A few thoughts on healthcare

So, it's been a little while since I last wrote (I blame lapse on Twitter, but that's a different post for an upcoming day). And while this is supposed to be a marketing blog, I wanted to get some general thoughts out about healthcare reform.

Overall, I think that anything that leads to more Americans being insured is a great thing for all of us. Right now 20% of all emergency room admittees are uninsured. But, the hospital has to treat them anyway. Additionally the number of people on Medicare and Medicaid is increasing, and we know that the government doesn't pay the same as the private payors. So, where do hospitals make up the difference? And what does this do to your standard of care? Think about it. The less money hospitals are reimbursed, the less they have to invest in necessary technology and improvements, to pay nurses and physicians, and even in some cases to continue operating.

I think most people are in agreement there. The issue tends to arise when we look at where the money is going to come from to pay for all of this. One of the areas that is quickly pointed to is medical imaging. Granted, the amount spent on medical imaging is rising every year. However, it is important to look at how imaging, when used properly (more on this in a minute) can actually save money in the long term. For example, let's assume that it costs $1,000 to do a Coronary CTA exam of a patient that presents with some basic risk factors. From there, the physician can assess any treatments that might be needed. Let's say these cost $5,000. Sounds pricey, right? Consider the alternative. The patient never gets scanned. Two weeks later he suffers a massive heart attack. He is then rushed to the hospital and has to undergo surgery. He is then in the hospital for a week to recover. I'd venture to guess that this proposition is not only less appealing to the gentleman that suffers the heart attack, but also that it is going to cost much more than the imaging and prescribed treatments.

That's the one aspect that seems to get missed the most. Medical Imaging, when used in the proper instances (those developed by physicians as generally accepted standards of care), is a very effective screening and prevention tool. If we look at costs in medicine, the majority are on the treatment side. Any time a disease or condition is caught in its early state, it costs much less to treat. If the focus is on prevention and screening, I would anticipate a long term savings in overall health care costs. Of course I'm not an economist, statisitican or anyone else that actually crunches the numbers, but...

(note: I'm not advocating the willy nilly use of imaging because there is always the real risks of overexposure. Thus the emphasis on proper usage).

Reform is definitely needed, and it's going to be expensive to do. I didn't really offer any solutions other than provide a focus on preventative care and screening, whatever that's worth. Just some thoughts as I'm trying to follow the process. I'm intersted to see where it will go, and ultimately how it will affect me both professionally and personally. It could generate a real marketing challenge, or it could generate a real marketing opportunity. At this point, it's hard to tell.

Is penetration pricing a lost art?

Maybe this one is a little more of a personal gripe and it doesn't happen to everyone, but in my world, it's something that's bugging me, so I'm going to write about it.

Any marketing text will tell you that there are two primary strategies when introducing a new product, penetration pricing and prestige pricing. Each of these has its place. For prestige pricing, a company needs to have an established brand, a loyal fan base, and a true differentiator of a product. The best example of this is Apple with the iPhone. They launched the thing at $400-$500 a pop and were selling out of them left and right. They were the most expensive phone and people paid. Since then, the price has come down as the masses have joined the early adopters. This is classic prestige pricing.

On the flip side is penetration pricing. This tends to be used by companies that are introducing more of a "me-too" type product, or ones that don't have quite the established brand. It's designed to quickly take market share away and validate your product. The early purcahsers get a "deal" because they assume the risk of a new company or new product when the established players already have something. Then as they validate, the price creeps up as more customers are willing to give it a try (actually in today's markets this seems to be more that the new player sets the new price and others come down, but...). You tend to see this played out in the auto industry.

Now, my gripe. If you are introducing a me-too product, you better have one helluva brand reputation if you are going to use prestige pricing. And if you don't have that brand reputation, don't expect to get premium pricing! If there is a company that has 6,000 pieces of equipment installed, and you are trying to get your first, why would anyone pay more?

