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Classmate #1—
Environment Factors in Marketing
Companies that are developing a marketing strategy are responding to consumer needs
(Berkowitz, 2017). It is also critical to consider the environmental conditions that a company
must take into consideration that can affect trends in the market (Berkowitz, 2017). The five
environmental factors in marketing include economic, technological, social, competitive, and
regulatory (Berkowitz, 2017). Environmental scanning is “conducted to assess the trends in each
of these five areas for their potential impact on the organization’s target market” (Berkowitz,
2017, p. 98). Utilizing environmental scanning to include these specific environmental factors
allows healthcare facilities to adjust its marketing strategy accordingly to best assess the trends
of these five areas.
The first scenario regarding in-company clinics that deal with employee medical
problems, such as those established by Toyota, focuses on competitive factors. Toyota is
competing against other companies in the market for consumer’s needs. To help Toyota stay up
to date there are “four basic structural forms of competition can be arrayed on a continuum: pure
competition, monopolistic competition, oligopoly, and monopoly” (Berkowitz, 2017, p. 124).
Pure competition is described that every company has the same product and has to compete
against other companies based on distribution (Berkowitz, 2017). The same concept applies to
the medical field. When patients are comparing the competition some factors they may take into
consider would be seeing which office is more convenient their home or work, weekday or
evening office hours, or has specific hours on the weekends (Berkowitz, 2017). Offices that
provide more availability for patients can ultimately attract more patients (Berkowitz, 2017).
Monopolistic competition is where there are many sellers that offer products or services that are
similar, but not perfect substitutes (Berkowitz, 2017). An example would be when two
alternatives managed care plans are available (Berkowitz, 2017). Both of these plans will need to
compete for consumer’s needs but can make small changes that can make a
difference (Berkowitz, 2017). An example of a change can be a small price change from one plan
than another (Berkowitz, 2017). This could be the deciding factor of a consumer choosing one
plan over the other (Berkowitz, 2017). The third factor is competitive market structure is an
oligopoly. Oligopoly is where few companies will control most of the business (Berkowitz,
2017). Some oligopolistic markets are considered differentiated (Berkowitz, 2017). This means
that buyers perceive a difference among a few competitors (Berkowitz, 2017). The automobile
industry can be viewed as this type of market because a few of the major manufacturers try to
protect their differentiation by focusing on the product component of the market (Berkowitz,
2017). The final factor is the monopoly. Monopoly is where there is only one firm that sells a
product they have a monopoly over the competition (Berkowitz, 2017). In the medical field,
monopolies are created through patents that give the manufactures “exclusive rights” to make
and sell a particular product (Berkowitz, 2017, pg. 125).
In the second scenario, what is the success of after-hours clinics and urgent care facilities
in many metropolitan areas? The factor that would most be relatable to this scenario is social
factors. Demographics is defined as “statistics that describe members of a population in terms of
who they are, where they live, and the types of jobs they have” (Berkowitz, 2017, pg. 111).
These factors are looking at the patients overall as a population, culture, and its values
(Berkowitz, 2017). Health care systems are considering this factor due to challenges being
identified involving an increase in the demand for services which lead to higher costs and also
availability and delivery of services (Berkowitz, 2017). This is where after-hours clinics and
urgent care facilities are being more popular. By having facilities that are opened longer or more
availability of multiple services patients can receive care without having to go to the hospital
(Berkowitz, 2017). “After-hours care refers to care for medical problems arising between 5 p.m.
and 8 a.m., and on weekends and holidays, that could be appropriately managed by the patient’s
primary care physician/team” (O’Malley, Samuel, Bond & Carrier, 2012, pg. 1406). Health care
systems that are strategically placing these facilities by analyzing geographic markets it is
helpful to see the description of communities that reflect the bulk of the population to which they
are serving (Berkowitz, 2017). By offering after-hours patients can still be seen for primary care
issues instead of going to the hospital (Sturgeon, 2017). After-hours clinics and urgent care
facilities are working to offer benefits for local communities and closer working between
primary and secondary care practitioners to meet the needs of the community (Sturgeon, 2017).
