of helping agents in their market area.

Healthcare Providers deliver services and not products. Healthcare Providers that perform Ergonomics, Employment Testing, and Functional Capacity Evaluation provide Industrial Rehabilitation and Consulting Services (IRCS). This is a relatively narrow specialty area in the Physical and Occupational Therapy professions when compared with physical rehabilitation provided in inpatient and outpatient clinics or other traditional rehabilitation settings.

Aside from the unique nature of Industrial Rehabilitation and Consulting Services (IRCS) is the intangible nature of a service versus a tangible product. Marketing services is different than marketing products: products are made/services are delivered; products are used/services are experienced; products possess physical characteristics we can evaluate before we buy/services do not even exist before we buy them; products are impersonal/services are personal. The personal nature of a service suggests that a relationship with a customer needs to be solicited, nurtured, and maintained (Beckwith, 2000).

This article will first define the characteristics needed to market IRCS utilizing the rules of the “Tipping Point” Theory. Then the article will review methods to research a need for these Services, build a plan, and prepare the market so the provider can deliver IRCS and maintain a competitive edge.

“Tipping Point” Theory:
In sociology, a “tipping point” is the event of a previously unique phenomenon becoming rapidly and dramatically more common (Grodzins, 1969). Nowhere is this more applicable than marketing IRCS. A “tipping point” is otherwise known as collective behavior or the boiling point, or the domino effect. This term has been applied to consumer buying behavior, crime trends, teenage smoking, the phenomenon of word of mouth, disease epidemics, or any number of the changes in everyday life. Changes in buying behavior normally have three characteristics: a small number of people begin behaving in a different way and this spreads to other similar individuals with similar needs and wants; a number of incremental changes in behavior occur that builds to a critical mass; and buying behavior changes (Gladwell, 2002).

Gladwell describes three rules that are required for reaching a Tipping Point: the Law of the Few, the Stickiness Factor, and the Power of Context. The first rule, the Law of the Few, draws on the 80/20 principle or the fact that change occurs from the efforts of relatively few individuals. The individuals that initiate and perpetuate this momentum for change are: Connectors, Mavens, and Salespeople. Connectors are individuals who know a lot of people, routinely interact with a lot of people, and bring people together. They tell everyone in their vast networks about a new product or service – and they tell them if it is good or bad. In the IRCS world, they are most often Nurse Case Managers and some Insurance Adjusters. Mavens are those with special skills or highly valued expertise. In the IRCS world, they are most often the Healthcare Providers who want to build their practice, who enjoy sharing their knowledge, and benefit by sharing the knowledge. The problem is they just don’t know how. They are the readers of this article. They are you. The third change agent is Salespeople. Salespeople are the individuals that make customers change their buying behavior. Successful salespeople continually monitor the perceptions and commitment of customers to continue to use the Provider’s services. So, Connectors are the social glue, Mavens are data banks, and Salespeople are persuaders. The truth is, most Providers have two or more of these skill sets, but individual providers have one that is dominant. They key in marketing IRCS is to have all three characteristics in play at all times, and if the Provider lacks one or more of these characteristics then they should surround themselves with people that do.
The second rule of the Tipping Point is the Stickiness Factor. The Stickiness Factor refers to the content of the message that makes its impact memorable. In the IRCS world, this involves media – brochures describing products or services; gimmicks – pens or stress balls or magnets, and presentations or informational seminars a Provider uses to educate potential customers on the technical advantages of using IRCS. The key component of this Factor that the message should communicate is quality. Quality in IRCS is its scientific evidence basis.

The third rule of the Tipping Point is the Power of Context. The Power of Context refers to the fact that the buying behavior of customers is sensitive to the conditions and circumstances of the time and places in which they occur. In the IRCS world this would involve the solutions to problems the service is designed to provide. In IRCS the solution is to prevent work injury claims or enhance return to work outcomes.

These “Rules” will be apparent in the rest of this article which focuses on how to launch a new IRCS in a market area. One fact by now should be clear to the reader – the Provider should be aware of their strengths and weaknesses; the Provider should understand consumer buying behavior and continually monitor customer satisfaction; and the Provider should adjust their delivery of IRCS to changes in their market area or changes in context.