By demanding a higher price for a me-too product, validation is delayed, the competition has more time to build a story against you, and the sales team feels an incredible amount of pressure. It usually ends in deep discounting, one off price reductions, and totally erratic behavior (at least in my cases).

Overall, it seems that there are many more examples of prestige pricing than penetration pricing. Sometimes prestige works, sometimes it doesn't, but it seems to be the preferred method (of course I could be in a bubble that doesn't see pricing in the rest of the industries throughout the world).

I could go on and on about pricing and theory and execution, but if you are still reading this, I don't want to bore you any further. I'll wait for another post where I can look at pricing with regards to the technology adoption curve. Then there is the whole market pricing vs. "I just need to cover my costs, market be damned" pricing argument. Or the one-of-a-kind pricing phenomenon.

But in the end, just remember, have you earned the right to prestigously price your product, or would it be better to gain users quickly to help validate?

Ivory Tower Marketing

In the hussle and bustle of trying to close out a quarter, I've been distracted from my posting. I know, terrible excuse, but it is what it is (check back next month for the lastest excuse for not posting...)

Anyway, something that one of my specialists mentioned the other day really kind of piqued my attention. We were talking about our factory and he said "It's like they try to market from an ivory tower." I wonder how many other businesses fall into this trap.

As marketers, we have to remember who we are marketing to. If we stay inside, behind a desk and computer, and rely on a couple market reports to try and understand what is going on, we will struggle to be successful. One of the biggest complaints that I hear is "how do they know without asking?"

Anecdotally we have a person that just started in a new position. He has been there three days and has already commented that the field doesn't know what they are doing or how to sell. I found this to be amazing insight from someone that has never spoken to anyone in the field, let alone a customer.

Ideally, a marketer needs to be out meeting customers, gaining insights, understanding what is wrong and how to fix it. We need to leave the ivory towers that we work in (ok, the carpet lined cubes, but whatever) and interact. Worst case we need to talk to the salespeople, the individuals that have developed relationships with customers.

What's with Bing?

Ok, so granted I've only seen a couple commercials and read one article, but I'm already annoyed by Bing. Two reasons. One, the commercial doesn't make sense, you don't know what it's for, and it is borderline obnoxious. Thank goodness for Tivo. And two, what is Microsoft thinking? Rumor has it that they are going to drop $100 million on promoting this (rumor also has it that BING means Beacause It's Not Google). That's a lot of money to be the next best thing since Google, especially since Google didn't go anywhere.

Here's the thing, and I don't think Microsoft is alone. But how much sense does it make to be "as good as" the best? As a customer, if you have a choice between someone who is as good as the best or the best, what are you going to choose? As a company, if your goal is to be as good as the best or leader, then you have already failed. Because while you are working at being as good as the best, they are working at being better (and if they aren't well, that's a whole other story).

It's something that I see here every now and then. Aspirations to be 2nd best, or developing products to meet a current need as opposed to a future need. It's frustrating, and one thing that we aspire to push beyond.

There's no point in trying to be second best, or trying to be as good as the leader. The goal should always be the best. Two cliches, but the work... 1.) To be the best you have to beat (not tie) the best. 2.) Second place is the first loser.

Who can help me?

I'm stuck in quite the predicament with my internet provider, Clearwire right now. When I first made the switch from Comcast, I was excited about the new technology, and very optimistic. When the issues started, I was patient, trying to work through the glitches. Now, the problems have continued, the customer support has been terrible, and I've completely soured on Clearwire.

I've run through all of the troubleshooting steps at least five times because every time I chat or call, I get told to do the same thing (maybe they should consider keeping a record of things I've tried). Last time I was asked to try the modem in every room in the house, even though the nearest tower is to the SE and when in the second story SE window, I get virtually no signal. Putting it in the garage was a real good use of my time. So now, I want to cancel. I've been fighting for a year, and I'm tired of it. Unfortunately, I am locked into a two year contract. My opinion is that since Clearwire has failed miserably to uphold their service promise, and I have continually jumped through hoops to try and make it work, they should waive the termination fee. But who can actually help me with this?

