Duke Medicine works to shape positive image

This year, Duke Medicine will care for 60,000 inpatients, treat 1.4 million outpatients and graduate nearly 300 medical and nursing students.

Internationally known, Duke Medicine has a reputation strong enough that, according to one health industry insider, competitors call Duke Medicine “Teflon Duke”—even when it missteps, its name escapes unscathed. And a marketing expert called Duke Medicine one of the “cash monsters;” after all, funding a hospital with a global brand is an expensive undertaking.

But given the structure of the highly competitive local health care industry, retaining an edge requires extensive and constant marketing.

For Duke, most of the competition takes place within North Carolina’s borders—where it draws the vast majority of its patients—against local rivals, especially UNC Health Care and WakeMed Health and Hospitals. It’s fighting for the “share of health care mind,” said Guy Miller, a partner at REACH3, a customer relationship management company in the health care industry headquartered in Wisconsin.

“[Duke Medicine has] a very sophisticated, 360 [degree] view and 24/7 marketing communications commitment,” Miller said. “Because, it’s not just the general advertising, it’s also the PR, it’s the communications, it’s their relationships with local and national journalists.... That is the full-time job for a number of people at Duke.”

Miller’s firm helps Duke Medicine achieve its long-term goals through customer relationship management by identifying specific individuals who would likely become patients of the health system. The work means compiling a vast database of names, determining who is likely to need a certain type of care, reaching out to the potential patient and—months later—seeing if it all worked. Miller calls it “CRM” and of the approximately 6,000 community hospitals across the country, only about 10 percent are using the data technique.

Bruce Kennedy, assistant vice president for marketing management for the Duke University Health System, declined to disclose how much it pays REACH3 because it might compromise their competitive intelligence edge. But Miller described Duke Medicine’s spending on the service “significant.”

It was a move that differentiated the health system from its competitors, but it also represented a substantial undertaking, Miller said.

“It was a bold move because no one else was out there branding themselves like that,” he said. “Any time you go through a brand evolution... that’s a two to three year commitment to your community, to your patients, to your internal staff, to your medical staff, to your board, to insurers, to employers... all of those different audiences need to be educated as to, ‘What does Duke Medicine mean to you?’”

What Duke Medicine meant to Duke was a greater emphasis on the health system’s primary care. Although the health system has traditionally been associated with its academic and research units, Kennedy said the brand name helped further the mission of emphasizing the health system’s primary care because Duke Medicine did not have to be associated with just research, academia or the University’s campus.

The shift in philosophy also meant emphasizing the system’s statewide presence; Duke Medicine has locations in 28 cities across North Carolina. In addition to the complex procedures that the organization is well known for, the Duke Medicine marketing team sought to inform patients that primary care and more standard procedures are performed with the same standard of excellence throughout Duke Medicine’s many locations, Kennedy said.

Duke Medicine has worked hard to support outpatient operations, which includes primary care, urgent care and special care, he added. The system’s expansion throughout the state has aided Duke Medicine’s presence as a community provider.

At the onset, it seemed difficult for Duke to excel both as an academic medical center and a community provider, said Dawn Carter, president of Health Planning Source, a Durham consulting firm that assists hospitals in strategy and planning. Duke is not a regular client of HPS, but has occasionally received HPS’ assistance on projects. As the organization worked with the University on a facility in Knightdale, Carter was told that Duke Medicine’s mission encompassed both the academic and primary care side of care.

“[At the time I said,] ‘I think it’s going to be really challenging for Duke,’” Carter said. “To be honest, they’re pulling it off better than I thought they’d be able to.”

Courting the public

After adopting the Duke Medicine name, the marketing team assembled a campaign to establish the brand. The efforts were particularly robust within a 90-mile radius of Duke, Kennedy said.

Health system administrators began introducing employees to the Duke Medicine name in 2005, and in the middle of 2006, officials kicked off a public campaign for Duke Medicine, Kennedy said. Duke Medicine purchased print, radio, online and television advertisements. Videos in which doctors explained Duke Medicine directly to patients sought to break down walls between the health system and its patients, Kennedy said. A second campaign beginning in 2008 promoted Duke Medicine’s heart disease and cancer treatment.

A survey in 2006 interviewed 1,500 customers and evaluated Duke Medicine based on 18 different attributes. When compared with a second survey conducted in 2009, Kennedy said there was an increase in Duke Medicine’s ratings of community mindfulness.

“They’re one of the leader hospitals that really do, as a health care organization, have a significant and sophisticated understanding of what marketing is,” Miller said. “And marketing just is not putting ‘Duke Medicine’ on a TV commercial. Marketing is identifying patients and prospects that need that kind of care [and] reaching them on a one-to-one basis.”