Functions of Marketing:
A provider introducing IRCS in a market area has one shot to get it right. Customers will look for inconsistencies in what is presented versus what is delivered. Every stumble made by the provider will be amplified by the provider’s competition. So a coordinated effort must be made to introduce IRCS in the best light. This effort requires research, analysis, planning, acquiring necessary resources, and promotion (Kotler et al, 2008).

Market Research and SWOT Analysis:
Prior to completing a SWOT Analysis, market research is required. As a new provider of IRCS, the provider should consult local nurse case managers, physicians, insurance adjusters, attorneys, and employers to assess the conditions of a market. First, the provider needs to find out who is currently providing IRCS in the area. Second, the provider needs to assemble a group of leading consumers of IRCS in the area and then meet with them individually or in a focus group to gauge customer satisfaction: what consumers like, what they dislike, what payers are reimbursing providers for IRCS, and what they would like to change in the services they are currently receiving. The third task is asking these customers for names of other contacts to add to the provider’s list of experts. And finally, the provider should ask for their business. After performing the necessary research, the provider is ready to assess their potential for establishing themselves as an IRCS provider via SWOT Analysis.

SWOT Analysis is a strategic planning method to evaluate the Strengths, Weaknesses, Opportunities, and Threats involved in a business venture. It involves specifying the objective of the business venture or project and identifying the internal and external factors that are favorable and unfavorable to achieve that objective (Armstrong, 1999). Using SWOT, a provider identifies its current position in the market relative to its competition and what it requires to achieve a competitive advantage in IRCS.

A provider’s strengths would include staff expertise, location, current client base, facilities, and reputation. A provider’s weaknesses might be lack of staff or training, poor location or inappropriate facility layout, or lack of reputation in a market segment such as experience in workers’ compensation. Opportunities may include a company opening a new manufacturing plant in a provider’s region, the provider signing on with a workers’ compensation preferred provider network, or a new physician moving into an area. Threats would involve the provider’s competition or any other reason for which business is or is expected to decrease. After completing a SWOT Analysis, if the provider assesses that there is a favorable balance between the advantages and disadvantages of adding IRCS, the provider can implement a plan to assess the costs v. benefits.

Business Planning:
The two main components of an IRCS Business Plan are the business plan outline and the pro-forma (SBA, 2010). The business plan outline includes a description of IRCS, fee structure, the number and variety of potential customers, the resources currently available in the market, and the equipment or training necessary for the provider to add IRCS. The pro-forma includes financial data in the form of a profit and loss statement that balances the cost to develop and provide IRCS v. the projected profit and expected growth over 3-5 years. Projected revenues are balanced against expected costs. Costs would include hiring staff, buying equipment, construction, advertising media, and the day to day costs of doing business. If there is a favorable potential for profit, the next step is to move forward with acquisition of resources.

Acquisition of Resources:
The first resource necessary is to develop or hire staff that will deliver the services. Key in establishing a provider as an expert in IRCS is certification in Ergonomics, Functional Capacity Evaluation, and Employment Testing. If a provider does not already have the necessary staff, then it will be necessary to court a certified professional currently working for the competition. The provider should have compiled a list of these professionals in their market research. Once the staff issue is solved, the provider should move forward with any necessary construction or equipment purchases necessary to deliver and necessary media to advertise IRCS.

Packaging:
Media allow the IRCS provider to project an image and educate the market. Brochures and other printed media are developed, a vendor booth will be necessary to advertise at conferences and trade shows, and give-a-ways such as pens, magnets or other items should be developed with the provider’s logo. Talking points that will define the IRCS are developed. The best talking points will briefly outline the type of IRCS offered, some bullet points to describe features and their scientific basis, and the necessary contact information to access the service.

Networking & Market Education:
This step is an ongoing process. Networking will involve building a list of potential customers – Physicians, Nurse Case Managers, Insurance Adjusters, Employers, Attorneys, and Vocational Rehabilitation Specialists. The IRCS provider should always ask a contact for their business and also ask for names of their colleagues. The advantages of building a vast e-mail address book cannot be understated. Quarterly e-mail blasts are a great way to remind customers that you are out there and cost you nothing.

Market education includes public speaking at conferences, lunch ‘n learns, and breakfast meetings and are the best way to capture multiple potential contacts in one event. Offering continuing education credits is an excellent way to increase attendance. Setting up a vendor booth at conferences is another way to distribute media to multiple contacts. Case managers, human resource professionals, safety professionals, attorneys, and insurance adjusters all attend regular continuing education courses and many of their organizations have an annual fall or spring conference. A provider’s initial market research should have identified the events that a provider should attend.