When I ask the online chat person, they aren't able to do anything, and I have to call. When I try to send an e-mail because it is after the appropriate calling hours, I get a response that says I have to use the online chat. When I finally take time during my day to get ahold of someone on the phone, I have to do phone troubleshooting steps (this is challenging given the fact that I am at work during the day and can't troubleshoot my internet). Assuming I can ever get through those steps, I must then have a technician come out and look at my modem (apparently I'm uncapable of pointing it in SE direction, and am just making up problems because I get kicks out of talking to customer service and not being able to use my own internet). The technician though is only available from 9-4 Monday - Thursday (I'm not kidding, won't come early, won't come late because that might inconvenience the tech). This means I have to miss a half day of work because I have to wait for a tech, and I can't actually work at home because of the whole internet problem. So, do I horribly inconvenience myself to have a tech show up to tell me that it's not that bad for the five minutes that he is there, or do I pay an unrealistic cancellation fee to save myself the headache of continuing to have a modem that is as effective as a paperweight?

Why do companies do this? Rather than me being able to part ways, and chalk it up to it just didn't work for me, I am now so upset that I am telling everyone I know to stay away from Clearwire at all costs. Why is customer service so difficult? And it's not just Clearwire.

Companies spend so much time and effort on acquiring the customer that they have nothing left for their current customers. Current customers are a source of revenue and dollars. Non-customers are a source of expenses. Customer complaints should not be discouraged, dismissed, or thought of as frustrating. In fact, customer complaints should be seen as a great marketing opportunity. Handling a current customer's issue quickly and effectively is some of the best PR possible. All consumers know that there will be issues, nothing is perfect. It's how those issues are handled that really reflects on a company.

Marketing Budget Slashed? Time to get creative!

It's a fact that in the current business climate marketing budgets are getting slashed left and right. But there are two things one can do. Either complain, panic, fret, and ultimately just do less of what you usually do, or find creative new ways to market.

At one of my former employers, a reduced budget was a cause for panic. Whatever to do!? Rather than send a direct mail letter twice a month to every household in the state, they only send to 80% of the households. Rather than run an ad in the Sunday paper every weekend, they would run them only two weekends. Etc. etc. with all of the traditional marketing. And what happens? Overall response go down, they struggle to make their numbers, and then they ask for more money to send more mail. There are no thoughts about how to reach customers in a different way (and I'm not even touching on newspaper advertising in this post).

The current climate allows a marketer to explore so many different delivery vehicles, and be creative in how to reach a customer. Blogs, Facebook and even Twitter allow you a way to update your customers on what is going on at little to know costs. Podcasts are a unique and inexpensive way to provide short presentations to your customers and clients (by the way both of these can work for B2B and B2C businesses of all sizes). Limited budgets force marketers to be more targeted with messages in an effort to go after those potential customers that can buy. Messages need to be more tailored, more specific, and more unique.

Overall, I think that one of the best things to come out of this down turn will be a different type of marketing. A creative marketing, a more targeted marketing in general. Marketers have less money to get people that have less money to spend it. Those that are successful will really stand apart once we get through this downturn and move to the next profitable cycle.

Those marketers that throw up their hands and simply do less are missing a golden opportunity to try new and creative approaches.

Insufficient Evidence?

I found this newsletter to be interesting. In the first article, the discussion is about how great it is that CMS denied coverage for CTC (see earlier posts to learn what this is). The very next article on the very same day shows that through Early Detection (read: screening), we show declines in cancer rates. Yet there was insufficient evidence to support the CMS decision. Some days it is absolutely fascinating to see our government in action.

America's Favorite Radio Station

One of the keys to being a successful marketer, whether marketing big expensive healthcare equipment or toothbrushes, is to remember America's favorite radio station:

WII-FM (What's In It For Me?)

