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November 17, 2015
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David W. Johnson
Consumerism Outcomes

The Why, The How and The What: Consumerism, Trust and Brand Love

Market Corner Commentary for November 12, 2015-The Why, The How and The What: Consumerism, Trust and Brand Love

Health systems are awakening to the market reality that consumerism is redefining healthcare delivery. Winning companies connect with customers, gain their trust and earn their business, over and over again.

Alison Lewis, Johnson & Johnson’s Chief Marketing Officer, observes that “brand love leads to loyalty beyond reason.” True “brand love” overcomes price disparities, inconvenience and logic. Customers not only buy products they believe in. They buy products that support their own beliefs. Emotional connection drives consumer decision-making.

The question, of course, is how do companies establish durable brand love. This question is vital for health systems, since they historically have executed transactions with limited input from patients/customers.

Start with Why

Conventional marketing begins with “what” products companies sell, explains “how” those products differentiate and ends with logic-based pitches for “why” customers should buy them. Rational appeals highlighting product features and competitive prices rarely generate breakout sales. It’s too easy for customers to find the same or better value elsewhere.

Simon Sinek, the author of Start with Why, describes conventional marketing as “outside in”. Everyone knows what they do. Some know how they do it. Very few know why they do what they do. By contrast, Sinek’s “golden circle” has the “why” at its center. Human beings are hard-wired to respond to appeals grounded in purpose, trust and belief. The “why” gets us up in the morning and motivates us to act.

In a widely-viewed Ted Talk, Sinek uses Apple to highlight the power of “inside-out” appeals. In reality, Apple is one electronics manufacturer among many competing for global market share. Conventional marketing would showcase images of Apple’s computers (the “what”) and highlight their elegant design, integrated operating system and ease of use (the “how”) before making the “why” sales pitch. Pretty boring.

Apple is anything but a conventional company. Apple’s marketing starts with the “why” and works outward. Apple’s iconic founder, Steve Jobs, wanted to “make a dent in the universe.” Apple challenges the status quo and “thinks different.” Apple demonstrates this through its computers’ elegant designs, integrated operating system and ease of use. Same “how”, different context. Customers flock to buy Apple products.

In Sinek’s words, people don’t buy Apple for what Apple does. They buy Apple for why Apple does what it does. By using Apple products, customers align with Apple’s values and project those values to the world. In so doing, customers begin to see themselves as they would like others to see them. Like all positive relationships, brand love increases self-esteem, confidence and interconnectedness. It satisfies deeply human needs.

Start with Customers

Steve Jobs intuitively understood the importance of customer perspective, self-image and experience in building the Apple brand. In response to a hostile question during a 1997 press conference, Jobs described Apple’s creative process as “starting with the customer experience and working backward to the technology. You can’t start with the technology and try to figure out where you’re going to sell it.”

Health system advertising often starts with breakthrough technology and/or stories of miracle cures. They feature the what and not the why. All health systems have great doctors, grateful patients and believe in quality. That’s not enough to differentiate and build true brand love.

Consumerism is forcing health systems to appreciate customers’ actual experience – to feel their fears, frustration and confusion. Patients/customers want caregivers on their side, looking out for their interests and easing their way. The unfortunate truth is that health systems often fail at this human level. Care is impersonal and systematic. Patient experience is an afterthought. Even quality is inconsistent.

Introspection can lead to redefining the organizational “why.” It’s never been more important.   Health companies can’t say they put patients first and act otherwise. Hypocrisy crucifies brand loyalty. Ask Volkswagen.

Answering “Why”- Brand Loyalty

Consumerism gives health systems the opportunity to rewrite their relationships with patients/customers. If undertaken with wisdom, empathy and humility, brand building can establish trust, win “loyalty beyond reason” and make everything better for patients, caregivers, employees and communities.

Johnson and Johnson uses the following quote to communicate its commitment to customers, “Consumers are our invited guests. It’s our job to make every experience a little better.”

Imagine how great American healthcare could be if health systems adopted this philosophy. Brand love isn’t clever. It reflects deep trust between companies and customers built over years of interactive, mutually beneficial experience.

To paraphrase Scottish theologian William Barclay, “There are two great days in an organization’s life – the day it’s created and the day it discovers why.” Discovering and acting upon “the why” is the foundation for building “brand love” and winning for everyone in post-reform healthcare.

