Chapter 4
7. The United States is experiencing a deadline of the middle class. What does this trend imply for the future of organizations such as: (a) the U.S. Public Health Service, which operates many inner-city health clinics for the economically disadvantaged and (b) the Scripps Clinic was seen as an exclusive medical provider known not only for treatment but also for its research. 
Chapter 6
1. Assume the multispecialty medical group has decided to segment the market in the community by income level. The group has decided to target a small niche of middle-aged, white-collar professionals who are married, with both spouses working outside the home. How might this medical group tailor its marketing mix to appeal to this segment?
2. A women’s health clinic has recognized the need to segment its market. Identify three bases by which this clinic might segment the female market, and identify the manner in which the “product” component of the marketing mix would change in light of the segmentation base used. 
4. A neurology group practice recently analyzed its level of patient referrals and referral sources. This analysis showed that 60% of all referrals came from 35% of all physicians who referred to the group. The remaining referrals came from the other 65% of the referral physicians. In examining this referral pattern, it was also revealed that 20% of all the primary care physicians in the group’s primary service area had never sent a patient to the group for diagnosis or treatment. As the practice manager of the group, you have been asked by the physicians to develop a marketing strategy to deal with this information. 

Chapter 7
1. Most medical specialty groups historically have relied on primary care physician practices for referrals. At a recent society meeting, the senior partner returned with a renewed perspective in terms of looking at the customer base of referrers. “We need to develop relationships with these practices rather than view them as individual transactions when they send us a patient.” How might this perspective shift the strategy of the group?
2. For many years, health care organizations, as well as traditional businesses, have been frustrated that high customer satisfaction scores do not necessarily lead to higher levels of profitability or sales. Explain why this inconsistency tends to exist.
3. Recently, a surgical group in Manhattan posted a Web site that includes a page that refreshes every 10 minutes and shows how close the doctors are following their “scheduled appointment ” times. In terms of the value equation, what component or variable is this group trying to work on with its market?
4. An orthopedic group in Virginia has decided to conduct a survey of referral physicians. The results, which are posted on the group’s Web site, indicate the level of customer satisfaction. The group has also posted comments that some of the physicians wrote in the surveys. What is this group doing in terms of attempting to recognize the customer contact process? Explain the integration of this strategy into a total marketing program for the orthopedic group.

Chapter 10
1. In recent years, two nationally known health care providers have established satellite facilities a great distance from their main clinic locations. The Mayo Clinic of Rochester, Minnesota, has opened facilities in Arizona, Florida, Iowa, Wisconsin, and Minnesota as well as in Mexico City. The Cleveland Clinic has opened a Brain Institute in Nevada, a facility in Florida, and a hospital in Abu Dhabi. Explain the changes in distribution intensity these actions represent.
2. Explain the vertical integration options and directions for the following providers: (a) a major academic medical center such as the University of Iowa, (b) a fiveperson general surgery group, and (c) a manufacturer of durable medical equipment.
5. Examine Figure 10-7 and explain how the community hospital in its present position (quadrant 3) could reposition itself to quadrant 2 and to quadrant 1.
Chapter 11
1. After a recent presentation of health plans at her company, Julia Brouck joined ABC PPO. The next week she made a visit to a pediatrician in the plan with her son, Arthur, and daughter, Emmy Lou. After seeing the pediatrician, she was told that there was a $15 co-payment for the visits. “I don’t understand,” Julia said, “I thought all physician visits were free.” Explain the potential source of this misconception.
4. In recognition of the post-purchase role of promotion, what strategies would you suggest for: (a) a busy hospital emergency room, (b) an executive fitness program that provides health screening and fitness evaluation, and (c) an occupational medicine program that contracts its services to companies?
Chapter 12
2. Write an awareness objective for a newly formed adolescent chemical dependency program whose target market consists of judges and social workers who refer to the facility. How would this objective change for the trial level of the hierarchy of effects?
3. As the newly hired hospital marketing director, you have your first meeting with the administrator. “Okay,” he says, “we need to advertise our physical rehabilitation program. I’ll give you a couple of days to tell me how much you’d like to spend. Is $5000 enough? I think we can afford a little more if you need it. And, based on what I’ve seen in the newspapers, St. Mary’s seems to be spending a little less than that. Give me your thoughts in two days.” Your 2 days are up.
4. Recently, the physician marketing task force at State University Medical Center developed a physician referral directory and advertisement. The target was primary care physicians in the region who could refer patients to State University for tertiary care. A cardiologist who was an undergraduate English major chaired the committee and drafted the materials. Three months after distribution of the advertisement and directory, responses were disappointing. Explain how this could have been improved to increase likely response.
5. The director of a cardiac rehabilitation program was recently approached by a sales representative from the community newspaper selling advertising space. The sales representative underscored the fact that the paper had the largest circulation of any of the three papers serving the area and that it had the lowest cost-per-thousand. Before deciding to use this medium, what other factors should the program director consider?