What will motivate a customer to buy, to respond to a call, to do anything? What incentive do they have? What do they gain? Understanding these questions, and the underlying factors, are integral to marketing success.

It's all about emotion

People are emotional beings. Which means your customers are emotional beings (unless you are selling to actual robots). As much as we like to think people make buying decisions based on rationale facts determined by the features you provide them, it's just not the case. I didn't buy a BMW because it had a 240 hp, inline 6 that gets 22 mpgs in the city. I bought it because of how it makes me feel when I drive it, when I think about myself as a BMW owner.

Anyone that has sat through a marketing class knows this. That's why the professor spent seemingly too long talking about features and benefits. But it's important to remember that it will always be the benefits that sell the product. It's not that my product spins faster because of cool technology. It's that you can make a better diagnosis because of the faster spin (and you can be an owner of cool technology).

Remember, when talking to customers, always think about it backwards. What is the need that could benefit from your feature. Not the other way around.

To post or not to post?

As I'm getting into this blog thing, I find myself in a quandry...is it better to post to make sure things stay up to date, or is it better to wait until the perfect topic hits? I actually think the former is better than the latter.

Give your audience little bits to read. Sometimes it's enough to keep them coming back. Keep it interesting and relevant.

The biggest thing that I'm learning about blogging is that it isn't about always having the perfect topic. It's about sharing your thoughts and expressing your ideas while trying to stay relevant.

Marketing is much the same way. You take a big risk waiting for the perfect campaign, the perfect message, the perfect solution. During all this waiting, you customers are listening to everyone else. Makes getting their ear a whole lot more difficult when you are finally ready to spread the message.

For those of you who stick with me, and have read my posts, thank you for your patience. It's time to blog the way I want to market, and hopefully grow this thing a little bit.

Field of Dreams Marketing

I was going to do a post on what I call Field of Dreams Marketing, and how it is become antiquated. It's the idea that I can develop a campaign or a product that the customers will want; an "If you build it, they will come" mentality.

I had the post all written out and was going to publish it when I stopped. My original argument that it is important to listen to the customer and deliver what they want is sound, I think. It will allow you to be a good marketer and have happy customers. The thing is, it's a very reactive approach.

The more I think about it, the more I think that a great marketer is someone that can listen to customer feedback and deliver what the customer doesn't even know they need. Someone that can anticipate a problem and develop a solution that is beyond the customer expectations.

Ultimately, the Field of Dreams approach isn't antiquated at all, as long as it is persued with one caveat; the customer is at the center of what you do. As a company, you run a risk trying to develop something you think the market will want without actually talking to a customer. However, if you listen to a customer and build something that not only meets, but exceeds expectations, that presents value where they never anticipated it, then they will come, and they will come in droves.

What makes an exceptional story?

I was told recently that we had an "exceptional marketing story" around a particular function of the business, but the problem was that it wasn't told in a comprehensive or consistent manner. So is it really an exceptional story?

An exceptional marketing story is something that can be easily told, easily remembered and resonates with the recipient. If it doesn't do this, it isn't an exceptional story.

Too often in marketing you will hear people say that we have a great story, but no one gets it, or understands it. This by default means you don't have a great story. A great product or solution does not equal a great story.

Ready, Fire, Aim...

Just a tip for those that might read this and are in marketing...

Whenever someone tells you that by doing a targeted message, or a targeted campaign (no matter the industry) is going to take longer, your response should be "So."

If you think it is more important to rush something out the door now, be it a campaign, a promotion, a product, etc. than to take the additional time to make sure you have the right message reaching the right person at the right time, then you are doomed for failure.