The “Why” in Action: Shared Accountability at Intermountain Healthcare

 Exactly a year ago, Intermountain Healthcare (“IHC”) changed its mission statement from “Excellence in the provision of healthcare services to the Intermountain West” to “Helping people live the healthiest lives possible.” A commentary accompanying the mission change announcement demonstrates the power of emphasizing the “why”:

We are now focusing even more strongly on prevention and wellness, shared-decision making with our patients, and on using our resources and technology to help patients enjoy their lives without need our hospitals and clinics, if possible. Our new Mission reflects that expanded role – it describes “why we exist.”

Wow! Who wouldn’t want to receive healthcare services from companies that live this mission?

Of course, rhetoric is cheap. Intermountain’s challenge is to put its lofty brand ambitions into practices that improve people’s lives. That’s not easy. The “sickcare” business in America is lucrative. Our healthcare system rewards acute intervention, not prevention. This makes Intermountain’s decision to embrace wellness even more impressive.

For calendar year 2016, Intermountain is launching a “shared accountability” insurance product through SelectHealth. SelectHealth Share operates on the premise that providers, insurers, employers and employees must collaborate to create affordable healthcare that delivers necessary medical services, promotes wellbeing and engages all participants.

To participate, employers, employees, providers and SelectHealth agree in writing to comply with provisions that support “predictable premiums, greater affordability and healthier lives.” Specifically, participants stipulate to do the following:



  • Agree that SelectHealth will be the company’s brand sole carrier
  • Offer high deductible health plans and subsidized health savings accounts
  • Contribute at least 70% of the premium cost
  • Create a health work environment
  • Meet 50% to 70% employee participation over three years in key “employee engagement” metrics (see below)


  • Establish health savings accounts
  • Select and engage with primary care physicians
  • Complete annual health assessments
  • Participate in digital coaching
  • Engage in at least two physical-activity campaigns annually
  • Participate in management programs for chronic diseases
  • Complete preventative screenings


  • Support employer and employee engagement with meaningful brand financial incentives
  • Employ evidenced-based medicine
  • Practice shared medical decision-making
  • Develop reports and metrics to track progress and increase adherence
  • Develop online tools to support quality and cost transparency
  • Implement population health and wellness programs
  • Implement efficient and effective prescription drug programs


  • Comply with evidenced-based standards and business best practices
  • Provide complete, timely and accurate documentation
  • Participate in compliance training
  • Participate in emergency call coverage
  • Keep patients, where possible, in the SelectHealth care network
  • Provide equal access for all patients
  • Accept accountability for quality, cost and patient engagement
  • Share performance data
  • Disclose all conflicts of interest

SelectHealth Share excludes no-one, but participation requires commitment and accountability. This can be particularly difficult for physicians and subscribers who cherish independence. The offsetting benefits, however, are wonderful – healthier workplaces, communities and individuals. Everyone wants this.

The Moral of the Intermountain Story

Like Apple, people will flock to SelectHealth Share not for what it does, but for why it does it. Customers align with Intermountain’s values because they make them feel better about themselves. These values burnish the image customers wish to project to others. Shared values create powerful company-consumer connection. It’s brand love in the making.

Bert Zimmerli, Intermountain’s avuncular Chief Financial Officer, repeatedly makes the statement that “Healthcare is personal. It touches our teams, family and friends.” Bert personifies an Intermountain brand culture that truly cares about its community and its customers. No organization is perfect. Intermountain makes its share of mistakes. Here’s the difference. Intermountain lives its values. Nothing is more important in winning customers’ trust.

Apple and Intermountain illustrate a simple truth. Companies develop love for their brand when customers believe that company is “in their corner” and “on their side.” Here’s the catch. Companies, including health systems, actually have to be on their customers’ side to earn brand love. They can’t just say it. They have to live it.

About the Author

David W. Johnson

David Johnson is the CEO of 4sight Health, an advisory company working at the intersection of healthcare strategy, economics, innovation. Johnson is a healthcare thought leader, keynote speaker, and strategic advisor to organizations busting the status-quo to reform our healthcare system. He is the author of Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, and his second book, The Customer Revolution in Healthcare: Delivering Kinder, Smarter, Affordable Care for All (McGraw-Hill 2019). As a speaker, Dave plays the role of rebel, challenger, industry historian, investor and company evaluator to push audiences forward. (Watch bio video.) Johnson applies his 25+ years of investment banking in healthcare to identify ways the healthcare industry must change to deliver better care. He received a Masters in Public Policy from Harvard Kennedy School, an English degree from Colgate University, and served in the African Peace Corp service. Join over 10k+ healthcare executives who read our weekly insights and commentary on www.4sighthealth.com. His third book, Less Healthcare, More Health: The Prescription for a Happier, More Equitable and Productive America, will publish in 2024.

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