Ultimately, the healthcare system’s purpose is to serve others that are in need. The Bible
mentions that we should serve with a grateful heart because the LORD has provided us with
blessings. “Only fear the LORD and serve him faithfully with all your heart. For consider what
great things he has done for you” (Hebrews 13:16, English Standard Version).
Berkowitz, E. N. (2017). Essentials of health care marketing. Burlington, MA: Jones & Bartlett
O’Malley, A. S., Samuel, D., Bond, A. M., & Carrier, E. (2012). After-hours care and its
coordination with primary care in the U.S. Journal of general internal
medicine, 27(11), 1406-15.
Sturgeon, D. (2017). Convenience, quality, and choice: Patient and service-provider perspectives
for treating primary care complaints in urgent care settings. International Emergency
Nursing, 35, 43-50. doi:10.1016/j.ienj.2017.06.005
Classmate #2Economic Factors
Frustrated by runaway health costs, the nation’s largest employers are moving rapidly
to open more primary care medical centers in their offices and factories to offer convenient
service and free or low-cost health care (Freudenheim, 2007). Today a new wave of clinics is
opening, driven largely by a motive that was less of a factor in the past: employers’ desires to
reduce their health insurance premiums by taking care of workers before they need to see outside
doctors (Freudenheim, 2007). For employers, on-site clinics can mean gains in worker
productivity and lower health-insurance outlays (Freudenheim, 2007).
One suggestion would be to ramp up marketing efforts to emphasize that the health
care provided in in-company clinics will expand from basic services to partnering with other
providers such as urgent care facilities to offer discounts to their employees and families and
cover the cost of generic prescription drugs. By expanding services and offering after hour
clinics and urgent care, Freudenheim (2007) surmised that “big health insurers say they are
closely watching the proliferating clinics, which could potentially pose a competitive threat. A
vendor company that runs on-site clinics, for example, could steer patients to its own programs
for disease management, say, or smoking cessation, instead of equivalent ones offered by the
patient’s health insurer.” This could bring more convenience to the customer (employees) but
also gain bargaining power when it comes to negotiating contracts for future providers to their
Technological Factors
Regarding employers offering in-company clinics or availability and convenience of after
hour and urgent care clinics, there is still documentation that must be completed. Primary care
physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct
patient care (Arndt et al., 2017, p. 421). Demand for non–face-to-face care, such as
communication through a patient portal and administrative tasks, is increasing and contributing
to burn-out (Arndt et al., 2017, p. 421). Direct time-motion observations validated EHR-event
log data as a reliable source of information regarding clinician time allocation (Arndt et al., 2017,
p. 421).
Another suggestion would be to digitally automate tasks as much as possible and promote the
fact that the clinic or urgent care is state of the art. Automated text messages letting people
know they have an appointment or that their prescription is ready is a very simple use of
technology but offers great convenience and assistance to the consumer. Wait times or progress
counters flashed on TV screens in the waiting rooms will remind them how quickly there are
really being processed through with little effort from staff as this is also a function that can be
Social Factors
Health systems and hospitals have moved beyond the “sickness” model to the population
health approach (Berkowitz, 2017, p. 122) as have companies that have instituted in-company
clinics to care for the health of their population which is their employees. In addition, the health
of the population in metropolitan areas is being served with the success of urgent care and after
hour clinics to assist alleviating high volumes of patients in local emergency departments during
those times in more heavily populated areas. Berkowitz (2017) purports that the trend for Baby
Boomers is rapidly rising in divorce rate which has increased the rates of busy single parents and
in addition, 34% of children live in homes with dual working parents. This suggests that quality
and convenience are key factors that healthcare consumers are looking at when making choices
to spend their healthcare dollars as families are busy and do not have time to waste on the poor
quality of care or be inconvenienced.
Marketing suggestions would center around quality and convenience. Marketing
campaigns and changes should focus on improving the environment, courtesy of physicians,
modern equipment, effects of treatment, etc. (Asefzadeh, Jahandideh, & Asadabadi, 2012, p. 16).