This is the classic Ready, Fire, Aim approach, and I am mired in it right now. Everyone wants to seem like they are doing something so they come up with these ideas for programs, promotions, etc. and just fling them against the wall. Unfortunately nothing is sticking (as is usually the case). It's like shooting at a target without taking the time to actually aim. Eventually you might hit it, but what have you expended in the process?? The more people a message has to reach and resonate with, the more diluted, and the less effective it gets.

Take the extra hour, day or week to aim before firing. It will be worth it in the end.

Marketing sells the first, Service sells the rest

In most business, it isn't the first sale that generates the revenue and the profits that businesses seek. It's the repeat business. Getting a customer for the first time is expensive. Sales costs, marketing costs, it all adds up. But assuming that the job is done correctly, customer purchase 2 and 3 and so on should cost the company less time and less money.

Customer retention is like dating. When you first start, there is a lot of work that needs to be done. Flowers and dinners and trips. But once you get married, the maintenance is less in order to keep the same level of happiness and excitement. A well-timed flower, card or compliment.

How does this translate? It's about service. As great of a job that is done by sales and marketing up front, it is up to service to maintain the relationship and keep things moving in the positive direction. For me, this became very evident on a recent trip. I absolutely refuse to fly Delta now. I will go out of my way to avoid them. It's not that the plane wasn't sufficient, or that I didn't get to my destination, or that there aren't problems on other airlines. It's that the customer service was so poor that I refuse to deal with them any more.

As marketers, this is important for us to keep in mind. Service should be a huge part of any marketing plan that we put together, and should be kept in consideration at all times. Work with the service organization to make sure that they are living up to the promises that you are making on behalf of the company.

A new type of Bait and Switch

The bait and switch. A term that has been tossed around for years that implies negative marketing. You tell a customer you have some amazing deal only to find out the deal doesn't exist and they must instead buy something of higher monetary value. It's bad and it's illegal. So why do I want to talk about it?

Over the past week on two instances, I've thought about the bait and switch from an entirely different perspective. Let's start with my car buying experience over the weekend. I've been looking at buying a BMW (insert yuppie comment here) for quite some time. I found what appeared to be a great deal, and headed to my local dealership. When I got there, was the first car that I looked at the one that I was interested in? No, of course not. When I walked on, I wanted to look at the top of the line, state-of-the-art, best thing out there. Then I went and looked at my car.

The same type of thing happened a couple days later during a training session. One of the salespeople said something that really stuck in my head. "Everyone wants to talk about iCT." That's when it clicked. See, the iCT is a super sophisticated, high-end CT scanner. The technology is amazing and everyone wants to know about it. Can everyone afford it? Absolutely not. But does it mean something when they buy the powerful workhorse scanner from the company that makes the iCT? You bet it does.

Customers want to see companies put their best foot forward. They want to see what the top-of-the-line technology is. They want to see where the future might lie, where they aspire to get to someday. This is present in all buying decisions, and all sales whether it is B2B or B2C. There is something about saying you own this widget from a company that makes this amazing superwidget. It's the thought that you can some day be there.

Think about your own life. How often do you look at the high-end, but purchase a little more reasonably? We all want to drive a Mercedes, but then buy a Volkswagen. We want the 62", 2" thick superHD TV, but buy the "standard" 32" LCD.

As marketers, it's up to us to support those dreams. Show what our companies are capable of, show the places a customer can go. Yeah, they may not buy the latest whiz-bang gadget, but they will buy a gadget. And they'll keep wondering if and when they can get to the next level.

Tell a great story. Put your company's best foot forward. Help your customer dream.

Is more technology really better?

I'm struggling a little with how to phrase this, so I'm just going to write and see how it goes...

Lately I've been noticing what I find to be an interesting dilemma for many specialists. As we develop technology, we talk about how it will improve someone's life. For a cardiologist, we are able to use CT to do a basic coronary analysis without an invasive procedure and rule out many patients that they would otherwise have to take to the cath lab. For the gastroenterologist, we are proposing the same thing with virtual colonoscopy.