Bringing it All Together – My Top 10 for Selling Services:
1. Be the expert in your market area.
• Publish articles in journals, teach a class at the local university, speak at seminars – be a Maven. Attend as much continuing education as you can afford. You will be sought out for your valuable information.
2. Develop a chorus of raving fans.
• Give an extra effort for your customers who are the Connectors. They will tell everyone they know about you and do a lot of selling for you.
3. Operate a favor bank.
• Healthcare and particularly IRCS is a relationship-based business. Thank your customers by doing something special like hand-delivering a report.
4. Do not abuse a Cold Call.
• A Cold Call is an unannounced stop-by at a customer’s office. Keep it brief. An example is stopping by a physician’s office to ask who sets the appointment schedule or who calls providers to refer cases.
5. Make the most of a Warm Call.
• When meeting with a customer or a group, provide them with a snack, your brochure, your business card, and if appropriate offer continuing education credits for a presentation. Ask for their business and for names of others in their organization or other organizations that could benefit from your services.
6. Client-share.
• Introduce a physician to a group of case managers, introduce a case manager to an employer client and ask them to return the favor.
7. Equip your Salespeople with a simple message.
• Your services should be presented as a big idea with a limited number of powerful support points. Emphasize the science behind your services and the expertise of your staff. The more concise and objective the message, the better your sales staff will be able to persuade customers to use you.
8. Be visible.
• Set up your vendor booth at Safety Conferences, Human Resources Conferences, Case Manager Conferences, and others. If physician practices or law firms have Holiday parties or business organizations have business after hours meetings, try to be invited. Speak at the Rotary, manufacturing associations, and trade groups.
9. Follow up.
• A month or so after you have provided a service, contact the referral source to ask if your services made a difference. Ask them if anything can be done better to improve your services.
10. Show a return on investment for using your services.
• IRCS prevent new injuries and contain existing injuries. Provide data to show a cost savings from using your services to keep the customer coming back for more. OSHA’s Safety Pays Program provides a simple return on investment analysis. The analysis is based on the type of injury prevented, the profit margin of the company, and the number of injuries prevented and the tool calculates the cost savings from preventing these injuries (OSHA, 2010).

References:
1. Kotler, Philip; Gary Armstrong, Veronica Wong, John Saunders (2008). “Marketing defined”. Principles of marketing (5th ed.). p. 7. Retrieved from http://books.google.com/books?id=6T2R0_ESU5AC&lpg=PP1&pg=PA7#v=onepage&q=&f=true.
2. Beckwith, H. (2000). “The Invisible Touch”. Little, Brown and Company, New York, NY
3. Grodzins, Mortin (1969). “The metropolitan area as a racial problem”. University of Pittsburgh Press, Pittsburgh, PA.
4. Gladwell, Malcom (2002). “The tipping point: how little things can make a big difference”. Back Bay Books/Little, Brown and Company. New York, NY.
5. Kotler, P., Stevens, R.J., Shalowitz, J. (2008). “Strategic marketing for health care organizations: building a customer-driven health system”. Jossey-Bass, Inc.
6. Armstrong.M Management Processes and Functions, 1996, London CIPD ISBN 0-85292-438-0
7. US Small Business Administration (2010). “Write a business plan”. Retrieved from http://www.sba.gov/smallbusinessplanner/plan/writeabusinessplan/.
8. Occupational Safety and Health Administration (2010). “The Safety Pays Program”. Retrieved from http://www.osha.gov/dcsp/smallbusiness/safetypays/index.html.

Vic Zuccarello, OTR/L, C.E.A.S. II, ABDA graduated from the University of Missouri Program in Occupational Therapy in 1985 and has since specialized in disability prevention and management. He is owner and Vice President of BIO-ERGONOMICS, Inc., an industrial rehab and consulting company. Aside from providing impairment evaluation services (FCE’s), he is certified as an Ergonomic Evaluation Specialist, Ergonomic Assessment Specialist – Advanced, and a Senior Disability Analyst and Diplomate through the American Board of Disability Analysts. He has been published in several professional journals and has presented locally, regionally, nationally, and internationally.