Market orientation in healthcare: focus on the patient

Market orientation in healthcare: focus on the patient

Article Type: Editorial From: International Journal of Pharmaceutical and Healthcare Marketing, Volume 4, Issue 1

What does marketing mean for healthcare? How should one apply marketing in a social service like healthcare? Questions like these are frequently raised in healthcare forums. The answer lies in the very concept of marketing. At the heart of the market orientation is the patient or the consumer of healthcare services. Kohli and Jaworski (1990) define market orientation as the organization wide information generation and dissemination and appropriate response related to current and future customer needs and preferences. The patient is the raison d’etre of the science and service of healthcare. Narver and Slater (1990) observe that market orientation consists of three behavioural components – customer orientation, competitor orientation, and interfunctional coordination – and two decision criteria – long-term focus and profitability. Market orientation is necessary for healthcare institutions to survive and perform well in today’s economy.

As we step into the fourth year of the journal, we see a clear focus on market orientation through our published articles and case studies. Future research in healthcare should strive to expand on this idea. Research in healthcare marketing needs to increasingly focus on the market orientation in the sector. Healthcare marketing research focusing on the patient should be defined by three perspectives:

1. 1.

   Substantive. The problems and issues that patients and their families face in their healthcare consumption process.

2. 2.

   Conceptual. The theories and conceptual frameworks used to understand patient problems and issues.

3. 3.

   Methodological. Research design and analytical methods used to investigate patient issues in healthcare.

Several emerging substantive issues in healthcare call for urgent research attention. For example, as consumers spend more time in social media sites, what are the implications for dissemination of healthcare information and experiences and the new opportunities for opinion leadership and word of mouth communication? With e-healthcare emerging as an important alternative channel, how much do we know about consumers’ online information processing, their trust, security and privacy concerns, and barriers to self-services such as EHR and PHR? What are the implications of the proposed healthcare reforms in the USA on pharmaceutical and healthcare marketing? With as many as 50 million previously uninsured patients getting renewed access to healthcare, how will the shortage of physicians and nurses impose a strain on the quality of care? What is the future of DTC advertising in the USA and other countries, and its online form? New research into patient compliance for healthcare is urgently needed, particularly in view of the potential for cost savings and the availability of new technologies that can improve compliance. The traditional role of the pharmaceutical sales function is being challenged by e-detailing, e-promotions, electronic sampling, and use of multimedia. Has the economic downturn had any significant effect on the pharmaceutical and healthcare industries? Consumer information processing and choice for physicians, hospitals, insurance, and medications are constantly being re-conceptualised by considerations for access, quality, cost, and customisation. All these issues and many more need to be examined through the lens of market orientation with a clear focus on understanding patient behaviour.

A plethora of consumer-related theories characterise the conceptual domain of healthcare research. Some of these theories are: microeconomic theory, consumer choice theory, social exchange theory, information processing theory, technology adoption theory, satisfaction theory, competitive theory, attribution theory, reference pricing theory, etc. Innovative solutions to contemporary problems of patient care demand interdisciplinary approaches and theories.

New research designs and analytical methods, and triangulation of existing ones are needed to enrich the methodological domain of research in healthcare marketing. Patient surveys, secondary data, experiment, industry survey, focus group, interviews, ethnography, qualitative studies, analytical and statistical modelling, simulations, etc. can all be useful in expanding the horizons of healthcare research.

As healthcare evolves to a market-oriented paradigm across the globe, it will have to struggle with the fundamental problems of balancing perspectives of the patient, the healthcare provider and caregiver, and the pharmaceutical industry. It is important to question the role that each actor can and should play in this triad. This issue provides a valuable examination of the complex relationships among different stakeholders to enhance market orientation.