The marketing pitch is easy, right? We tell the physicians this will make your life easier. You don't have to worry yourself with the routine procedures. You can get more patients through. Life is good. Or is it?

As a cardiologist or a gastroenterologist, yeah, it's great to have the challenging cases that allow you to stretch your thinking, perform an amazing procedure, and live up to the lofty views. But, it's the routine that puts the money in the pocket. A routine colonoscopy with no complications can take 30 minutes or so, and put 2-3x more money into the GIs pocket. Same with a routine angio. And, these are less likely to be met with complications, stress, etc.

When positioning to these customers, it is important to keep this in mind. As marketers, we want to tout all the time saving, risk saving that these cool and great technologies offer the physician and ultimately the patient. But it's also important to remember that we need to show them how to build a business around these new technologies. We need to become more consultative. For the GI guy, it's about helping him set up a practice that will allow him to boost screening by using virtual, which will in turn keep enough people coming through the door to keep the endoscopy suite packed. The same goes for helping the cardiologist get her practice established.

Ultimately, it's about helping them first embrace the technology as something to help them grow, showing them how to attract more patients/referrals, and really differentiating themselves from all of the other practices out there by truly catering to the different needs and desires of the end customer, the patient.

Virtual Colonoscopy; A Three Part Series - The Facility

After a short absense while I attended the Abdominal Radiology Course (great content for a future blog or two), I wanted to wrap up my discussion on the series of virtual colonoscopy by looking at the facility.

CTC should offer facilities a unique way to differentiate themselves from everyone else. There are many different places that could offer the procedure including hospitals and diagnostic imaging centers. But, the place that I want to focus is the physician's office, namely the GI office.

Right now, it seems that many gastroenterologists are fighting the idea of CTC. They don't want to take the scope out of their hands. But, they are missing a golden opportunity to market to the communities they serve, grow their business, and even make their work more enjoyable.

Here's an ideal scenario. As a practice they structure themselves to offer both VC and OC. They structure the facility so that the patient comes in and goes through the VC screening. If there are any questions or lesions, they are sent over to OC for a procedure. For the 88% that are clean, they are done, and they go home (the 88% is from the ACRIN trial where it was concluded that 88% of participants would not have had to undergo an optical colonoscopy based on the CTC findings).

As a facility, you can then market this concept to the physicians and patients in the area. Non-invasive screening, but the option for same day removal. One single prep. Go about your day, and feel good. What are the chances that the number of patients increases? Initial studies indicate it will be better than good.

Next, market this to insurance companies as a package. Say they pay one flat rate regardless of outcome. This means you win on VC, lose a little on OC, but end up ahead because you are doing far more VC than OC. Plus by covering screening, they are less likely to have to pay on the back end for the treatment of cancer.

Lastly, market to the physicians. To the GI guys, it's not about taking the scope out of their hands. Rather, it's allowing them to forego the mundane, basic, non-polyp colons and focus on more challenging cases and polypectomies, thus being more stimulating for them (the same thing is occuring with the cardiologists as they realize it's more "fun" to deal with the challenging cases and leave the basic, routine ones to CT). For radiologists, this allows them an opportunity to do some additional reading, or it allows teleradiology practices the opportunity to increase their workload.

All-in-all, if this is properly positioned, it should be a win-win for everyone. It is going to take some education of the parties involved, but in the end, I think the advent of VC is going to lead to increased screening, which will lead to increased survival rates and increased revenues for the GI facilities. Because, when we get right down to it, it's not about taking the scope out of their hands, it's the fear of taking the dollars out of their pockets.

What Gives you Credibility?

So, I'm breaking from the VC topic prior to the 3rd part in the series because there is something that bugged me a little bit yesterday.

Does who you work for and what you do for a living increase or decrease your credibility?

I would say that if you are expressing an opinion regarding your industry, it should count for something right? My friend Andy is a partner in a consulting company that specializes in social media marketing. So when he talks about social media marketing, he is more credible even if he is trying to sell me his service than say my sister who is a teacher.