Considering patients’ views and opinions with their care may provide valuable information to
those who are interested in understanding or predicting patients’ behavior and opinion about the
services (Asefzadeh, Jahandideh, & Asadabadi, 2012, p. 17) and expounding on the main topics
that the majority of customers care most about.
Competitive Factors
According to Berkowitz (2017), competition between providers and health plans has
evolved into a “value-driven model based on data that rewards quality over quantity of
care.” The competition for a consumer’s healthcare dollar is changing to accountable care
organizations which are basically a set of healthcare providers that work together collaboratively
and accept collective accountability for costs of quality care provided (Berkowitz, 2017, p.
127). In-company clinics should not really have an issue with other in-company clinics because
they are from different populations; however, after hours clinics and urgent care facilities must
not only compete with like kind but with the larger hospital systems as well.
Marketing strategy suggestions would include an emphasis on how the quality of care is
provided and what makes that particular clinic so special (i.e.: technology, caring staff, patient
portals, etc.) but also the ability to communicate with their primary care physicians and how they
communicate with their patients. Developments in health information technology have
dramatically changed the way health care is delivered, but there are still hurdles which prevent
patients from fully benefitting from online health records (Belyeu et al., 2017, p. 491). Electronic
patient portals create both challenges and opportunities for patients to participate in their care,
and all stakeholders should be thoughtful in developing and implementing this technology so as
not to aggravate existing health disparities (Belyeu et al., 2017, p. 491). Nevertheless, it is very
important that the information is shared appropriately and accurately from a clinic physician to
primary care physicians.
Regulatory Factors
According to Berkowitz (2017), the majority of promotional activities for healthcare are
closely regulated by the Federal Trade Commission (FTC) which forbids deceptive or misleading
advertising and unfair business practices. In addition, there are plenty of regulatory bodies
monitoring the quality of care clinics provide as well. For example, The Joint Commission
(TJC), as well as the Accreditation Association for Ambulatory Health Care (AAAHC), serve as
monitoring entities for the Centers for Medicare and Medicaid Services (CMS) to ensure the
quality of care is provided as standard care to be able to participate in CMS programs and
reimbursement. Transparency with quality data and pricing as well as financial relationship
agreements are required as their standard for accreditation.
Marketing strategies would have to include an emphasis on quality care provided through
accreditation as well as the requirement for transparency for quality data. Posting the
information regarding the accreditation status on the clinic’s website and mentioning it in
brochures is usually the standard method for many outpatient facilities such as clinics and
ambulatory care centers such as urgent care centers.
Biblical Worldview
The Bible says in Titus 2:7, “Show yourself in all respects to be a model of good works,
and in your teaching show integrity and dignity.” Marketing is about putting the product or
client out there and showing the best features to the public in order to attract customers for a
business to succeed. It is vital that we remember that there is also an amount of ethical
responsibility that is required by following the laws around fair business practices and
advertising we should all be mindful of how we inform and care for one another with dignity and
Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W., Sinsky, C. A., &
Gilchrist, V. J. (2017). Tethered to the EHR: Primary care physician workload
assessment using EHR event log data and time-motion observations. The Annals of
Family Medicine, 15(5), 419-426. doi:10.1370/afm.2121
Asefzadeh, S., Jahandideh, S., & Asadabadi, E. B. (2012). Dental services marketing: A case of
dental clinics in Iran. International Journal of Healthcare Management, 5(1), 1218. doi:10.1179/2047970012z.00000000010
Belyeu, B. M., Klein, J. W., Reisch, L. M., Peacock, S., Oster, N. V., Elmore, J. G., &
Jackson, S. L. (2017). Patients’ perceptions of their doctors’ notes and after-visit
summaries: A mixed methods study of patients at safety-net clinics. Health
Expectations, 21(2), 485-493. doi:10.1111/hex.12641
Berkowitz, E. N. (2017). Essentials of Health Care Marketing (4th ed.). Burlington, MA:
Jones & Bartlett Publishers.
Freudenheim, M. (2007, January 14). Company Clinics Cut Health Costs. Retrieved from

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