This issue is a collection of three articles on patient perspective, one on provider perspective, and one on pharmaceutical salesperson perspective. Kimball P. Marshall, Lisa A. Micich, and Arthur G. Cosby open this issue with an in-depth study of attitudes and beliefs in the general population towards pain which are critical in understanding their self-acceptance of pain medication. In their paper titled “Health beliefs related to willingness to accept treatment of pain with potentially addictive drugs,” they address the intriguing question of how health beliefs toward pain may influence willingness to approve pain treatment for self with potentially addictive drugs. A random sample of 633 respondents drawn from the Southern Pain Prevalence Study 2004 responded to a telephone interview. The results show that six of 11 patient health beliefs about pain do influence acceptance of treatment with potentially addictive medications. These salient beliefs about pain are: “can worsen if untreated”, “can be treated as a separate medical condition”, “has addiction as a side effect”, “medicine only when pain becomes worse”, “heals body better when treated properly”, and “treating pain more important than keeping people from abusing”. This research based on individuals contributes to better formulation of pain management approaches from healthcare provider and pharmaceutical industry perspectives.

Increasing salesperson effectiveness is an area of primary research concern in pharmaceutical marketing. Charles E. Pettijohn, Elizabeth J. Rozell and Andrew Newman, in their paper “The relationship between emotional intelligence and customer orientation for pharmaceutical salespeople: a UK perspective”, posit that emotional intelligence and dispositional affectivity can affect pharmaceutical salespersons’ customer orientation levels. Based on survey responses from 71 pharmaceutical salespeople in the UK, the authors demonstrate positive impact of emotional intelligence on customer orientation. The study also reveals that while positive dispositional affect improves customer orientation of salespeople, no significant effect is found for negative dispositional affect.

Neonatal health, outlining an infant’s development from birth through the first 28 days of life, is a serious issue in public health management. Neonatal health in South Asia is the subject of Muhiuddin Haider and Avinandan Mukherjee’s paper “Analysis of neonatal health in South Asia”. The main challenge, the authors contend, is that nearly 75 per cent of the global neonatal deaths occur in South Asia, where lack of adequate funds, healthcare access, health education, clinical procedures, health policies and regulations, quality of training, and medical equipments presents a critical global health problem. Case studies of six South Asian countries and several international participating agencies and NGOs working in the area of neonatal health are presented. The authors conclude by proposing a social marketing framework designed to address this public health challenge.

Our fourth paper titled “Measuring perceived service quality for public hospitals (PubHosQual) in the Indian context” by Jayesh P. Aagja and Renuka Garg is a bold attempt to develop a perceived service quality measurement scale for public hospitals from the patient’s perspective. Five dimensions of the PubHosQual scale are admission, medical service, overall service, discharge process, and social responsibility. The authors have undertaken the rigorous scale development procedure and have demonstrated the superiority of their proposed scale over the generic ServQual scale.

The final paper by Michel Rod and Nicholas J. Ashill, titled “Management commitment to service quality and service recovery performance: a study of frontline employees in public and private hospitals” addresses the very important question of comparison of public and private hospitals with regard to their service philosophies. A sample of 186 frontline hospital employees in New Zealand was surveyed to explore the relationship between management commitment to service quality (MCSQ) and service recovery performance. A structural equation model is tested in both cases on the linkage between management commitment to service quality (expressed in terms of employee rewards, customer service training, empowerment, and customer service orientation), organizational commitment, job satisfaction, and service recovery performance. The results show that the relationship between MCSQ and service recovery performance is mediated by organizational commitment. Further, while MCSQ positively influences organizational commitment as well as job satisfaction in both public and private hospitals, only organizational commitment (and not job satisfaction) is found to affect service recovery performance. The relationship between MCSQ and organizational commitment is found to be much stronger for private hospitals.

We conclude with a review by Bansari Shah of the book Fusion for Profit: How Marketing and Finance can Work Together to Create Value authored by Sharan Jagpal.

I hope that scholars, policymakers, opinion leaders, and students alike will find that the International Journal of Pharmaceutical and Healthcare Marketing consistently captures the essence of the healthcare debates that define our era. Papers published in this journal will continue to identify, explain and resolve new problems, apply new theories to existing problems, fill knowledge gaps, formulate solutions and their implementations, reconcile contradictory findings, and tackle interesting practitioner problems. Please join us in our pursuit for excellence by proposing, refining and critiquing research that offer ideas with impact. Happy Reading!

Avinandan Mukherjee