What you do and who you work for should enhance your credibility in your field as it is what you do on a daily basis. For Andy, his credibility is enhanced in a discussion involving social media marketing. His opinions should be more relevant and matter more in these discussions.

So why do I bring this up? The other day I read a post by a family practice physician that was against reimbursement for VC. So, I challenged his position by pointing out studies that indicated it was more effective than he gave it credit for as well other procedures that are reimbursable but have a lower sensitivity than VC. Rather than make a counter argument, he simply dismissed my comments because I work for a company that produces a VC product!! How does this make sense? I've spent the better part of a month researching and trying to understand the validity of this procedure, where the benefits lie, and why it would make sense. Yes, I want to see it approved because it is good for my company. But at the same time, my argument was based on research, patient care, etc. Doesn't this qualify me as having some credibility to my argument?

When you are talking to people, what they do can lend a lot of credibility to an argument, even if they are trying to eventually sell you something. People that are trying to sell actually spend a lot of time understanding their products and services, thus bolstering their credibility. Plus, people try to find things that they enjoy to do, enjoy learning about, and enjoy talking about. You definitely shouldn't dismiss those people.

Virtual Colonoscopy; A Three Part Series - The Patient

Let's switch gears a little from a discussion of Health Care reform, and get to understand Virtual Colonoscopy from the perspective of the customer, or as they are known in the medical world, the patient.

Imagine for a minute that you are in the at-risk population and should be screened for colorectal cancer (for anyone reading this over 50, this probably isn't much of a stretch). Odds are you feel fine other than some of the general ailments that tend to present themselves once you cross the half-century line. You meet with your doctor and he recommends that you get screened for CRC. You think, no big deal, it's just a blood test right? Then your doctor starts describing your options.

Option #1: Optical colonoscopy. Basically what you will have to do is find a GI and make an appointment. You will have to go through this process to cleanse the colon. Not great, but you can do that. Then you have to take a day off work, and find someone to drive you to the doctor. Why do you need someone to drive? Because you are going to be sedated. Once sedated, the doctor is going to spend 30-60 minutes looking for any polyps or lesions. Then you get to go home to recover.

Option #2: Stool DNA Testing. Let's just say you have to send a bowel movement to a facility to be tested.

While there are many other options, they really aren't as effective as you would want.

As you leave the office, you are thinking, "I really feel fine, do I need to go through all of this?". You then tend to put it off because you don't have any symptoms.

This happens more often than not. With all of the different screening options out there, less than 50% of the at-risk poplulation gets screened. What does this mean? Basically that over 50,000 people will die this year of colorectal cancer. By the time you start experiencing systems, it's too late.

However, if the doctor told you that you had another option, a virtual option, what would think? Yeah, you still have to go through the prep, but then you go to the facility, get scanned, and go about your day? Are you now more likely to get screened?

For the patient it's about having choices. Some people will elect the traditional colonoscopy as it is the gold standard, and they want only the best. Some will elect virtual for their various reasons. And some will elect to do nothing. When it comes down to it though, as a patient, I want to have different options. Let me choose which method I want to be screened by.

I think that we will see a significant increase in the number of patients being scanned by simply offering a virtual choice, even if some have to pay for it themselves.

Virtual Colonoscopy; A Three Part Series - Healthcare Reform

If you had asked me a year ago what my thoughts were about colonoscopies, I may have given you a blank look and quickly turned my attention to something sports related.  Now however, colonoscopies, specifically virtual colonoscopies (also known as CTC) occupy a good part of my thoughts throughout the day.  As such, I thought it would be an interesting topic to try and get this little blog up and running.

I wanted to look at the idea of virtual colonoscopy, and the recent memo issued by CMS stating that they would not reimburse for the procedure, from three different aspects.  The first is general health care reform as some state this is the beginning of changing times (more on this in a moment).  The second is through the perspective of the patient.  The third is through the perspective of the provider.  The latter two will have a much more marketing perspective to them.

Last month the Centers for Medicare and Medicaid Services (CMS) issued a memo stating that they would not be reimbursing for Virtual Colonoscopy as a screening method for Colorectal Cancer.  Many different articles and editorials, such as this one from the New York Times, suggest that these type of decisions are "fundamental to any successful health care reform effort".  The author goes on to say that "Eliminating unproven procedures and reducing needless costs is necessary if the nation is to improve the quality and lower the cost of care over all."

Now, I don't disagree with this sentiment, per se.  However, are we really going about this the right way?  Currently there are other "screening" tests that are reimbursed by CMS, such as Fecal Occult Blood Test, that have been proven to be far less effective than CTC.  Wouldn't it make more sense to review current procedures that are reimbursed as to their efficacy?  Or do we leave them because at one point they were the gold standard, but as technology has advanced, it would be too much of a hassle to reevaluate these antiquated methods?  

Taking this a step further, shouldn't it also be important to look at the types of procedures that are being reimbursed?  By this I mean screening, diagnostic, treatment, monitoring, etc.  When looking at it from this perspective, preventative medicine is far less expensive than treatment of a disease.  Just ask anyone that has had an overnight stay in a hospital, or a surgical procedure.  And how much of that is paid for by Medicare and Medicaid?  By simply preventing the disease in the first place, how much money would be saved?  I don't have the answer to this, but I would assume it is quite a bit. 

So, let's return to the case for Virtual Colonoscopy.  Why is this become a hot topic?  Colorectal cancer is the second leading cause of cancer death in the U.S. annually (nearly 50,000 deaths per year), but is one of the most treatable if caught early.  Unfortunately, less than 50% of the at-risk population (adults over the age of 50) are screened using any method including those that are less effective.  Not only do there exist numerous studies that indicate that this procedure is as effect as optical colonoscopy (the current gold standard) at identifying lesions of 10 mm and greater, but there are additional studies that show the at-risk population is more likely to be screened using this method.  On top of this, the numbers indicate that 80% of those that are screened do not have lesions that need to be removed, thus saving additional time and money (no anesthesia and CTC costs less per procedure than optical).

In my opinion, this decision by CMS concerning Virtual Colonoscopy is a short-sighted view that could affect access to an proven procedure, and is at best a veiled attempt at reform without really digging deep and asking some tough questions about the entire system.  Are all currently reimbursable procedures still adequate?  Can money be saved by removing older, less effective, but still reimbursable procedures?  What types of procedures are being reimbursed?  Can money be saved in the long-term by putting more emphasis on screening procedures?  It won't be until CMS begins looking at things from this perspective that we will see actual reform begin to take place.

Here we go again

So, I figure it's time to jump into the world of blogging, to find a place to express my thoughts, and to build a little bit of a knowledge base. Right now, I'm not entirely sure what this blog will be. I anticipate read and respond from the world of Healthcare, random musings on things going on in the world, day by days of my conferences and tradeshows, all with a marketing twist.

I had started a blog a couple years back with the goal of writing about sports 2 times a week. 5 posts in it faded and died. It wasn't from lack of material or thoughts, but more a lack of any internal reason to keep it going. I hope that this time it will be different.

I'm not sure where this is going to go. I anticipate that the the first posts will be rough, the writing not so fluid, and the ideas maybe a little muddy. But I hope through time and practice, this encourages me to continue reading about the world around me and expressing my thoughts, and slowly rounds into something fun and coherent.

So here it is, my first post of hopefully many. We'll see if I can keep this going, if I can develop a readership, and if I can take it somewhere. This time, I'm not approaching it simply as a "creative outlet", but rather an opportunity to build my personal brand, and develop myself professionally. As Seth Godin says "Google never forgets", so I hope to give it good things to remember.